The relationship between musicianship and pain. Is chronic pain and its management a problem for student musicians only?

Abstract

Introduction: The neuro-biological side of chronic pain research has presented reliable evidence of distinct cortical and spinal alteration compared to healthy individuals. Furthermore, research suggests that musicians are especially vulnerable to pain, and recent neurological investigations into musicians' brain plasticity support this hypothesis. However, chronic pain is not acute pain plus time, but a separate condition, and little is known about musicians' chronic pain-related emotions and behaviors. This knowledge, however, is a crucial step in understanding how chronic pain is processed by musicians.

Methods: This study investigated pain catastrophizing as a critical pain-related behavior and emotional concept alongside six complementary variables: anxiety, depression, depersonalisation, burnout, coping strategies and professional identity.

Results: 103 under- and postgraduate students from various higher education institutions participated in an online survey. Students were allocated into three groups according to their main study subject and type of institution: music college musicians, university musicians and university non-musicians. A tree model confirmed the current chronic pain multifactorial model, suggesting a combination of several variables before catastrophizing pain. Group testing, however, showed that university non-musicians' pain catastrophizing was significantly worse especially when compared to music college musicians. Music college musicians and university musicians were less prone to maladaptive pain processes, despite perceiving pain for significantly longer.

Discussion: This novel finding indicates that chronic pain does not inevitably lead to dysfunctional pain processing for musicians and should be reflected accordingly to optimize pain-control. The biopsychosocio model of chronic pain provides a robust framework for future research in this population.

Keywords: chronic pain; emotions; music students; pain catastrophizing; pain-related behavior.

Figure 1

Violin plot for the Orebrö Musculoskeletal pain screening representing the group distribution for music college musicians, university musicians and university non-musicians, including box plot with mean points (diamond shape) and a dotted cut-off lines at ≥105 for moderate and at ≥130 for high pain catastrophising.

Figure 2

Boxplot for MIMS subscales (self-identity, social identity, negative affectivity, and exclusivity) comparing professional identity for music college musicians and university musicians; significant differences marked by asterisks.

Figure 3

Tree model predicting the combination of variables needed for a high likelihood of pain catastrophizing. Following the boxes from top to bottom, the highest likelihood combination (i.e. the most significant predictor pathway) is anxiety, social identity, personal burnout, < 29 years of age, cognitive functional abilities and burnout with fellow students.