Performance-Related Musculoskeletal Disorders in Musicians: An Integrated Orthopaedic and Radiological Perspective

Published Date: 26th October 2025

Publication Authors: Iyengar. KP

Abstract

Instrumental musicians, whether performing in Western orchestras or Indian classical traditions, face a high risk of performance-related musculoskeletal disorders (PRMDs), which manifest as pain, weakness, numbness, or tingling that impair their ability to play at their accustomed level. With a lifetime prevalence of 60%-90%, PRMDs result from repetitive motions, awkward postures, forceful exertions, and, occasionally, vibration inherent to specific instruments. This chapter integrates orthopaedic principles-encompassing epidemiology, biomechanics, diagnostics, management, and prevention-with radiological insights to enhance diagnostic precision through advanced imaging modalities like MRI, ultrasound, and X-ray. It emphasizes instrument-specific stressors, particularly those affecting Indian classical musicians who adopt cross-legged or kneeling postures, which pose unique biomechanical challenges. Clinicians diagnose PRMDs using detailed, instrument-specific history, thorough physical examinations, and targeted imaging to identify underlying pathologies. They prioritize conservative management, including physiotherapy, ergonomic retraining, and activity modification, reserving surgical interventions for severe or refractory cases. Emerging technologies, such as wearable sensors, support preventive strategies to ensure sustainable musical careers. This multidisciplinary approach equips clinicians with a robust framework to manage PRMDs effectively, safeguarding musicians' health and professional longevity.

Iyengar. K.P.; Et al. (2025). Performance-Related Musculoskeletal Disorders in Musicians: An Integrated Orthopaedic and Radiological Perspective. In: Bhamidipaty, K.D.P,; Botchu, R.; Bhamidpaty, V. (Ed). Injuries in Musicians - Imaging and Management. New York: Springer. pp.105-122.