Musicians’ Cramp: Instrumental and Gender Differences

Musicians’ cramp is a disorder characterized by its task specificity and gender bias; male musicians have a higher prevalence of this disorder than females. Previous epidemiological studies on musicians’ cramp have demonstrated that certain instrumental groups are more prone to develop this disorder than others. These studies, however, have not accounted for the gender distribution in healthy musicians. Therefore, the current study investigated 2,661 healthy musicians collected from eight music conservatories within Germany. These controls were compared with 183 patients (154 males) with musicians’ cramp in an outpatient clinic at the Institute for Music Physiology and Music Medicine (IMMM), Hannover, Germany (1994-2000). Comparisons between groups (musicians’ cramp and controls) were made for gender and instrumental groups (keyboard, strings, woodwind, brass, plucking, and percussion). Results were consistent with earlier studies suggesting that particular instrumental groups were more at risk for developing musicians’ cramp than others. When gender was not a factor, both woodwind and plucking (guitar) instrumentalists were more likely to develop musicians’ cramp, while musicians playing string and percussion instruments were less likely to develop musicians’ cramp. Musicians playing keyboard and brass instruments were not significantly different than expected. When gender was included in the analyses, the following pattern was revealed: the number of male patients with musicians’ cramp was greater than expected, even when the number of healthy male musicians was accounted for; the opposite was found for female patients. Furthermore, when gender was also included in the instrumental analyses, male musicians were more likely to have musicians’ cramp than females in keyboard, string, woodwind, and plucking instruments. The only instrumental group without a gender bias for symptoms were the brass instruments. These results suggest that male musicians are more likely to develop musicians’ cramp within certain instrumental groups, and may reflect a general predisposition for male musicians to develop this disorder. The ages at onset of symptoms were not different between the males and females in this sample. The current study demonstrates a clear association between gender, instrumental groups, and the presentation of dystonic symptoms.