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I evaluated 226 instrumentalists for playing-related symptoms.There were 103 players(46%)of string instruments,73 keyboard instrumentalists(32%),44 players(19%)of wind instruments,and 6 percussionists(3%).The mean age was 32 years;58%were women.Sixty-five patients(29%)had a peripheral nerve disorder;27 had symptoms of thoracic outlet syndrome,12 had median neuropathies(carpal tunnel syndrome in 9);9 had ulnar neuropathies;6 had cervical radiculopathy;5 had digital neuropathies;3 had cranial neuropathies;and 3 had other peripheral nerve disorders.Treatment consisted of modification of playing schedules and technique,plus physical and occupational therapy in 51 and surgical procedures in 9 patients;5 were not treated.Follow-up at 1 to 8 years showed 74%had a satisfactory result,14%had slight or minimal improvement,and 12%had no improvement.At the time of writing,all but 4 patients remained in the music profession.It is concluded that playing-related symptoms among instrumentalists are frequently neurological in origin and that the large majority can be helped by conservative or,on occasion,surgical means. |
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