Arm- und handspezifische Beschwerden, angstbedingte Vermeidungshaltung und Schmerzverhalten professioneller Orchestermusiker: Hohe und Tiefe Streicher

Introduction. Professional musicians, especially string players, are at increased risk of health problems due to the intense and continuous physical strain of practicing, rehearsing and performing for several hours. The stress particularly affects the hand, shoulder and neck areas, although this can vary depending on the type of instrument. The strain can affect both professional and private quality of life. The aim of the study was to investigate the hand-specific and arm-specific stresses on string players. Methods. From January 2016 to August 2018 a prospective cross-sectional study was conducted with 60 professional string musicians from 6 German orchestras. The stressors and strains of professional musicians in the string group were assessed using a comprehensive catalogue of questionnaires on sociodemographic data, professional situation, sporting activities as well as general health, health measures, hand strain and hand-specific complaints (Michigan Hand Outcome Questionnaire; MHQ), pain coping (Pain Behavior Questionnaire; FSV), fear-related avoidance behavior (Fear Avoidance Belief Questionnaire; FABQ) were recorded and analyzed according to instrument type. Results. The average age of the 60 professional musicians was 43.9 +/- 13.1 years. There were 61.7% men in the sample. Chronic tension in the shoulder and neck area was found in 34.8% of violinists, while 52.2% suffered from acute shoulder pain. Of the double bass players one half and one third stated that they suffered from acute or chronic tendonitis (self-diagnosis), respectively. The average total score on the MHQ was 56, indicating moderate hand strain. There were significant differences in complaints between the instrument groups: violinists reported more neck tension and shoulder pain, while double bass players and cellists complained more about problems in their wrists and thumbs. The FABQ results showed that 7 musicians had an increased risk of avoidance chronicity due to pain. Discussion. The results underline the significant instrument-specific health risks that professional string musicians are exposed to, particularly in the area of the upper extremities and illustrate the need for compensatory and preventive measures to ensure long-term health and ability to work. More intensive occupational medical care in orchestras could also help to reduce the risk of chronic symptoms and improve the musicians' quality of life.