Musculoskeletal pain, performance anxiety, and stress-producing life events among orchestral players in Brazil: An observational study

BackgroundProfessional musicians face substantial physical and psychological demands, increasing their vulnerability to musculoskeletal pain and music performance anxiety (MPA). In middle-income settings such as Brazil, additional socio-economic stressors may intensify these occupational health challenges.ObjectiveTo investigate the association between musculoskeletal pain, MPA, and stress-producing life events (SPLE) among Brazilian orchestral musicians.MethodsA cross-sectional study was conducted with 273 professional orchestral musicians from Rio de Janeiro, Brazil. Musculoskeletal pain was assessed using the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM-Br), MPA using the Kenny Music Performance Anxiety Inventory (K-MPAI), and SPLE through a checklist of stress-producing life events. Descriptive statistics estimated the prevalence of pain and clinically significant MPA (K-MPAI ≥105). Binary logistic regression examined factors associated with pain and clinically significant MPA, while multivariable linear regression analyzed associations between MPA scores and pain intensity and interference.ResultsMusculoskeletal pain was highly prevalent, with 93.4% reporting lifetime pain and 86.8% reporting pain in the previous 12 months. Clinically significant MPA was observed in 60.4% of participants. Higher K-MPAI scores were associated with greater pain intensity and interference. Female musicians reported higher pain levels, and weekly playing hours were positively associated with pain interference. Financial problems and separation/divorce increased the likelihood of clinically significant MPA.ConclusionsBrazilian orchestral musicians experience a high burden of musculoskeletal pain and MPA. Psychological vulnerability and socio-economic stressors contribute to these conditions, underscoring the need for integrated occupational health strategies addressing both physical and mental health.