A pilot population study of musculoskeletal disorders in musicians

Abstract--A pilot population-based telephone survey was performed to obtain estimates of the number of people playing musical instruments and of the prevalence of hand, arm, and neck pain of musicians. Of the 954 respondents, 209 (21.9%, 95% confidence interval of 18.9-24.9%) indicated that they played musical instruments. Of those who played instruments, keyboards (44.8%, CI 35.6-54.0%) and guitar (28.1%, CI 20.8-35.8%) were by far the most commonly played instruments. Of those respondents who played instruments, 35.3% indicated that they played 5 hours or more a week, with 9.1% playing 20 hours or more. Overall, 29% (CI 21.4-37.0%) of all musicians indicated significant pain. The highest rates were among those who played 5-9 hours per week (48%), followed by 20 hours or more (42%), 0-4 hours (24%), and 10-19 hours (18%). The study indicates that playing a musical instrument may be second only to computer use in prevalence as a possible risk factor for cumulative trauma disorder, and that more extensive research is needed.

**********

Instrumental musicians may constitute the most underrecognized and underserved large occupational group with highly prevalent upper-extremity musculoskeletal disorders (UEMSD). Cross-sectional estimates cite a prevalence of UEMSD ranging from 39% to 87% for professional musicians. (1) Yet there is little information on how many people play musical instruments in the general population, and the resulting potential burden of UEMSD. This is a report on a pilot random-digit dialing telephone survey investigating how many people in the U.S. population play musical instruments, a measure of risk exposure (hours of playing by instrument), and a measure of outcome (significant UEMSD) based on self-report.

BACKGROUND

Approximately 274,000 Americans reported being a musician as a primary occupation in 1996, (2) with nearly three in five working part-time. This is very likely to be a substantial underestimate, since it is based on the Current Population Survey, which asked the individual for the occupation with the highest number of paid hours. In addition, there are a large but unknown number of musicians for whom music is a second job (such as some church organists, club or wedding bands, and community symphony members), an even larger number of amateur musicians who play for recreation, and students (many of whom are working at other jobs). The specific category of "musicians and composers" is reported as including 39.7% women, 10.8% blacks, and 7.2% Hispanics. (4)

Three out of five professional musicians were part-time in 1996, (2) and they often receive low wages for their music work. Many musicians are unable to support themselves on income from performances alone and therefore have second jobs. Risk factors accrue from both positions, and if they overlap (such as piano playing and computer keyboard work appear to), this may lead to further risk. If UEMSD occur, the conditions can have an impact on the performance of both occupations, and musicians have had to either end or seriously curtail their music careers as a result. (4,5) Full-time musicians are known to have a very high attack rate for UEMSD from the few...