Stress and Musculoskeletal Disorders: TMJ Disorder as an Example

Abstract

Introduction: The stressful life was found to affect the body health through the psychosocial mode of action. Only a few data are available about the association between emotional stress and TMD problems. Thus, this review aimed to examine the association between stress and TMD incidence.
Methods: A literature search was carried out in the Cochrane, PubMed, Scopus and Web of Science databases covering the period before 2022. Various combinations of keywords related to TMJ dysfunction and aspects of etiology were used (etiologic factors, etiology, temporomandibular joint dysfunction, disorder, disc displacement, dental occlusion, estrogen hormones, emotional stress, anxiety, depression). Databases were searched for papers published in English. Of the initial 121 abstracts found 102 were excluded. Excluded abstracts were those of repeated studies and studies with unrelated scopes. Another 5 studies were also excluded because they were not clearly related to the review topics.
Results: A total of 14 articles considered most relevant were selected for this review. The etiology of TMD is complex and multifactorial. There are numerous factors that can contribute to this disorder, which are grouped into three categories. Psychological factors such as stress, mental tension, anxiety or depression can cause TMD. Initiating factors lead to the onset of the symptoms and are primarily related to trauma or adverse loading of the masticatory system. Various studies have confirmed that patients with stress or myofascial pain associated with arthralgia, arthritis or osteoarthritis presented more advanced stages of temporomandibular joint disorder.
Conclusions: Stress, anxiety, and other psychological factors induce muscle hyperactivity and muscle fatigue with the appearance of muscle spasms and the following consequences: contracture, occlusal disharmony, internal disturbances and degenerative arthritis. These factors can alter the occlusal scheme of the masticatory cycle so that these alterations are more a result of TMD and not a triggering factor.