Neuromuscular and musculoskeletal problems in instrumental musicians

Abstract

Over the past 20 years, there has been increasing interest in the medical problems of performing artists. In this review, the major playing-related disorders seen in instrumental musicians are discussed. Among the 1353 instrumentalists personally evaluated, the major diagnoses included musculoskeletal disorders in 64%, peripheral nerve problems in 20%, and focal dystonia in 8%. Of these instrumentalists, 60% were women, although men were the majority in the group with focal dystonia. The average age at the time of evaluation was 37 years for men and 30 years for women. Among musculoskeletal disorders, regional muscle pain syndromes, particularly of the upper limb, upper trunk, and neck, were most common. Specific entities such as tendinitis and ligament sprain were less common. Frequent peripheral nerve disorders included thoracic outlet syndrome, ulnar neuropathy at the elbow, and carpal tunnel syndrome. Each instrument group showed a characteristic distribution of symptoms and signs that appeared to be directly related to the static and dynamic stresses inherent in the playing of the instrument. Electrodiagnostic studies are an important part of the evaluation of these disorders, particularly nerve entrapment syndromes. With carefully designed treatment, the majority of instrumental musicians can return to full and pain-free playing. Nerve entrapment syndromes have the highest treatment success rate, followed by musculoskeletal pain syndromes. Despite some recent innovative approaches, focal dystonia remains largely resistant to therapy.

Playing-Related Musculoskeletal Disorders of Professional Orchestra Musicians from the North of Portugal: Comparing String and Wind Musicians

“…More recent data states that the percentage of affected musicians varies between 64% and 94%. [5][6][7][8][9] Common PRMD of musicians include overuse complaints, entrapment neuropathies and occupational hand cramp 10 that frequently affect the upper part of the body including neck, shoulder, arm and wrist. [11][12][13] Those injuries can cause symptoms ranging from slight to severe pain.…”

“…9 Research also shows that instruments imposing asymmetric postures e.g. violin, viola, flute, and others also contribute to the assuming of unhealthy postures by the musician.…”

“…Recent studies are not completely conclusive about which instrument group is the most prone to suffer from PRMD. Some authors affirm that string instrumentalists are more prone to suffer from PRMD 9,21 and wood wind players the least 22 but in contrast Llobet 8 (2004) affirms that percussionists are the most affected by PRMD, followed by wind and string players.…”

Prática instrumental e desconforto corporal: um estudo com músicos de violino e viola

“…Os músicos em geral, sejam eles profissionais, professores ou estudantes, representam um grupo ocupacional único, no qual os problemas neuromusculares relacionados ao tocar parecem ser comum 21 . Por este motivo, é importante educá-los sobre os riscos a que podem estar expostos, uma vez que estes podem levá-los a uma lesão relacionada ao trabalho 22,23 .…”

“…De acordo com as queixas apresentadas, foi possível observar que as dores musculoesqueléticas localizam-se principalmente na região do pescoço (72,7%), parte superior das costas (63,6%), ombro esquerdo (54,5%) e braço esquerdo (45,5%) (Figura 4). Em músicos de orquestra americanos, 64,4% dos 1353 avaliados, apresentaram disfunções musculoesqueléticas nas regiões das mãos, punhos e antebraço 21 . Resultado semelhante obteve Brandfonbrener 30 que avaliou 2394 músicos, também americanos, entre os anos de 1985 e 2002.…”