Cervicogenic Headaches, Tension-Type Headaches, and Temporomandibular Joint (TMJ) disorders are among the most common complaints in modern clinics. Frequently, these patients undergo an exhausting journey between physicians, neurologists, and X-ray scans, only to discover that the source of their pain is myofascial—originating from the muscle tissue and fascia. In this article, we will understand how Dry Needling penetrates the "noise center" to provide a neurological and mechanical solution to these pains.

 

The Neurological Mechanism: The Trigemino-Cervical Nucleus

To understand why needling the neck helps with pain behind the eye or in the temple, we must recognize the Trigemino-Cervical Nucleus. This is a neural junction in the spinal cord where signals from the Trigeminal nerve (responsible for the face and jaw) meet signals from the upper cervical nerve roots (C1-C3). This neurological "convergence" is the reason why trigger points in the neck muscles radiate pain to the head. Dry Needling modulates this neural junction and reduces the Central Sensitization that causes headaches.

 

Key Muscles in Head and Face Treatment

• Suboccipitals: A small group of muscles at the base of the skull. These are the "eyes of the neck." Trigger points in this area are the primary cause of headaches felt as an "arc" above the ear toward the forehead.
• Sternocleidomastoid (SCM): The key muscle of the anterior neck. Precise needling of the SCM can resolve dizziness, ear pain, and pain above the eyebrow.
• Masseter & Temporalis: The primary masticatory (chewing) muscles. For patients suffering from Bruxism (teeth grinding) or jaw locking, dry needling provides immediate relief that is difficult to achieve with manual massage due to the area's sensitivity.

 

Safety Above All: Needling at the "Top Floor"

The neck and face are dense with sensitive structures: major arteries and veins, glands, and cranial nerves. Needling these areas requires specific certification and high-level palpation skills.

1. Safe SCM Needling: We utilize the Pincer Palpation technique to isolate the muscle from major blood vessels, such as the Carotid Artery.
2. TMJ Needling: Requires intimate knowledge of the mandibular angle to avoid the Facial Nerve and parotid gland.

 

Orthopedic Dry Needling Course – Practical training in safe needling techniques for the neck and face

 

Research Evidence: Proof from the Field

Recent systematic reviews (e.g., France et al., 2020) show that Dry Needling is significantly effective in reducing the intensity and frequency of tension-type headaches. Other studies highlight the immediate improvement in mouth opening range for TMJ patients following a series of needling treatments to the masticatory muscles.

 

Clinical Integration: Neck-Jaw-Vision

As I emphasize at Manual IL, the head is not disconnected from the body. Neck pain is often influenced by posture (Forward Head Posture), psychological stress, and prolonged screen time. Dry Needling is the "starter" that turns off acute pain, but it must be accompanied by cervical stabilization exercises, C0-C1 mobilization, and ergonomic education.

 

Join the Manual IL certification track and become an expert in treating headaches and neck pain

 

Summary

Resolving a patient's chronic headache of many years with a few needles is one of the most rewarding experiences for a therapist. Dry Needling for the neck and face is the perfect blend of precise science, topographical anatomy, and the art of manual therapy.