Dystonia in musicians an unrecognized cause of career loss

Musician’s dystonia is a task-specific focal dystonia affecting approximately 1% of all professional musicians. Dystonia develops in all types of instruments (keyboards, strings, woodwind, brass and percussions), presenting as focal dystonia of the hand or as embouchure dystonia. There is an association between the musical instrument and the localization of dystonia (piano and guitar players are affected in the right hand,violinists and violists in the left hand). Genetic predisposi­tion and a variety of triggering factors,such as trauma,compressed nerve,emotional stress and mainly overuse of the hand due to marked increase in practice time,are implicated for the development of the focal dystonia. Treatment of musician’s dystonia is currently symptomatic and includes drugs, botulinum toxin injections, pedagogical training, relaxation techniques, ergonomic changes and psychotherapy. The results of the treatment are more or less unsatisfactory and a proportion of profes­sional musicians are forced to change career