Performing arts medicine - instrumentalist musicians part I - general considerations

Performing arts medicine is a relatively new specialty addressing the medical needs of dancers, musicians, ice skaters, and gymnasts. This paper focuses on the role of healthcare providers in the diagnosis and therapeutic management of instrumentalist musicians. Musicians are at high risk for developing painful musculoskeletal problems, including pain and overuse injuries, entrapment and peripheral neuropathies, and focal dystonias. Musicians' careers are threatened, when they are no longer able to play their instrument because of pain and dysfunction. To appreciate music-related injuries, it is important that clinicians are familiar with the context of musicians' injuries and disorders. This is the first paper in a series of three. This paper discusses the importance of taking an extended history. The typical history procedures need to be broadened when interviewing musicians, and should include instrument-specific questions, and questions regarding practice habits, education, repertoire, and employment. The second article addresses the physical examination, while the third article provides three case reports of musicians with hand problems, which serve to illustrate the points made in the first two articles. The articles are illustrated with several tables and photographs of musicians to assist the reader in assessing instrumentalist musicians and determining the most appropriate course of action.