Analysis of deep tissue hypersensitivity to pressure pain in professional pianists with insidious mechanical neck pain

Abstract

BackgroundThe aim of this study was to investigate whether pressure pain hyperalgesia is a feature of professional pianists suffering from neck pain as their main playing-related musculoskeletal disorder.MethodsTwenty-three active expert pianists, 6 males and 17 females (age: 36 ± 12 years) with insidious neck pain and 23 pianists, 9 males and 14 females (age: 38 ± 10 years) without neck pain the previous year were recruited. A numerical pain rate scale, Neck Disability Index, hand size and pressure pain thresholds (PPT) were assessed bilaterally over the C5-C6 zygapophyseal joint, deltoid muscle, the second metacarpal and the tibialis anterior muscle in a blinded design.ResultsThe results showed that PPT levels were significantly decreased bilaterally over the second metacarpal and tibialis anterior muscles (P < 0.05), but not over C5-C6 zygapophyseal joint and deltoid muscle (P > 0.10), in pianists with neck pain as compared to healthy pianists. Pianists with neck pain had a smaller (P < 0.05) hand size (mean: 181.8 ± 11.8) as compared to pianists without neck pain (mean: 188. 6 ± 13.1). PPT over the tibialis anterior muscles was negatively correlated with the intensity of neck pain.ConclusionsOur findings revealed pressure pain hypersensitivity over distant non-symptomatic distant points but not over the symptomatic areas in pianists suffering from neck pain. In addition, pianists with neck pain also had smaller hand size than those without neck pain. Future studies are needed to further determine the relevance of these findings in the clinical course of neck pain as playing-related musculoskeletal disorder in professional pianists.

Have musicians’ musculoskeletal symptoms been thoroughly addressed? A systematic mapping review

“…injuries and illnesses during a band camp [174]. There were also 12 case-control studies [96,97,110,111,115,140,141,[162][163][164][165]178]. Of these case-control studies, 3 included a playing-task [111,115,178], 1 resisted finger extension/flexion [165], and another emotionally and physically stressful tasks [110].…”

“…Some 22 studies also investigated the association between different MSS outcomes. Similar to the extent/severity studies, the majority (86%) of the studies of risk factors reported general symptom outcomes[27,28,30,38,[40][41][42][43][44][45][46][47][48][49][50]53,54,60,64,65,69,71,74,76,[79][80][81][82][83][84][85][86][87][88][91][92][93][95][96][97][106][107][108]110,111,115,116,119,122,125,126,[129][130][131][133][134][135][138][139][140][141][142][154][155]…”

Reliability of an instrument for screening hand profiles: The Practical Hand Evaluation

“…playing-related pain. [17][18][19][20][21][22] However, 2 systematic reviews among musicians 12,23 found no consistent results regarding these features, which might be due to the diversity of anthropometric aspects they included.…”

Structural and Functional Changes of Cervical Neuromuscular System Associated with Insidious Onset Mechanical Neck Pain: A literature Review

“…About 0.6% of the general population is exposed to disability caused by IOMNP and females are more prone to recurrent and / or chronic pain than males [3]. The IOMNP can be considered a work-related disorder in some professions, including pilots [4][5][6][7], musicians [8][9], and workers using personal computer for prolonged times [10][11][12][13][14].…”

“…About 0.6% of the general population is exposed to disability caused by IOMNP and females are more prone to recurrent and / or chronic pain than males [3]. The IOMNP can be considered a work-related disorder in some professions, including pilots [4][5][6][7], musicians [8][9], and workers using personal computer for prolonged times [10][11][12][13][14].Cervical spine supports the head and orients it in space, transmits forces on the upper limb and has close relations with the visual and vestibular function [15][16][17][18]. Given the complexity of this region and the close link between central nervous system (CNS) and muscles, several abnormalities in structure and function of the neuromuscular system may develop when pain occurs [2,15].…”