gms | German Medical Science

Objectives/Interrogation: There are no standard methods of treatment for musicians with hand and wrist problems interfering with their ability to play. Many are treated conservatively, either symptomatically or with physical/occupational hand therapy. As there is little scientific data on the subject, it was the authors' aim to retrospectively analyze and compare the patient-perceived impact of these therapies.

Methods: 58 patients (31 female, 27 male, mean age 46 years) who visited the music-medical outpatient clinic between 01/15 and 02/18 were surveyed, using a previously developed questionnaire on pain and impairment (on a numeric rating scale (NRS) of 0 to 10), plus epidemiological data [1]. Exclusion criteria were surgery, a history of specific hand trauma and failure to contact by the third try. The primary outcome was defined as an improvement of at least 3 points on the NRS.

35 patients were professional musicians, 9 university music students, 7 retired, 6 amateurs and 1 high-school student preparing for university auditions. 27 played string instruments, 15 piano, 2 woodwinds, 5 plucked, 1 percussion and 8 two or more instruments. Playing time per day averaged at 2.9 hours. 33 received physical/occupational hand therapy, 25 were treated symptomatically (e.g. rest and pain medication), based on individually evaluated, patient-specific criteria such as severity and duration of symptoms, plus expected compliance and time of recovery.

Results and Conclusions: Of 33 patients who followed at least 6 sessions of hand therapy, 24 reported an improvement in pain and 25 in impairment. For the 25 patients treated symptomatically, it were 15 (pain), respectively 13 (impairment).

29 patients changed their playing and practicing habits after hand therapy, 13 after symptomatic treatment. Alterations included longer and more frequent breaks, warming-up and cooling-down periods, use of relaxation techniques, increase of awareness to the physical limitations of practicing, and changes to position, playing technique and literature.

This is one of the largest numbers of musicians ever surveyed after following hand therapy and the only perceived-outcome comparison of hand therapy and symptomatic treatment. The response to hand therapy was good and the self-perceived impact positive. In contrast, patients treated symptomatically reported a less favorable outcome.

This analysis will build a base for future research, such as a specific hand therapy regime for musicians with hand or wrist problems interfering with their ability to play.