Most of Australia's finest musicians are suffering for their art, according to new University of Sydney research.
More than 80 percent of 377 professional orchestral musicians surveyed reported having experienced physical pain severe enough to impair their performance.
Fifty percent of the musicians reported moderate to severe performance-related anxiety while 32 percent had symptoms of depression.
The findings, published in the Psychology of Music online, are based on the first study to examine the relationship between self-reported performance-related pain, performance anxiety, and depression in professional musicians.
The research was undertaken by Professor Dianna Kenny of the School of Psychology in the Faculty of Science and Dr Bronwen Ackermann, School of Medical Science.
Their study of members of the eight state and opera orchestras in Australia has implications for how best to treat performance-related pain.
"The survey found 84 percent of professional classical musicians have experienced pain severe enough to interfere with their performance. Half of those surveyed reported that they were currently experiencing pain," Professor Kenny said.
"There is a strong relationship between the severity of performance-related pain and music performance anxiety. Those reporting more severe pain also reported higher music performance anxiety."
Music performance anxiety can manifest itself as trembling, shaking, elevated blood pressure and heart rate and cognitively as dread, worry, rumination or catastrophic thinking.
"Seventy-five percent of the musicians showed the expected relationship between pain and depression. Those reporting no depression were also more likely to report little to no pain. Those reporting some depression reported higher levels of pain," she said.
Professor Kenny believes the respondents who reported pain but not depression warrant further investigation.
"Of most significance was a group of 25 percent of respondents who did not report depression but reported the highest pain severity.
"These results suggest some musicians might somatise their pain. This means that they may convert their psychological distress into muscle tension which leads to physical pain.
"The implication of these findings is that physically based treatments of performance-related musculoskeletal pain that do not address associated anxiety and depression might not prove to be effective," Professor Kenny said.
The research paper by Dianna Kenny and Bronwen Ackermann is titled 'Performance-related musculoskeletal pain, depression and music performance anxiety in professional orchestral musicians: A population study'.
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