After an excruciating three-hour recording session on the Beatles’ White Album, drummer Ringo Starr screamed, “I got blisters on my fingers!” His exclamation was captured at the end of the song Helter Skelter. Well, blisters and calluses are just a couple of the minor occupational hazards for musicians. But other than that, what could be the danger in strumming a guitar or blowing a horn, right? You watch a string quartet perform and may remark on their virtuosity and dramatic instinct, but you probably wouldn’t say, “Oh no, somebody’s gonna get hurt.” But making music is a complex neuromusculoskeletal process; over time, the repetitive motion and unnatural positions required can take a toll on the performer’s health. Following are 10 of the serious health issues that plague this occupational group.
10. Trigger Finger and Carpal Tunnel Syndrome
The complex, multi-fingered organ at the end of your arm — the hand — takes the brunt of punishment inflicted by a merciless musical passion. One of the most common injuries incurred is an inflammatory disorder of the tendon, often called trigger finger (stenosing tenosynovitis). When this occurs, the finger or thumb is painful to bend, and once bent, may lock into place. Fortunately, it is often successfully treated with anti-inflammatory medication, injections, acupuncture, or, as a last resort, surgery. Guitarist Eddie Van Halen underwent surgery in 2009 when his thumb and little finger locked up. In Van Halen’s case, a cyst, bone spur and twisted tendon caused the inflammation. He regained full use of his hand.
Carpal tunnel syndrome, so often associated with production-line workers and those working at a keyboard all day, can affect musicians as well. Making the same hand motion over and over again puts pressure on the median nerve, causing tingling, numbness and weakness in the thumb and three fingers (another nerve operates the pinky finger so it’s not affected). For guitar players, carpal tunnel syndrome usually happens on the left hand, while brass players feel pain on the right. This is one of the occupational “overuse injuries.”
9. Musician’s Cramp
Musician’s cramp, easily misdiagnosed as a stress injury, is actually a neurological condition. Technically known as focal dystonia, it occurs when the brain sends incorrect information to the muscle, causing involuntary contractions. It can affect any profession that performs repeated hand movements, but it is most common among musicians. Our hands evolved primarily for grasping. Developing the kind of dexterity needed to attain high-level musicianship can overload the sensory imaging in our brains. Imagine the musician’s horror when his hands seem to possess a mind of their own! It can be a real career killer. Concert pianist Leon Fleisher, recipient of the Kennedy Center Honors in 2007 and “Instrumentalist of the Year” award by the Royal Philharmonic Society in 2010, was afflicted with musicians’ cramp. The condition forced him to leave the concert stage for more than 20 years; he was finally properly diagnosed and treated, at which time he made an inspiring comeback. Many musicians with focal dystonia have gone to heroic lengths to cling to their art.
The Dystonia Society reports that some right-handed violinists have made a heroic effort and learned to play left handed. Unlike Parkinson’s disease, a more extensive motor-control disorder, musician’s cramp is task-specific; it ceases when the musical instrument is not being used.
8. Upper-Extremity Overuse Syndrome
Many violinists and violists report numbing, tingling and “a cold feeling” along the left arm and fingers, along with a dull ache in the elbow. This condition can often be overcome by rest and improved technique. If, on the other hand, it is a result of genetic vulnerability, it can be career threatening. One violist interviewed for a study of this issue complained of weakness in her ring and little finger, making it necessary to use alternate fingering in her playing.
7. Neck and Back Pain
Sitting at the keyboard, leaning slightly forward and looking down at the hands, causes a static contraction of the upper trapezius, the muscle in the upper back that allows us to move the shoulder blade and neck. Over time, symptoms can develop, including chronic back and neck pain.
6. Rotator Cuff Tendinitis
Here’s a condition that swimmers and pitchers share with the sedentary cello player. The symptoms include pain and swelling in the front of your shoulder. It causes a lack of mobility and a pain so severe it can wake you from sleep.
5. Substance Abuse
The strung-out rocker or jazzman is such a ubiquitous stereotype, it is tempting to be flippant about this tragedy. Too much free time, too much money, too many hotel rooms and life on the road, peer pressure, parties, opportunistic dealers and too much permissiveness, all conspire to lure young and immature musicians into the abyss of addiction. The names of those who have succumbed to this occupational hazard could fill a long granite wall — a memorial to those who threw it all away.
Some artists have drawn inspiration from their struggles with drugs and alcohol. Neil Young’s moving Needle and the Damage Done is a case in point, along with the hauntingly powerful Signed D.C. by Arthur Lee of Love. Lee’s music wasn’t as well-known as it might have been had he toured in support of several excellent albums released by Love in the 1960s, but an intense fear of flying kept him earthbound. In that sense, drugs did help the creative process, but only in hindsight. Stereotype aside, most musicians today are too busy working and supporting a family to get high on a regular basis.
4. Nerve Compression
After seeing the violinist, an odd grimace on her face, fiddle jammed into her neck, you’ve maybe wondered, “Is that natural?” We may marvel at the sound coming from it, at the way the music seems “discovered” and natural rather than composed, but the creative process requires some decidedly unnatural physical contortions to produce those sounds we love. An example of the resulting condition is thoracic outlet syndrome, which is nerve or blood vessel compression at the base of the neck.
3. Insomnia and Other Sleep Disorders
A recent study found a higher incidence of sleep problems among performing musicians as compared to the general population. Surprisingly, this problem was most prevalent among classical, country and rock players. Perhaps insomniac Lady Gaga should croon a few bars of Come Rain or Come Shine before retiring for the evening. Maybe jazz players just don’t notice insomnia because they’re up all night anyway.
2. Hearing Problems (Hyperacusis and Tinnitus)
If Beethoven were a contemporary keyboard player, he may have hooked up on gigs with Eric Clapton or Pete Townsend, Ozzy Osbourne or Brian Wilson, all of whom shared his experience with hearing loss, although not quite as severe. On the other hand, the mere suggestion may have had him rolling over. In any case, noise more than 85 decibels can damage the hair cells in the inner ear, bones in the middle ear or, in extreme cases, rupture the eardrum. A rock concert is often measured at 120 decibels. On the other hand, will.i.am from the Black Eyed Peas claims making music cured his hearing problem, the tinnitus that caused the incessant ringing in his ears. Isn’t it ironic.
1. Mental Health Issues
True, many musicians may be born with this malady. It has been said that, “there is no great genius without a touch of madness.” The origin of that quote is lost in time, but as it is sometimes attributed to Aristotle, clearly people observed long ago that creative individuals may be eccentric. One recent study from the UK’s University of Westminster found that musicians were three times more likely to suffer from depression than the general public. The study focused on “working” musicians, those who have to deal with the stress of the business of music, and the pressure to be creative on a deadline.
The common theme among observers is that creative people are “emotionally fragile.” Of course that doesn’t address the existence of the exceptions to the rule, the great musicians who are perfectly sane. It has been said that extreme statements require extreme evidence, which is not abundant on this subject. However, Frank Zappa appeared to live a normal life. Of course, he did name his children Moon Unit and Dweezil.
A poignant postscript is that musicians, being generally self-employed with erratic incomes, are also on the list of those who are chronically uninsured.
(Slideshow photo credit: Irina Long)