Temporomandibular disorders, pain in the neck and shoulder area, and headache among musicians

Abstract

Background Uncertainties still exist about the role of playing musical instruments on the report of musculoskeletal complaints and headache. Objectives To evaluate the prevalence of and risk indicators for symptoms of temporomandibular disorders, pain in the neck or shoulder, and headache among musicians. Methods A questionnaire was distributed among 50 Dutch music ensembles. Results The questionnaire was completed by 1470 musicians (response rate 77.0%). Of these, 371 musicians were categorised as woodwind players, 300 as brass players, 276 as upper strings players, 306 as vocalists and 208 as controls; nine musicians had not noted their main instrument. The mean age was 41.6 years (standard deviation [SD] 17.2), and 46.5% were male. Irrespective of instrumentalist group, 18.3% of the musicians reported TMD pain, 52.5% reported pain in the neck and shoulder area, and 42.5% reported headache. Of the functional complaints, 18.3% of the musicians reported TMJ sounds, whereas a jaw lock or catch on opening or on closing was reported by 7.1% and 2.4%, respectively. TMD pain was associated with playing a woodwind instrument, whereas pain in the neck and shoulder was associated with playing the violin or viola. For each complaint, oral behaviours were found as risk indicator, supplemented by specific risk indicators for the various complaints. Conclusions The current finding that pain‐related symptoms varied widely between instrumentalist groups seems to reflect the impact of different instrument playing techniques. Playing a musical instrument appears not the primary aetiologic factor in precipitating a functional temporomandibular joint problem.

Prevalence of temporomandibular disorders in musicians: A systematic review and meta‐analysis

“…Of the 13 selected studies, three were conducted in Portugal, 6,19,21 two were carried out in Brazil, 23,27 and the remaining eight were conducted in Spain, 24 Korea, 20 Japan, 22 Poland, 26 Germany, 25 Holland, 28 Nigeria 29 and Chile 30 . Regarding the type of study, only one dissertation 19 and one course conclusion paper 30 were selected; the others were articles published in peer‐reviewed Journals.…”

“…The sample size ranged from 31 25 to 1470 28 participants. Four articles 21,27,28,31 used the RDC/TMD diagnostic tool.…”

“…The sample size ranged from 31 25 to 1470 28 participants. Four articles 21,27,28,31 used the RDC/TMD diagnostic tool. Four studies using similar or RDC/TMD‐based tools were identified, these tools being the SQ‐TMD 22,26 and the Fonseca Questionnaire 6 .…”

“…Regarding the overall risk of bias, two studies 22,24 were classified as high risk of bias, five 20,23,25,29,30 were classified as moderate risk of bias, and six were classified as low risk of bias 6,19,21,26‐28 . The results on risk of bias are described in Figure 2 and Appendix .…”

Prevalence of orofacial pain in wind instrument players

“…A previous study with these individuals, using the same diagnostic method, found a prevalence of 68.3% of participants with some type of TMD 15 . A research that investigated the association between being a musician and having shoulder, neck and head pain, or having TMD symptoms, found results that support the association between the presence of TMD and the practice of woodwind instruments 16 . When comparing the prevalence obtained in this study with prevalence in other risk groups, such as high impact athletes, a study with professional of mixed martial arts showed that 61% of them had some type of TMD, while the prevalence among athletes of the Brazilian karate team was 54% 17 .…”