Playing and Singing: A Demanding Profession

Even if they were not described, work-related health problems of professional performers existed even in antiquity. Bernardino Ramazzini (1633–1714) was one of the first authors to describe health problems in this specific class of workers’ disorders in his renowned treatise “De Morbis Artificum Diatriba” (1700). Until the beginnings of the twentieth century, physicians mainly continued to study only voice disorders in singers, and then they started to be interested in disease of all musical performers, as demonstrated by the book “Die Berufskrankheiten der Musiker” (1926). His author, the German neurologist and musicologist Kurt Singer (1885–1944), first systematically described symptoms of musicians’ diseases and their treatment. Modernly, health problems of professional performers include voice and hearing disorders and musculoskeletal and psychological problems. Nowadays, the most common of these disorders of professional singers are vocal fatigue and muscle tension dysphonia or aphonia. Music-induced hearing loss was seen in up to 58% of classical musicians. In addition, permanent or temporary shifts of hearing thresholds, hyperacusis, loss of hearing sensitivity and tinnitus were observed among professional performers. Common musculoskeletal disorders of musicians include overuse problems, such as tendonitis and peripheral nerve entrapment syndromes, that typically affect the upper extremities, the neck, the back, and the facial musculature. These disorders can interfere with the ability to play the instrument, which could be career-ending for a professional musician. Music performance anxiety is one of the most frequently reported psychological disorders among professional performers, with an estimated prevalence rate between 15% and 25%. Finally, the impact of the recent COVID-19 pandemic on the internal organization of opera houses and the health of singers, dancers and musicians is discussed.