Professional musicians are susceptible to a number of occupational conditions, including task-specific focal dystonia. Dystonia is a neurological disorder characterised by involuntary muscle contractions and postures.
The term focal indicates that the dystonia a single, specific area of the body. The term task-specific indicates that the symptoms only occur when the individual is completing a particular task, such as playing a musical instrument.
Experts estimate that 1-2% of professional musicians are affected by dystonia, but there are likely large numbers of musicians living with symptoms who remain unidentified. Almost all individuals with musician’s dystonia are classically trained, and most are male.
The first signs of musician’s dystonia are lapses in the usually instinctive ability to perform on the instrument. Musicians may perceive the early symptoms of dystonia as a result of faulty technique or insufficient preparation.
Musician’s dystonia is triggered by playing the instrument and does not typically affect other activities. The top three musical instruments associated with musician’s dystonia are piano, guitar, and brass instruments.
Pianists typically develop symptoms in the right hand, often affecting the fingers. String players usually experience symptoms in the left hand. Guitarists and percussionists may develop symptoms in either hand. Woodwind players may develop symptoms in the hands, face or mouth. Brass players are usually affected in the corners of the mouth and jaw.
There is typically no pain associated with musician’s dystonia.
Because musician’s dystonia is a neurological disorder the aim of treatment is to help the nervous system relearn the ability to complete specific movement tasks without triggering dystonia.
The origins of musician’s dystonia are being researched by scientists around the world. As a person develops and learns movement tasks, these movements are stored in the brain as sensory motor programs. Musician’s dystonia somehow corrupts the sensory motor programs associated with playing the instrument.
Although there is no cure for musician’s dystonia at this time, several options exist.
Embouchure dystonia is a type of dystonia that affects brass and woodwind players. Embouchure dystonia targets muscles in the mouth, face, jaw, and tongue.
The involuntary, abnormal movements associated with embouchure dystonia are often very subtle and occur only when the musician is playing, buzzing into mouthpiece, or forming the embouchure.
Symptoms of embouchure dystonia may include air leaks at the corners of the mouth sometimes accompanied by a tremor, and involuntary contractions of the muscles in the face.
Treatment may include rehabilitative methods that attempt to retrain the nervous system to perform on the instrument without triggering symptoms, oral medications, and botulinum toxin injections. administered by an experienced doctor.
A neurologist who specialises in movement disorders is typically the most appropriate doctor to diagnosis to treat embouchure dystonia.
Focal hand and limb dystonia is characterised by involuntary, abnormal movements in the hands and/or fingers. Hand dystonia is seen in pianists, string players, guitarists, percussionists, and woodwind players.
Symptoms of hand dystonia may include subtle loss of control in fast passages, lack of precision, curling of the fingers “sticking” to keys involuntary flexion of the thumb in strings, and tremor.
Musician’s hand dystonia is highly task specific, and may have a prominent sensory component. For example, a pianist may experience symptoms with playing on ivory keys but not plastic keys.
Treatment may include rehabilitative methods that attempt to retrain the nervous system to perform on the instrument without triggering symptoms, oral medications, and botulinum toxin injections administered by an experienced doctor.
A neurologist who specialises in movement disorders is typically the most appropriate doctor to diagnose and treat hand dystonia.