Dr. Anuj Netto discusses upper extremity pain in musicians.
Musicians have an uncanny ability to transform our emotions and thoughts through the sound of music they create. However, numerous years of practice and dedication to their craft can come at a cost to their health, specifically the health of their hands and upper extremities. Often times, repetitive motion, long practice hours and awkward postures can lead to musculoskeletal problems with pain being the primary complaint. Other symptoms include weakness, numbness, swelling, cramping, loss of dexterity, and stiffness. That being said, certain conditions occur at higher frequency in musicians including overuse syndrome, nerve entrapment disorders, and focal dystonia.
Overuse syndrome is by far the most common disorder affecting musicians and is due to the individual playing beyond the point of muscle fatigue. Symptoms typically present during practices and performances where constant repetition during intense playing occurs. Symptoms include pain, weakness, fatigue and stiffness and string musicians are most at risk whereas percussionists are least affected. Treatment initially consists of rest and the cessation of playing the instrument, typically for at least 12 weeks. This is augmented with anti-inflammatory and analgesic medication. Therapy is subsequently initiated for stretching and strengthening exercises as the musician slowly works back into their routine. Braces or custom instrument modifications such as chin/clavicle straps or playing a curved flute can aide in minimizing symptoms.
Nerve Entrapment Disorders
Musicians are not necessarily predisposed to nerve entrapment disorders but when they occur, can lead to loss of finger control and subsequently the inability to play their instrument. Symptoms often times occur while the musician is playing their instrument and typically consists of pain, numbness and decrease in strength. Treatment is often non-operative consisting of splinting, anti-inflammatory medications and stretching exercises. In recalcitrant situations, operative intervention is required.
Focal dystonia is a fancy way of describing an uncontrolled muscle spasm that leads to twisting and abnormal posturing. Much remains to be discovered as to the etiology of focal dystonia but what is known is that a correlation exists between the muscles involved in repetitive movements, such as playing an instrument, and these uncontrolled muscular contractions. Wind players are particularly susceptible and treatment is aimed at retraining musicians on techniques used to play their instruments.
If symptoms fail to resolve, call or make an online appointment with one of our physicians for further evaluation and treatment. Resurgens Orthopaedics is here to help musicians continue to make beautiful music.