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

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.

Are vocalists prone to temporomandibular disorders?

BACKGROUND: As vocalists demand high physical strains of the masticatory system, singing is frequently mentioned as a risk factor for temporomandibular disorders (TMDs). OBJECTIVES: This study investigated whether vocalists report a higher prevalence of two types of TMDs (viz., TMD pain and temporomandibular joint sounds) compared with instrumentalists who do not load their masticatory system while performing. In addition, we examined which risk indicators are associated with the presence of these TMDs among musicians. METHODS: A total of 1470 musicians from 50 different music ensembles completed a questionnaire. Of these musicians, 306 were vocalists (mean age ± SD 37.5 ± 17.7 years; 63.9% female) and 209 musicians enrolled the control group (mean age ± SD 42.7 ± 18.0 years; 40.7% female). RESULTS: The prevalence of self-reported TMD pain among vocalists was 21.9%, as compared to 12.0% in the control group. 20.0% of the vocalists reported TMJ sounds versus 15.1% of the controls. The multiple regression models indicated that being a vocalist was not a risk indicator for the presence of self-reported TMD pain nor for self-reported TMJ sounds. Instead, it appeared that the report of TMD pain among musicians was positively associated with female gender, next to the level of physical workload, depicted as frequency of oral behaviours and the hours of daily practice. Musicians' report of TMJ sounds was associated with oral behaviours. CONCLUSION: This study shows that singing is not associated with the reports of TMD pain and TMJ sounds, after adjusting for potentially confounding variables included in the models.

Oro-facial pain experience among symphony orchestra musicians in Finland is associated with reported stress, sleep bruxism and disrupted sleep-Independent of the instrument group.

BACKGROUND: To evaluate whether oro-facial pain experience was related to the type of musical instrument and to learn more about the roles of sleep and sleep-related issues in the pain among professional musicians. OBJECTIVES: A standard questionnaire was sent to all Finnish symphony orchestras (n = 19), with altogether 1005 professional musicians and other personnel. METHODS: The questionnaire covered descriptive data, instrument group, items on perceived quality of sleep, possible sleep bruxism, stress experience and oro-facial pain experience during the past 30 days. RESULTS: In the present study, which included the musicians only, the response rate was 58.7% (n = 488). All orchestras participated in the study, and there was no significant difference in the response rate between the orchestras. The mean age of men (52.3%) was 47.7 (SD 10.3) and of women (47.7%) was 43.4 (SD 9.8) years (P < 0.001). Overall, current pain in the oro-facial area was reported by 28.9%, frequent bruxism by 12.1% and frequent stress by 20.8%. According to Somers' d, there were statistically significant but moderate correlations between overall pain reports in the oro-facial area and disrupted sleep (d = 0.127, P = 0.001), sleep bruxism (d = 0.241, P < 0.001) and stress experiences (d = 0.193, P < 0.001). Logistic regression revealed, independent of the instrument group (string, woodwind, brass wind, percussion), that current oro-facial pain experience was significantly associated with disrupted sleep (P = 0.001), frequent sleep bruxism (P < 0.001) and frequent stress (P = 0.002) experiences. CONCLUSIONS: Among symphony orchestra musicians, oro-facial pain experience seems to be related to perceptions of stress, sleep bruxism and disrupted sleep rather than the instrument group.