Dry needling (DN) is an invasive physiotherapy technique employed for reducing myofascial pain. To compare the effectiveness of dry needling (DN) versus manual therapy (MT) in improving pain, active maximal mouth opening (AMMO) and cervical disability in patients with myofascial pain from temporomandibular disorders (TMDs) were investigated against these treatments. A single-blind, randomized controlled trial was carried out. Individuals (n = 50) with TMDs were randomly allocated in a 1:1 ratio to the DN (n = 25) or MT group (n = 25). Each group received three sessions, separated by 4 days, of either DN or MT. Outcomes were assessed according to pain intensity (Numeric Pain Rating Scale), AMMO (cm), disability (Neck Disability Index), and pressure–pain threshold (PPT) (digital algometry) from the active myofascial trigger points. In both groups, pain and neck disability were significantly lower at the end of treatment compared with those measured at baseline (pain: −2.52 with 95% CI: −3.43 to −1.60 for DN group; pain: −2.92 with 95% CI: −3.77 to −2.07 for MT group; disability: −3.2 with 95% CI: −4.31 to −2.09 for DN group; disability: −2.68 with 95% CI: −3.56 to −1.79 for MT group), but not were not lower after the first session, without differences between the groups. AMMO was significantly higher after the first session (0.16 with 95% CI: 0.03 to 0.29 for DN group; 0.30 with 95% CI: 0.20 to 0.41 for MT group) and at the end of treatment in both groups (0.27 with 95% CI: 0.14 to 0.41 for DN group; 0.37 with 95% CI: 0.22 to 0.52 for MT group) compared with the baseline measurements. Finally, PPT results for the masseter and pterygoid muscles were significantly higher at the end of treatment in both groups (without statistically significant differences between groups), but not after the first session. The assessed therapies, DN and MT, are equally effective in improving pain, AMMO, cervical disability, and PPT in the muscles directly involved in the temporomandibular joint biomechanics of patients with myofascial TMDs.
Background/Objectives: Non-specific low back pain represents a high number of primary care consultations, generating a great social and economic cost. There is a higher prevalence in women, and it may be associated with multiple factors. One of the most innovative tools in rehabilitation is virtual reality-based therapy. Virtual reality positively affects the motivation of participants and generates greater adherence to treatment, so this factor could lead to long-term functional improvement. The objective of this review is to update the effectiveness of virtual reality programs on pain, disability, kinesiophobia, and changes in the thoracoabdominal musculature in patients with chronic nonspecific low back pain. Methodology: PubMed, PEDro, SCOPUS, Web of Science, and the Cochrane Library were used in this systematic review. The research question was formulated using PICOS. The Physiotherapy Evidence Database (PEDro) scale was used. Inclusion criteria were randomized clinical trials, participants were men and/or women over 18 years of age who were diagnosed with chronic non-specific low back pain, and articles that included virtual reality as a treatment. Articles with a level of evidence lower than 5/10 on the PEDro scale were excluded. Results: A total of 14 studies were included with sample sizes between 34 and 188 participants. Studies showed significant improvements in pain reduction, kinesiophobia, and disability (inflammation and motor control). Some studies showed long-term benefits, with effects maintained up to 18 months post-intervention, especially in the reduction in pain and its interference with daily activities. Conclusions: The findings of this systematic review support the efficacy of virtual reality as an effective and safe therapeutic option for the treatment of chronic non-specific low back pain.