Overuse syndrome in musicians--100 years ago. An historical review

Overuse syndrome in musicians was extensively reported 100 years ago. The clinical features and results of treatment, which were recorded in considerable detail, match well the condition that is described today. The medical literature that is reviewed here extends from 1830 to 1911 and includes 21 books and 54 articles from the English language literature, apart from two exceptions; however, the writers of the day themselves reviewed French, German and Italian literature on the subject. The disorder was said to result from the overuse of the affected parts. Two theories of aetiology, not necessarily mutually exclusive, were argued. The central theory regarded the lesion as being in the central nervous system, the peripheral theory implied a primary muscle disorder. No serious case was put forward for a psychogenic origin, though emotional factors were believed to aggravate the condition. Advances in musical instrument manufacture--particularly the development of the concert piano and the clarinet--may have played a part in the prevalence of overuse syndrome in musicians. Total rest from the mechanical use of the hand was the only effective treatment recorded.