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Patterns of Pain Location in Music Students: A Cluster Analysis

 Welcome back to Musician's Journal Club, where each week we explore a piece of scientific literature relating to musician health. This week's article was a very recent article from February 2021 in the journal BMC Musculoskeletal Disorders entitled Patterns of pain location in music students: a cluster analysis. Many studies have investigated prevalence of playing-related pain in musicians, but this study attempts to identify what injury patterns exist in music students to identify the most common pain locations and combinations of symptoms.


Playing-related pain has been shown to be highly prevalent in both student and professional musicians, with the lifetime prevalence of musculoskeletal pain being estimated between 41% and 93% in professional musicians. In music students, the point prevalence is estimated to be 63% and the 1-year prevalence is estimated between 65% and 89%. Up to 40% of students experiencing playing-related musculoskeletal pain had some disabling impact from their pain. In previous studies, the most commonly identified sites for playing-related pain were the shoulders, neck/throat, back, and fingers.


This cluster analysis found five primary clusters of homogenous pain patterns. These are wrist pain, right shoulder pain, left shoulder pain, neck and back pain, and widespread pain. In general, women reported significantly more musculoskeletal pain than men and were more likely to be in the widespread pain cluster. Students who played instruments where both arms are elevated on the left (high string instruments) were more frequently in the left shoulder pain group, and a higher percentage of singers were in the neck and back pain group. Widespread pain was correlated with higher psychological distress and lower reported self-efficacy. Across all groups, there was a common belief that pain was related to playing the instrument, but this belief was even more prevalent in the widespread pain group.


Survey results showing that of respondents, most common self-identified pain clusters were the wrist and neck/back, but at least 50% of respondents reported pain in each of the 5 areas studied. 82% of respondents said that pain interfered with their ability to play their instrument.


Reflection

While there was not quite as much involvement in the survey questions this week, with an average of 27 views and 11 responses for each, there was greater involvement in posts, as the three main posts for this week's article had a combined 33 likes. My follower count grew 12% this week to 120 followers. 

Based on responses from the survey I did last week showing that most of my followers were primarily interested in musculoskeletal health and some in mental health, and the engagement with this week's posts, I have decided to tailor this project more toward musculoskeletal health. This is the area of musician health with some of the most existing literature, and an area I personally am most comfortable with. I also get the best responses in musculoskeletal health posts, so I believe that this is the most useful area for me to provide insight. Another recent change I made is to add a glossary to the blog posts to further explain some of the scientific terms used in the papers and that I use to present summaries. I am hopeful that these changes will increase the accessibility of this project to musicians with less scientific background.

Glossary

  • Lifetime prevalence - percent of individuals who will be affected by a condition at any point in their lives (eg. percent of professional musicians who experience playing-related pain at any point during their career)
  • Point prevalence - percent of individuals affected by a condition at any single point in time (eg. percent of music students experiencing playing-related pain on one specific day)
  • 1-year prevalence - percent of individuals affected by a condition at any point over the course of a year (eg. percent of music students who experience playin-related pain at least once in one year)
  • Disabling impact - limitation of one's ability to perform normal activities as a result of a condition (eg. a musician having to restrict practice time as a result of playing-related pain)
  • Cluster analysis - a statistical analysis that organizes data into discrete groups with highly similar values (eg. the wrist pain cluster was identifies as a large subset of respondents who reported significantly higher pain than all other respondents in the wrist but reported pain levels within the average for the group for all other areas)
  • Widespread pain cluster - cluster consisting of individuals with significantly higher than average pain reported in multiple locations on the body
  • Correlation (correlated) - when different values in one factor are associated with different values in another factor (eg. being in the widespread pain group is associated with higher psychological distress), but importantly there is no known causational relationship (we can't determine if increasing psychological distress would cause widespread pain or or increasing pain would heighten psychological distress)

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