Playing posture, instrument characteristics, and musculoskeletal pain among adolescent wind instrument players: an exploratory cross-sectional study

BACKGROUND: Playing-related musculoskeletal disorders (PRMDs) in musicians commonly develop around the neck-and-shoulder region and the low back. This study investigated the onset of neck-and-shoulder and low-back pain among wind instrument players in a high school brass band and examined how instrument weight and playing posture relate to the occurrence, severity, and duration of such pain. METHODS: This exploratory cross-sectional study included 120 high school wind instrument players who completed a questionnaire survey regarding their experience with playing-related pain in the neck-and-shoulder region and low back, and pain severity and duration while playing the instrument. The chi-square test was used to determine the possible relationships between the study parameters and playing posture and instrument weight. RESULTS: A total of 82 students (68.3%) experienced pain in the neck-and-shoulder region, whereas 53 (44.2%) experienced low-back pain. A significantly higher proportion of students who played light instruments reported low-back pain compared with those who played heavy instruments (p < 0.05), possibly reflecting sustained unsupported playing postures required for many light instruments. Moreover, a significantly higher proportion of participants with an asymmetrical playing posture reported moderate-to-severe low-back pain (NRS ≥ 4) lasting ≥ 3 months than those with a symmetrical playing posture (p < 0.05). Although asymmetrical posture was observed across all instrument groups, these findings suggest that posture-related factors may contribute to the persistence of low-back pain. Instrument weight and playing posture were not significantly associated with pain severity or duration in the neck-and-shoulder region. CONCLUSIONS: This exploratory cross-sectional study found that instrument weight and playing posture were not significantly associated with neck-and-shoulder region pain. However, more students who played light instruments had low-back pain compared to those who played heavy instruments. Moreover, an asymmetrical playing posture was associated with greater severity and longer duration of low-back pain. These results suggest that asymmetrical playing posture may be associated with greater biomechanical demands on the low back during performance, even among light-instrument players, and highlight important implications for the prevention of PRMDs and education for high school wind instrument players.