Should musicians play in pain?

Abstract

Musculoskeletal symptoms, including pain, are often experienced by musicians at all levels. These symptoms may have a detrimental impact on musicians’ personal and work lives, and may also impact upon the ensembles they work within. Providing musicians with appropriate, evidence-based advice regarding pain management is therefore paramount. In this review, we aim to improve the advice given to musicians regarding playing when in pain, by answering the question ‘should musicians play in pain?’. This multidisciplinary narrative review draws upon contemporary pain science, including factors associated with poorer prognoses for those in pain, as well as the reported experiences of musicians with pain (including those who have taken time off from playing). Our current understanding of pain science provides further support for the potential for consequences related to avoiding activities due to pain. Pain is modulated by a number of neuro-immunological processes and is influenced by a range of psychosocial factors. Taking time off from playing might therefore not have any benefit. Importantly, one of the leading causes of a transition from acute to chronic pain is fear-avoidance behaviour (e.g. not playing when in pain); hence, encouraging such behaviour cannot be supported. Musicians who have taken time off from playing due to pain have experienced a range of consequences, including emotional and financial consequences. These experiences indicate that there are potential negative consequences related to taking time off from playing which need to be weighed against any benefits. We conclude that musicians should not necessarily be advised to take time off from playing to manage their pain, in keeping with current best practice for pain management. Instead, we recommend that musicians be educated on contemporary pain science and when to seek treatment from a health professional for individualised advice to reduce the burden of musicians’ pain.

Patterns of pain location in music students: a cluster analysis

“…Elevated both frontal (n = 28): Music students playing musical instruments with both arms elevated in a frontal position; Elevated both left (n = 65): Music students playing musical instruments with both arms elevated in the left quadrant position; Elevated left (n = 28): Music students playing musical instruments with only the left arm elevated; Elevated right (n = 50): Music students playing musical instruments with only the right arm elevated; Neutral (n = 132): Music students playing musical instruments in a neutral position, without the elevation of arms; Singers (n = 37) type of novel interpretation might reasonably form the basis for even more sophisticated and comprehensive long term-research to quantify the impact trajectories of patterns of MSK pain affecting musicians at specific anatomical sites, and the efficacy of standardised interventions for both primary and secondary prevention. For example, prophylactic strategies for the management of pain before its escalation to a chronic levels have been advocated [50], together with approaches offering greater insights into the exploration of different aetiologies and personal significance of pain amongst musicians.…”

Autoconsciência corporal e queixas álgicas em estudantes universitários de música

“…In this research, most students stated that they took breaks while playing musical instruments (82.5%). Despite the pathophysiological understanding of pain after the performance and the importance of breaks, it is also relevant to understand that the need and guidelines for breaks in musical practice can have repercussions that can be as significant for the musician as the complaint of pain itself 38 , revealing the importance of preventive and health-promoting guidelines for this public continuously, to stimulate the adherence of these practices in their daily training.…”

Hard Work and Hopefulness: A Mixed Methods Study of Music Students’ Status and Beliefs in Relation to Health, Wellbeing, and Success as They Enter Specialized Higher Education

“…This translational approach to developing learning cultures is recognized in the WHO Shanghai Declaration ( World Health Organisation [WHO], 2017 ) which states that health literacy must be an integral part of the skills and competencies developed over a lifetime and incorporated into the educational curriculum. As pointed out by Stanhope and Weinstein (2020) , musculoskeletal disorders are the most common and costly compensation claims made by musicians. They suggest that although medical advice is typically to cease doing whatever is causing the pain, musicians may require a more nuanced approach to treatment.…”

“…The role of music institutions is not only to assess and guide playing abilities, but also to provide appropriate skills for the vocation ( Wijsman and Ackermann, 2018 ). In terms of the development of the role of higher education (HE) music institutions, it is important to plan for and provide a framework of specialized support, especially considering the potential impact of the Covid-19 pandemic on musicians’ livelihoods ( Elmer et al, 2020 ; Stanhope and Weinstein, 2020 ).…”