Get FORMED:

“Long-term stress triggers the body’s defensive reactions, generating various degrees of pathological emotional tension. Studies have shown higher muscle activity in the swelling of neck and head muscles, contributing to the generation of tension headaches and migraines. Increased masticatory muscle tension may be one of the factors predisposing people to temporomandibular disorders (TMD) and bruxism—clenching or grinding of the teeth and/or by bracing or thrusting of the mandible.”

Masticatory Muscle Pain and Associated Complaints-An Analysis of the Frequency and Coexistence of Symptoms Before and During the COVID-19 Pandemic

Zofia Maciejewska-Szaniec ¹, Barbara Maciejewska ², Małgorzata Gałczyńska-Rusin ¹, Weronika Jakubowska ³, Natalie Górna ¹, Izabela Maćkowiak ¹, Tomasz Gedrange ⁴, Marta Kaczmarek-Ryś ⁵, Agata Czajka-Jakubowska ¹

Abstract

Background/Objectives: Chronic stress has an undeniable effect in generating emotional disorders and physiological changes. It results in excessive muscle tension throughout the body, also in the masticatory system. A situation of chronic stress was the COVID-19 pandemic. The aim of this paper was to assess the prevalence of specific masticatory pain symptoms, their severity, and the co-occurrence of associated symptoms (otological symptoms and headaches) in patients diagnosed before and during the COVID-19 pandemic. 

Methods: A total of 202 patients were divided into two groups: Group A (mean age of 36.46; F = 64; and M = 37) and B (mean age of 26.04; F = 70; and M = 31) included patients who presented for the study before and after the COVID-19 pandemic, respectively. The Oral Behaviors Checklist (OBC) questionnaire was used: patients with result ≥2 scores in the OBC were evaluated by DC/TMD. To evaluate the intensity of pain in masticatory structures, the elements of the RDC-TMD questionnaire were used. Otologic symptoms and headaches were assessed as coexisted complaints. 

Results: A significant increase in pain occurrence was observed in Group B mainly for masseter muscles (p < 0.0001), temporalis (p = 0.0044), and medial pterygoid muscles (p = 0.0153). A significantly more frequent reporting of pain/tenderness was observed among men in most of the evaluated muscles. For the lateral pterygoid muscles, changes in palpation pain did not reach statistical significance. There was a statistically significant difference in the intensity of pain in the temporomandibular joint area between both the entire groups A and B (p = 0.000152), as well as between women in Group A and B (p = 0.006453) and men in the study groups (p = 0.007990). An increase in the incidence of headaches was observed among men in Group B (Group A with 40.6% vs. Group B with 67.3%). The most commonly reported otological symptom in both groups was ear pain and/or discomfort in the preauricular region, with the frequency of otological symptoms being higher in Group B. 

Conclusions: (1) The COVID-19 pandemic affected the incidence and severity of masticatory muscle pain and associated complaints. (2) A decrease in the age of patients reporting complaints of masticatory mm pain was observed during the COVID-19 pandemic. (3) An increase in the frequency of headaches was observed in the male group during the pandemic, while in women there was an increase in palpation tenderness of masticatory muscles.