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Feature Christmas 2008: Music

A symphony of maladies

BMJ 2008; 337 doi: (Published 12 December 2008) Cite this as: BMJ 2008;337:a2646

This article has a correction. Please see:

  1. Sarah Bache, core surgical trainee 1 in plastic surgery 1,
  2. Frank Edenborough, consultant respiratory physician1
  1. 1Northern General Hospital, Sheffield S5 7AU
  1. Correspondence to: S Bache sarahbache{at}

    Sarah Bache and Frank Edenborough uncover scores of health problems associated with making music

    Key points

    • Touring with a band or orchestra may lead to disrupted routines, late nights, poor food, reduced exercise and stress, all of which take their toll on general health

    • The instrument itself, as result of its composition, weight, and shape, together with the force required to play it and the prolonged and repetitive nature of practice, may lead to a host of instrument specific injuries

    • Overuse syndromes, focal dystonias, dermal sensitisation, and respiratory, oropharyngeal, and cardiovascular anomalies may result

    • Minor injuries are amplified by the precision required to play at the highest standard and may be career threatening

    Classical musicians have never been considered a daredevil bunch, and playing classical music is one of life’s more genteel pastimes. Yet the perils of the seemingly innocuous activities of the orchestra have long been a closely guarded secret. Fearful of being exposed as weak and jeopardising their place in the orchestra—or worse, their livelihood—musicians often suffer in silence rather than advertise their injuries. As two interested musicians, we carried out a Medline search of the available medical literature and scoured the internet for supportive organisations. We discovered the dangers hidden within the confines of the orchestral practice room; we also briefly looked at the dangers associated with other types of music making. Welcome to the world of fiddler’s neck, laryngeal blowouts, and Satchmo’s syndrome.

    Musicians who tour have unique stresses placed on their health, many of which are well documented on the website of the Performing Arts Medicine Association.1 Hours of travel disturbing the normal circadian rhythm, lack of healthy food and exercise, time spent away from home and family, and the pressures of maintaining performance excellence2 and of stage fright all take their toll on physical …

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