Dry Needling as an Adjunct to Rehabilitation of Temporomandibular Dysfunctions—Randomized Controlled Pilot Study

Background: Temporomandibular disorders (TMD) represent a significant source of musculoskeletal pain in the head and orofacial region. Myofascial TMD is characterised by pain, the presence of myofascial trigger points, and functional limitations. Methods: Forty patients (30 women and 10 men; mean age 32.4 ± 8.6 years) were enrolled in this pilot randomised controlled trial. The experimental group (n = 20) received a standard rehabilitation programme supplemented by a single dry needling session targeting the masseter and temporalis muscles, whereas the control group (n = 20) underwent standard rehabilitation alone. Pressure-evoked pain intensity (VAS) was assessed using a 0–10 visual analogue scale following the application of standardised algometric pressure to clinically identified myofascial trigger points. Quality of life was assessed using the WHOQOL-BREF questionnaire. Both outcomes were evaluated at baseline (T0), after the first treatment session (T1), and at the end of the rehabilitation programme (T2). The trial was registered in the ISRCTN registry (ISRCTN17648638). Results: After the first treatment session, both groups demonstrated a one-point reduction in pressure-evoked pain intensity (VAS). Quality-of-life scores increased by 10 points in the experimental group and by 8 points in the control group. At the end of the rehabilitation programme (T2), median pressure-evoked pain intensity (VAS) decreased to 2 (IQR 1) in the experimental group and to 3 (IQR 2) in the control group. WHOQOL-BREF scores increased by 36 points in the experimental group (50 [IQR 10] to 86 [IQR 7]) and by 30 points in the control group (54 [IQR 12] to 84 [IQR 8]). The Mann–Whitney U test revealed a statistically significant between-group difference in the early change in pressure-evoked pain intensity (VAS) from T0 to T1 (p = 0.023) and in WHOQOL-BREF score changes from T0 to T1 (p = 0.007) and from T0 to T2 (p = 0.035). However, the between-group difference in the overall change in pressure-evoked pain intensity (VAS) from T0 to T2 was not statistically significant (p = 0.585). Conclusions: The addition of a single dry needling session to standard rehabilitation was associated with a potentially more favourable early response in pressure-evoked pain intensity (VAS) and greater improvements in quality-of-life scores. However, no statistically significant between-group difference was observed in the overall change in pressure-evoked pain intensity (VAS) at the end of treatment. Given the pilot design and small sample size, these findings should be considered preliminary and interpreted with caution.