Hand Pain Attributed to Overuse among Professional Pianists: A Study of 200 Cases

Abstract

Two hundred professional pianists and students with hand pain (35 men and 165 women; 102 right, 62 left, and 36 bilateral; with a mean age of 26.3 years) attributed to overuse while playing the piano were investigated. The diagnoses were divided into six groups: tenosynovitis or tendinitis (56 cases), enthesopathy (49), muscle pain (38), neurological disturbance (28), joint pain (24), and neck or scapular pain (5). Tenosynovitis or tendinitis included de Quervain’s disease (29), flexor tenosynovitis (17), and tendinitis of the extensor digitorum communis (6). The enthesopathy group consisted of lateral epicondylitis (27), medial epicondylitis (7), olecranon pain (4), and distal pain of the flexor carpi radialis or ulnaris (8). Muscle pain was seen in the digital extensors (12) and flexors (5) of the forearm, the thenar muscle (8), the hypothenar muscle (6), and the interossei (6). Finger joint pain was noted in the proximal interphalangeal joint (15), metacarpophalangeal joint (6), and first carpometacarpal joint (1). Neurological disturbance included focal dystonia (18), cubital tunnel syndrome (8), and carpal tunnel syndrome (2). Seventy subjects stated that they were practicing some specific keyboard techniques at the onset of their overuse trouble; octaves (30 cases) and chords (22), which require hyperabduction of both the thumb and the little finger, accounted for 74% of these techniques.

A Physiotherapeutic Approach to Musicians' Health – Data From 614 Patients From a Physiotherapy Clinic for Musicians (INAP/O)

“…• genre of playing • pain during playing • subjective description of the primary complaint and its location Also, the therapist decides the type of treatment (e.g., physiotherapy, osteopathy, manual therapy) and how many appointments are needed. Fry, 1986;Fishbein and Middlestadt, 1988;Middlestadt and Fisbein, 1989;Schuppert and Altenmüller, 1999;Liu and Hayden, 2002;Sakai, 2002;Rosety-Rodriguez et al, 2003;Moraes and Papini, 2012;Paarup et al, 2012; Ackermann et al, 2002;de Greef et al, 2003;Barton and Feinberg, 2008;Chan et al, 2013aLópez and Martínez, 2013;McCrary et al, 2016 Manual therapy, therapeutic exercises, education and advice (e.g., about performance posture, practice habits, possible injury risks etc. ), music performance biomechanics feedback, ergonomic considerations Ackermann et al, 2002;de Greef et al, 2003;Shafer-Crane, 2006;Rabuffetti et al, 2007;Barton and Feinberg, 2008;Chan et al, 2013b;López and Martínez, 2013;McCrary et al, 2016 Mobility dysfunction Fishbein and Middlestadt, 1988;Middlestadt and Fisbein, 1989;Larsson et al, 1993;Gannon and Bird, 1999;Schuppert and Altenmüller, 1999;Brandfonbrener, 2002;Liu and Hayden, 2002;Sakai, 2002;Day et al, 2011;Driscoll and Ackermann, 2012;Paarup et al, 20...…”

Playing-related Musculoskeletal Problems in Children Learning Instrumental Music: The Association Between Problem Location and Gender, Age, and Music Exposure Factors

“…In adults, a higher prevalence of PRMPs has been reported in string 20,21,27,49 and keyboard players. 16,39,[50][51][52][53][54] Woodwind and brass players often have lower risk, with percussion players at the least risk of problems. 20,50,55,56 Among tertiary music students, string, keyboard, woodwind, and brass instrumentalists have been reported to have a high prevalence of problems.…”

“…Piano players most commonly reported problems affecting both hands, the right more than the left, with the specific requirements of repertoire, posture of the wrist and hands, and technique among some of the factors thought to contribute to this pattern of involvement. 45,51,53,63,[68][69][70] For upper string players, the left hand/arm and shoulder were more commonly involved than the right hand/arm; in addition, the neck and mid-back may be affected. 45,55,63,71 Problems in the left upper extremity may be explained by the asymmetric and extreme postures adopted and the specific techniques necessary to produce particular sounds.…”

Measurement of a number of indices of hand and movement angles in pianists with overuse disorders

“…The author has investigated the cause of pianists’ hand pain and has found that octave and chord technique practice may lead to overuse trouble (Sakai, 1992; 2002; Sakai, et al, 2006). These two techniques commonly involve abducting both the thumb and little finger, and the results suggest that pianists with a short hand span are likely to suffer from hand trouble due to overuse (Fig 1).…”