Rheumatic and musculoskeletal disorders in musicians: risks, adaptations and management

Music therapy is recognised as a complementary or alternative therapy for osteoarthritis and fibromyalgia, but playing music can have health repercussions for musicians in the field of rheumatology.Limited articles exist on artists developing rheumatic diseases before 1900, possibly due to underestimation, poor understanding or a lack of awareness. Conditions like Marfan syndrome may confer hypermobility-enhancing virtuosity, as seen in Paganini and Rachmaninov.Among contemporary musicians, Edith Piaf, Lady Gaga, Selena Gomez and Céline Dion suffered from rheumatic diseases, and it was true obstacles for their careers.Repetitive movements, inadequate posture and instrument-specific physical demands contribute to musculoskeletal disorders in musicians, particularly tendinopathies and entrapment syndromes affecting the upper limbs. These conditions result in chronic pain, reduced mobility and performance decline. String and wind instrument players face heightened vulnerability due to the unique constraints of their instruments.Given the longevity of musical careers compared with athletic ones, specialised medical management and targeted prevention strategies are crucial. Minimising the impact of these conditions is paramount to ensuring musicians can maintain optimal performance and extend their careers under the best possible conditions, enabling a preventive approach, follow-up and specialised care for as long as needed. Therefore, further exploration of rheumatic diseases in musicians is warranted, particularly with an emphasis on the evolution of medical knowledge and clinical practices. These pathologies are complex and require specific treatment. Some European health professionals and musicians are training in the practice of 'arts medicine'.