Immediate effect of DNT on frontal headache and otalgia originating from temporalis and masseter trigger points: a case report and physiotherapy management Doi: https://doi.org/10.55522/jhpo.V3I4.0078

Abstract

Chronic tension-type headache (CTTH) and migraine are frequently associated with myofascial trigger points (TrPs) in the neck, head, and shoulder muscles. Dry needling, a minimally invasive physiotherapy technique, effectively deactivates TrPs. This case highlights its rapid impact on frontal headache and ear pain. A 35-year-old female educator reported ongoing dull pain centered around her right eye and forehead, accompanied by discomfort in her ear. An examination by an ENT specialist revealed no evidence of underlying ENT pathology, while a physiotherapy evaluation revealed active trigger points in the right temporalis and masseter muscles, along with a history of teeth grinding. Management incorporated dry needling therapy (DNT) to the temporalis and masseter muscles while maintaining sterile conditions, followed by ischemic compression, ultrasound treatment, focused stretching, postural adjustments, and behavioral education. The patient reported an immediate decrease of about 60% in pain intensity following the initial needling session. Over the course of five treatment sessions, the Visual Analogue Scale (VAS) score decreased from 6/10 at rest to 2/10. The Pain Disability Index (PDI) score reduced from 38/70 (moderate disability) at baseline to 12/70 (minimal disability), indicating substantial functional improvement. This case illustrates how DNT, when used alongside multimodal physiotherapy, can quickly alleviate facial pain and associated symptoms arising from trigger points in the temporalis and masseter muscles. It is essential to promptly identify musculoskeletal origins when ENT and dental conditions have been ruled out.