A musician’s hands and arms are like elite athletes in themselves. Fingers sprint across the piano keys or wrists incline acutely to accommodate the strings on a violin, it is no surprise that musculoskeletal disorders occur in about 20% of musicians.

Generally disorders fall into one of six categories:

1. Overuse syndromes
2. Compressive neuropathies
3. Osteoarthritis
4. Focal dystonia
5. Thoracic outlet syndrome
6. Joint hypermobility

It is key to determine all factors relating to the presenting problem in the musician, as an increase in playing time and/or intensity, recent change in musical instructor, awkward posture, joint laxity, poorly fitting musical instrument, repetitive movements and improper technique are all risk factors for developing musculoskeletal problems.

Management of the musician is complex, and multimodal intervention is often necessary to help achieve the desired outcome. Many musicians have distinctive difficulties: sometimes they have several jobs to make ends meet, their leisure activities may involve playing their instrument, and their occupation places higher demands on their hands than most others. Each thus needs to be managed individually, with a comprehensive non-operative program being the mainstay prior to consideration of any surgery.