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Occupational Medicine (Oxford Journals). Vol. 64, Iss. 1, January 2014

Symptoms of craniomandibular dysfunction in professional orchestra musicians


Background Up to 80% of professional musicians are affected by playing-related musculoskeletal disorders, but data regarding the frequency of craniomandibular dysfunction (CMD) in professional orchestra musicians is scarce.

Aims To evaluate the frequency of CMD and its relation to musculoskeletal pain in various body regions.

Methods A questionnaire-based survey approach assessing CMD symptoms and musculoskeletal pain in professional orchestra players was adopted. Relative prevalence rates and prevalence ratios for different instrument groups were estimated.

Results A total of 408 musicians completed the questionnaire (response rate 57%). Playing-related pain in the teeth or jaw was reported by 19–47% of musicians and TMJ pain by 15–34%, depending on the instrument group. Current pain in the face indicating a painful CMD was reported in 6–10% and related symptoms such as teeth grinding in 25–34%, jaw clenching in 33–42% and jaw locking in 11–18% of musicians. Females were 2.4 times (95% confidence intervals (CI) 1.49–3.84) more likely to report having had orofacial pain within the last month. Musicians reporting orofacial pain within the last month were 4.8 times (95% CI: 2.83–8.02) more likely to report pain in the neck and 2.5–3.8 times (P < 0.05) more likely to report pain in other body regions, including shoulders, right wrist, left fingers and the thoracic and lumbar spine.

Conclusions Symptoms suggesting CMD were common in this study of professional orchestra musicians and were associated with pain in the neck, shoulder and hands. There is a need to enhance awareness of CMD to optimize early medical diagnosis and treatment.


Craniomandibular disorders, musculoskeletal pain, musicians occupational diseases, playing-related musculoskeletal disorders, temporomandibular joint disorders

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