Prevalence and treatment of playing-related musculoskeletal disorders (PRMDs) related to head, neck and upper body region in musicians: A systematic review of randomized controlled trials

Background
Excessive physical workload combined with psychosocial factors—such as performance-related stress—makes musicians particularly vulnerable to musculoskeletal disorders, especially within the head, neck, shoulder, and upper body regions.

Aims
This study aimed to summarize the current state of knowledge regarding the prevalence and treatment of musicians’ playing-related musculoskeletal disorders (PRMDs) affecting the head, neck, and upper body, based on evidence from randomized controlled trials (RCTs).

Material and methods
A systematic search of electronic scientific databases and gray literature was conducted to identify full-text RCTs published in English between January 1, 2010, and November 1, 2024.

Results
The search yielded 189 articles, of which eight met the inclusion criteria. PRMDs were highly prevalent among musicians and most commonly involved the head, neck, shoulders, and upper body. These disorders were also associated with impaired motor function, reduced sleep quality, and decreased quality of life.

Conclusions
Physical demands, psychological stress, and excessive workload contribute significantly to the development of PRMDs. RCT-based evidence indicates that exercise, manual therapy, and shockwave therapy may reduce PRMD symptoms; however, the current evidence base remains limited due to small sample sizes and methodological weaknesses. High-quality, largescale randomized controlled trials are urgently needed. There is also a strong need to better educate physiotherapists about PRMDs in musici