Synergistic modulation of cervical pain and function impairment via cranial stabilization and dry needling in temporomandibular disorder: Evidence from a randomized controlled clinical trial

Cervical spine dysfunction and temporomandibular disorders (TMD) often interact, resulting in decreased quality of life, limited jaw mobility, and persistent neck pain. Although there is still little data from randomized controlled studies, integrated rehabilitation regimens that target both the cranial and cervical regions may provide better therapeutic results. To assess the impact of dry needling in conjunction with a systematic cranial stabilization exercise program on pain, jaw function, and quality of life in people with neck discomfort associated with TMD. Ninety people with TMD and related neck discomfort participated in a single-center, parallel- group randomized controlled experiment. A control group (standard physiotherapy) and an experimental group (cranial stabilization exercises with dry needling) were assigned at random to the participants. For four weeks, the interventions were given three times a week. The Oral Health Impact Profile-14 (OHIP-14), Neck Pain and Disability Scale (NPAD), Pressure Pain Thresholds (PPT), Maximum Mouth Opening (MMO), and the World Health Organization Quality of Life–BREF (WHOQOL-BREF) were used to measure outcomes both before and after the intervention. Two-way mixed ANOVA was used to examine the effects of time, group, and interaction (p < 0.05). The experimental group showed significant improvements in all OHIP-14, NPAD, PPT, and WHOQOL-BREF areas when compared to controls (all p < 0.001). Pressure pain thresholds improved at every tested site, and maximum mouth opening rose by an average of 9 mm. Clinically significant advantages were confirmed by moderate-to-large effect sizes (Cohen’s d = 0.6–1.2). The four-week cranial stabilization and dry needling protocol significantly reduced neck pain and improved jaw function, oral health and quality of life among individuals with TMD. These findings support the clinical utility of this multimodal physiotherapeutic approach within comprehensive TMD management frameworks.