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Hand pain attributed to overuse among professional pianists: a study of 200 cases

Naotaka Sakai
From: Medical Problems of Performing Artists: Volume 17 Number 4: Page 178 (December 2002)

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Abstract: Two hundred professional pianists and students with hand pain (35 men and 165 women; 102 right, 62 left, and 36 bilateral; with a mean age of 26.3 years) attributed to overuse while playing the piano were investigated. The diagnoses were divided into six groups: tenosynovitis or tendinitis (56 cases), enthesopathy (49), muscle pain (38), neurological disturbance (28), joint pain (24), and neck or scapular pain (5). Tenosynovitis or tendinitis included de Quervain's disease (29), flexor tenosynovitis (17), and tendinitis of the extensor digitorum communis (6). The enthesopathy group consisted of lateral epicondylitis (27), medial epicondylitis (7), olecranon pain (4), and distal pain of the flexor carpi radialis or ulnaris (8). Muscle pain was seen in the digital extensors (12) and flexors (5) of the forearm, the thenar muscle (8), the hypothenar muscle (6), and the interossei (6). Finger joint pain was noted in the proximal interphalangeal joint (15), metacarpophalangeal joint (6), and first carpometacarpal joint (1). Neurological disturbance included focal dystonia (18), cubital tunnel syndrome (8), and carpal tunnel syndrome (2). Seventy subjects stated that they were practicing some specific keyboard techniques at the onset of their overuse trouble; octaves (30 cases) and chords (22), which require hyperabduction of both the thumb and the little finger, accounted for 74% of these techniques.

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