400 Section - Performance-Related Pain: A Comparative Analysis of Collegiate and Professional Musicians in Puerto Rico

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

KD

Kevin R. De Jesus, MD

PGY-4 PM& Resident
University of Puerto Rico
San Juan, Puerto Rico, United States

Corresponding Author/Autor a quien dirigir la corr(s)

Walter R. Frontera, MD, PhD, FRCP

Professor
University of Puerto Rico School of Medicine
San Juan, Puerto Rico

Co-Author/Coautor(s)

IF

Isabel C. Falcón-Asencio, BS

Medical Student
University of Puerto Rico
San Juan, Puerto Rico, United States
William Micheo, MD (he/him/his)

PM&R Department Chair
University of Puerto Rico School of Medicine
San Juan, Puerto Rico, United States
AP

Angel L. Pabon, DrPH

Assistant Researcher
University of Puerto Rico School of Medicine
San Juan, Puerto Rico, United States

Objectives :

Musicians experience repetitive biomechanical loads that increase their susceptibility to performance-related pain (PRP). Although both professional and collegiate-level musicians frequently report PRP, direct comparative analyses between these two populations are limited. This study aims to characterize and contrast PRP features between collegiate and professional musicians.

Design:

This cross-sectional study was conducted between September 2024 and March 2025 through one-on-one, investigator-administered interviews utilizing a combined instrument composed of the Nordic Musculoskeletal Questionnaire (NMQ) and the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM). Participants were recruited from the Conservatory of Music (CM; collegiate-level) and the Symphony Orchestra (SO; professional-level).

Results:

Of 134 potential participants, response rates were 90.7% (68/75) for SO and 91.5% (54/59) for CM. Mean ± SD age was 41.2 ± 13.2 years for SO and 20.2 ± 3.2 for CM. Sex distribution was 52M/16F (SO) and 29M/25F (CM). SO reported longer instrument experience (30.0 ± 12.4 vs. 10.0 ± 3.6 years, p < .001) and years performing professionally (21.3 ± 13.4 vs. 2.7 ± 1.5, p < .001). Weekly exposure time was comparable (30.3 ± 8.0 vs. 29.0 ± 11.0 hours, p = .457). Pain in the last 7 days was reported by 47.1% (SO) vs. 57.4% (CM, p = .28). Mean worst pain (NRS - SO: 5.5 ± 3.5 vs. CM: 4.5 ± 3.1, p = .152) and interference with performance (Likert scale - SO: 2.0 ± 3.3 vs. CM: 2.5 ± 2.9, p = .443) were similar. Upper string musicians reported highest pain prevalence.

Conclusion:

PRP is common among both collegiate and professional musicians. Despite comparable weekly exposure, cumulative years of playing appear to drive pain prevalence. Collegiate musicians reported slightly greater interference with performance. Upper string players showed the highest rates, emphasizing the need for targeted prevention strategies in high-risk instrumental groups.