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

Maurits K A Van Selms,Hedwig A Van Der Meer,Frank Lobbezoo,Corine M Visscher,Jari Ahlberg,Jetske W Wiegers

doi:10.1111/joor.12886

Maurits K A Van Selms, Hedwig A Van Der Meer + Show 4 more

Open Access

https://doi.org/10.1111/joor.12886

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Abstract

BackgroundUncertainties still exist about the role of playing musical instruments on the report of musculoskeletal complaints and headache.ObjectivesTo evaluate the prevalence of and risk indicators for symptoms of temporomandibular disorders, pain in the neck or shoulder, and headache among musicians.MethodsA questionnaire was distributed among 50 Dutch music ensembles.ResultsThe 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.ConclusionsThe 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.

Highlights

Due to the specific body postures and loading of the muscles, ten‐ dons and joints that are involved in playing musical instruments, musicians often suffer from playing‐related musculoskeletal disor‐ ders (PRMDs).[1,2] Partly because of the fact that there is still no strict definition for PRMDs,[3] a wide range of prevalence rates has been re‐ ported in the literature on performing arts medicine.[4]
The first aim of this study was to determine the prevalence of self‐ reported temporomandibular disorders, pain in the neck or shoul‐ der, and of headache in musicians
The results showed that 18.3% of the musicians reported temporomandibular disor‐ ders (TMDs) pain, 52.5% reported pain in the neck and shoulder area, and 42.5% reported headache

Summary

| INTRODUCTION

Due to the specific body postures and loading of the muscles, ten‐ dons and joints that are involved in playing musical instruments, musicians often suffer from playing‐related musculoskeletal disor‐ ders (PRMDs).[1,2] Partly because of the fact that there is still no strict definition for PRMDs,[3] a wide range of prevalence rates has been re‐ ported in the literature on performing arts medicine.[4]. Various studies have indicated that pain complaints in the upper part of the body, such as neck/shoulder pain and pain‐related TMDs, are associated with reports of headache.[13,14,15] Convergence of no‐ ciceptive inputs has been suggested to provide a neuro‐anatomical basis for the presence of these pains.[16] At the same time, headache can be provoked by sustained masticatory muscle contraction, for example induced by tooth clenching.[17,18] Besides, during a musical performance, anxiety and various sources of psychological stress can be highly prevalent among musicians,[19,20] which are risk factors for headache as well.[21] Given the uncertainties that still exist about the role of playing musical instruments on musculoskeletal com‐ plaints, combined with the fact that so far only little research has been devoted to headache among musicians, the aim of this ques‐ tionnaire study was to evaluate the prevalence of and risk indicators for symptoms of temporomandibular disorders, pain in the neck and shoulder area, and headache in five groups of musicians It was hy‐ pothesised that, for each of these musculoskeletal symptoms, differ‐ ences in prevalence between the musical instrument groups would be reflected by differences in overloading of the areas where the greatest muscular exertion occurs

| MATERIAL AND METHODS

Findings

| DISCUSSION