Evaluate the Effect of Dry Needling on the Temporomandibular Joint in Subjects Who Have Suffered a Whiplash as a Result of a Traffic Accident

Study Overview
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Brief Summary
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The transportation industry is growing rapidly and the most popular mode is overland by road. Traffic accidents are the most direct and serious risk to the lives of Western people. A large number of traffic accidents occur on the roads each year, especially those caused by motor vehicles on motorways and urban ring roads, often resulting in massive loss of life. According to the World Health Organization (WHO), 1.35 million people die each year worldwide. Whiplash is the most common injury in motor vehicle collisions, affecting 83% of injured people. The temporomandibular joint (TMJ) is one of the most complex joints in the human body, since in addition to performing functions in dental occlusion, it does so in the neuromuscular system. Due to the relationship of the neck with the mandible, the main objective of the study is to determine if there is an improvement in pain and functional limitation in general by applying the dry needling technique in the temporomandibular joint musculature.

Official Title
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Randomized, Open Clinical Trial to Evaluate the Effect of Dry Needling on the Temporomandibular Joint in Subjects Who Have Suffered a Whiplash as a Result of a Traffic Accident

Conditions
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Whiplash, Temporomandibular Joint Pain, Dry Needling Technique

Intervention / Treatment
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* Procedure: Dry needling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having suffered a traffic accident Having suffered a subsequent collision Having been diagnosed with whiplash in the hospital ''Fundación Jiménez Díaz (FJD)´´ emergency room in the first 72 hours after the collision. Age between 18-45 years, to avoid osteoarthritis and other degenerative problems. Minimum 3 in temporomandibular joint (TMJ) according to Visual Analog Scale (VAS) Consent to participate Exclusion Criteria: Temporomandibular joint (TMJ) or craniofacial surgeries Spinal surgery Direct trauma in temporomandibular joint (TMJ) or prior to the accident Botox, silicones or any type of cosmetic surgery in the facial region. Problems of migraines and tension headaches (pre-accident) Any degenerative musculoskeletal disease (fibromyalgia, rheumatoid arthritis, osteoarthritis) Fear of needles Any neurological disorder (trigeminal neuralgia, epilepsy) Pregnancy Uncontrolled vascular or metabolic problems

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br> | |
| Experimental: dry needle<br> | Procedure: Dry needling<br>* It is a minimally invasive treatment modality. Its effectiveness has been confirmed in numerous studies. It consists of applying an antiseptic in the puncture area and inserting the needle in the required aseptic conditions. During puncture, the patient's physical response is observed at all times, in order to control the local spasmodic responses in each muscle. After applying the technique, we assessed jaw pain, mouth opening, and the appearance of headaches. The adverse effects of the technique are the following: pain after puncture (1.7%), local bleeding at the puncture site (6.1%) and syncopal responses (0.7%).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Age | Years (Demographic variables) | Visit 1 (First day of treatment) | 
| Gender | Male, Female, Does not answer (Demographic variables) | Visit 1 (First day of treatment) | 
| Weight | Kilograms (Demographic variables) | Visit 1 (First day of treatment) | 
| Height | Meters (Demographic variables) | Visit 1 (First day of treatment) | 
| Mouth opening | Millimeters (Basal conditions) | Visit 1(First day of treatment) and Visit 2 (One week after visit 1) | 
| Jaw pain | Visual Analog Scale (VAS) 1-10 (Basal conditions) | Visit 1(First day of treatment) and Visit 2 (One week after visit 1) | 
| Headache | Visual Analog Scale (VAS) 1-10 (Basal conditions) | Visit 1(First day of treatment) and Visit 2 (One week after visit 1) | 
| Joint clicking | Yes/No (Basal conditions) | Visit 1(First day of treatment) and Visit 2 (One week after visit 1) | 
| Pressure masseter, pterygoid, and temporalis | Determine pressure in kg in the masseter, temporal, and pterygoid muscles with an algometer to obtain 5/10 in Visual Analog Scale (VAS) to all participants | Visit 1 (First day of treatment) | 
| Pain masseter, pterygoid, and temporalis | Obtain pain from 1 to 10 in the masseter, temporal, and pterygoid muscles according to the Visual Analog Scale (VAS) after applying the pressure obtained with the algometer in the previous step. *Patients in the experimental group are evaluated 10 minutes after the application of dry needling | Visit 1(First day of treatment) and Visit 2 (One week after visit 1) |