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C1 and C2 are called atlas and axis. C7 is denominated prominent vertebra because of its long and palpable spinous process.

In the cervical spine, (from the top to lower) :

- There is the upper cervical spine composed by CO-C1 (occipital-atlas) that follows a convex rule for flexion/extension, and C1-C2 (atlas-axis) with a concave rule for rotation. 

The resting position of the upper compartment is lordosis.

- Then, the medial cervical spine with C2-C6 that follows a concave rule. It is the most mobile part, with C3-C4-C5.

- And finally, the lower cervical spine: C7-D3 is the most fixated part of the cervical spine. It's physiological curve in lordosis.

Treatment of temporomandibular myofascial pain with deep dry needling :

The Temporomandibular joint (TMJ) is commonly victim of disorder and pain-dysfunction syndrome characterized by pain in the pre auricular area and alterations in the dynamic of open-close mouth movements. Painful hypersensitivity is often observed in the masticatory muscles as origin of myofascial pain syndrome, being the external pterygoid muscle one of the most frequently affected.

Consequently, the therapeutic intervention studied in this article deals with the external pterygoid muscle.

Indeed, the purpose of the article «Treatment of temporomandibular myofascial pain with deep dry needling » is : - to determine the importance of myofascial trigger points in temporomandibular pathology - evaluate the usefulness of the deep dry needling in the treatment of myofascial pain of the external pterygoid muscle.

Dry needling uses a needle (as in acupuncture) inserted perpendicularly through the skin taking into account the relationship between the muscle and trigger points with the surrounding anatomical structures.

Moreover, the treatment by deep dry needling of 36 patients studied (30women/6men) shows a statistically significant relationship between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline.

To conclude, deep dry needling in the trigger point in the external pterygoid muscle can be an effective manual therapy in the treatment of patients with myofascial pain located in that muscle and patients with temporomandibular disorder or TMJ pain-dysfunction syndrome.

Gonzalez-Perez LM, Infante-Cossio P, Granados-Nuñez M, Urresti-Lopez FJ. Treatment of temporomandibular myofascial pain with deep dry needling. Med Oral Patol Oral Cir Bucal. 2012 Sep 1;17(5):e781-5

Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti-Lopez FJ, Lopez-Martos R, Ruiz-Canela-Mendez P. Deep dry needling of trigger points located in the lateral pterygoid muscle: Efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction. Med Oral Patol Oral Cir Bucal. 2015 May 1;20(3):e326-33 Kalamir A, Graham PL, Vitiello AL, Bonello R, Pollard H. Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial. Chiropr Man Therap. 2013 Jun 5;21:17 Fernández-Carnero J, La Touche R, Ortega-Santiago R, Galan-del-Rio F, Pesquera J, Ge HY, Fernández-de-Las-Peñas C. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders. J Orofac Pain. 2010 Winter;24(1):106-12