Median and Ulnar Neuropathies in University Pianists

Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Pianists and keyboard players are at risk for entrapment neuropathies in the upper extremities and are sensitive to mild neurologic deficits. The purpose of this descriptive study was to determine the presence of median and ulnar neuropathies in both upper extremities of university pianists. Nineteen volunteer male and female pianists (ages 18 to 33 yrs) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music. Subjects completed a history, interview, and physical examination, and nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing motor, sensory, and F-wave (central) nerve conduction studies. These subjects had normal upper extremity neural and musculoskeletal function based on extensive evaluation, including a history and physical examination. When comparing the subjects' nerve conduction study (NCS) values with a chart of normal NCS values, all electrophysiologic variables were within normal limits for motor, sensory, and central (Fwave) conduction values. However, comparison of median and ulnar motor and sensory latencies in the same and opposite hand demonstrated that 3 of the 19 pianists (16%) had early evidence of median neuropathy at or distal to the wrist. The other 16 subjects demonstrated normal comparison studies of the median and ulnar nerves in both upper extremities.