Depression and music performance anxiety are associated with severity of performance related musculoskeletal pain in professional orchestral musicians

We examined self-reported frequency and severity of performance related musculoskeletal pain (PRMD), trigger point pain (TPP) and depression, social phobia (SPIN), and music performance anxiety (MPA; Kenny Music Performance Anxiety Inventory, K-MPAI) in a cross-sectional survey of 377 professional orchestral musicians. Most (84%) musicians had experienced performance impairing pain; 50% reported current pain. Females reported more performance-impairing pain and more current pain than males. Cluster analysis indicated a complex relationship between depression and PRMD severity. Three clusters showed the hypothesized relationship (i.e. more depression, more pain). Musicians in the fourth cluster denied depression but reported the most severe pain, suggesting a group who somatize their psychological distress. Cluster analysis also revealed a strong relationship between PRMD severity and MPA. Clusters with higher scores on K-MPAI reported higher scores on PRMD severity. TPP was not associated with self-reported PRMD frequency or severity. There was a significant linear relationship between TPP and MPA for females, but males scoring the highest MPA reported lower TPP than those with milder MPA. Neither SPIN nor beta blocker use were associated with PRMD frequency or severity. The complex relationships identified between PRMD, TPP, depression, and MPA may have important implications for PRMD management in professional musicians.