Performance-related Pain and Disability among Music Students Versus Professional Musicians: a Multicenter Study using a Validated Tool

Ana Zão; Eckart Altenmüller; Luís Azevedo

doi:10.1093/pm/pnae032

Performance-related Pain and Disability among Music Students Versus Professional Musicians: a Multicenter Study using a Validated Tool

Pain Med. 2024 Apr 27:pnae032. doi: 10.1093/pm/pnae032. Online ahead of print.

Authors

Ana Zão^{1

2

3

4}, Eckart Altenmüller⁵, Luís Azevedo^{1

2

6}

Affiliations

¹ Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.
² Center for Health Technology and Services Research (CINTESIS) and Associate Laboratory-Health Research Network (CINTESIS@RISE), Porto, Portugal.
³ Chronic Pain Unit and Physical and Rehabilitation Medicine Department, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar-Universidade do Porto, Porto, Portugal.
⁴ International Center of Arts Medicine, Porto, Portugal.
⁵ Institute of Music Physiology and Musician's Medicine; University of Music, Drama, and Media, Hannover, Germany.
⁶ Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS) at FMUP, Porto, Portugal.

PMID: 38676668
DOI: 10.1093/pm/pnae032

Abstract

Objective: To evaluate prevalence of performance-related pain among musicians and compare pain characteristics, associated disability and approach to pain management, between music students and professional musicians.

Methods: A multicenter cross-sectional study was performed in a multi-stage stratified cluster random sample of 585 musicians, stratified by music students (294, among which 234 were at pre-university level and 60 at university level) and professional musicians (291). The main outcome was performance-related pain, measured by Performance-related Pain among Musicians Questionnaire (PPAM). Secondary outcomes were: pain management approach, physical activity levels, fatigue, distress, and health-related quality of life.

Results: The lifetime prevalence of performance-related pain was 55.0% (n = 322), being significantly higher among professionals (57.5% versus 42.5%, p < 0.001). Pain intensity scores were significantly higher in professional musicians (p < 0,05), but pain interference in performance was higher among music students, who also reported significantly higher levels of fatigue (p = 0.008) and distress (p < 0.001), and lower quality of life (p < 0.001). Regardless of the high levels of pain intensity and interference, fatigue, anxiety and depression, and low levels of quality of life, 33% musicians who developed pain had never looked for healthcare (this proportion is significantly higher for music students, 57%, p < 0.001).

Conclusions: We present the first multicenter study on performance-related pain among musicians with different backgrounds, using a validated tool, and distinguishing music students from professional musicians. Performance-related pain is a highly prevalent and disabling condition among musicians, however, its proper evaluation and management are still often underappreciated, contributing to significant impairments and reduced quality of life.

Keywords: disability evaluation; musicians; pain.