Understanding self-management and digital health needs in musicians with playing-related musculoskeletal disorders: an explanatory sequential mixed-methods study

Clinical Snapshot

Key Findings

• Effect Size: Not applicable — qualitative and descriptive study; no effect sizes calculated

• Primary Outcome: Barriers to PRMSD self-management included limited music-specific health education during training, financial and time constraints, and insufficient accessible resources. Facilitators included music-aware healthcare professionals, personalised instrument-specific support, and peer networks. DHI preferences included self-assessment tools, automated reminders, health tracking, motivational features, peer support forums, and multimedia resources organised by condition or symptom stage.

• Nnt Or Sensitivity: Not applicable — exploratory needs assessment; no intervention tested. Key descriptive statistics: 38% experienced PRMSD symptoms interfering with playing >5 times in 5 years; 67% continued playing while symptomatic; 24% reported 3–5 episodes; 38% reported 0–2 episodes.

Clinical Application

The study's recommendations — music-aware clinicians, instrument-specific personalisation of digital tools, peer support integration — are feasible to implement in DHI design but require significant co-design investment. Integration into existing physiotherapy or occupational health pathways for musicians is clinically feasible. The identified preference for self-assessment tools and health tracking aligns with existing digital health infrastructure. However, the small qualitative sample means recommendations should be treated as hypothesis-generating rather than definitive design specifications. In Australia, PRMSDs in musicians are managed within the broader musculoskeletal physiotherapy and occupational health framework. The RACGP does not have specific guidelines for performing arts medicine, though the Australasian Performing Arts Medicine Association (APAMA) provides relevant clinical guidance. Physiotherapy management of PRMSDs is accessible via Medicare-funded Enhanced Primary Care plans (up to 5 allied health sessions per year), though this is often insufficient for complex or recurrent presentations. No PBS-listed pharmacological interventions are specific to PRMSDs. The study's findings regarding financial barriers to care are highly relevant in the Australian context, where out-of-pocket physiotherapy costs remain a significant access barrier. Digital health tools aligned with the Australian Digital Health Agency's national strategy could address identified gaps. Music conservatoria and universities (e.g., Australian Institute of Music, Sydney Conservatorium) could integrate these findings into student health programmes. Adult musicians (amateur and professional) with current or previous playing-related musculoskeletal disorders, particularly those in formal music training or performance settings. Findings are most directly applicable to UK-based musicians but have broader relevance to performing arts medicine globally.

Abstract

OBJECTIVES: To explore the characteristics of musicians with current or previous troubling musculoskeletal symptoms associated with musician self-limitation of activity (often referred to as playing-related musculoskeletal disorders (PRMSDs)), barriers and facilitators to PRMSD self-management, health needs and perspectives on digital health interventions (DHIs). The purpose of the study was to understand the unique needs of this population to effectively inform future DHIs to support this community. DESIGN: A mixed-methods study comprising an online survey and four online focus groups (2-3 participants per group). Survey data were analysed statistically, and focus group discussions were analysed thematically. SETTING: Online survey and focus groups conducted via Zoom. PARTICIPANTS: UK-based musicians with current or previous PRMSDs. RESULTS: A total of 100 musicians participated in the survey study, and 10 musicians participated in the focus group study. Over a third (38%, n=38) of participants had experienced musculoskeletal symptoms that interfered with their ability to play at their usual level 0-2 times in the last 5 years, 24% (n=24) reported 3-5 episodes, and 38% (n=38) had experienced them more than five times. The majority of participants (67%, n=67) continued playing music while experiencing these symptoms. Several barriers to self-management were identified, including limited music-specific health education during training, financial and time constraints and insufficient accessible resources. Key facilitators and health needs included healthcare professionals who understood musicians' professional demands and performance pressures, personalised instrument-specific health support, peer support from fellow musicians and accessible digital resources including self-assessment tools, automated reminders, health tracking, motivational features, peer support forums and multimedia resources organised by condition or symptom stage. Addressing these needs could enable musicians to better manage their symptoms, maintain playing activity and make informed decisions about when and how to seek help. CONCLUSION: This study reveals unmet health needs in musicians and offers recommendations for designing DHIs that promote musicians' health and well-being. Key design recommendations include personalisation by instrument type, health tracking, peer support and consolidated multimedia resources. These findings can inform both intervention design and policy development to better support this population.

References

1. 1.Eleryan, N., Hemming, R., Sparkes, V., & Sheeran, L. (2026). Understanding self-management and digital health needs in musicians with playing-related musculoskeletal disorders: an explanatory sequential mixed-methods study. BMJ Open. https://doi.org/10.1136/bmjopen-2026-116784