Development and Interrelation of Pain, Depression, and Anxiety in Music Students: Does Successful Treatment of Pain Have an Impact on Mental Health?

Abstract

OBJECTIVE: Musculoskeletal pain is a common problem among professional musicians as well as music students. Studies have emphasized the effectiveness of music-specific physiotherapy for affected musicians. This study was designed to evaluate if physiotherapy treatment of pain-affected music students had an impact on pain perception as well as psychological well-being. To explore the possible development of musculoskeletal pain, depression, and anxiety, a second sample of pain-free music students, matched for age and gender, was examined twice at identical time intervals. METHODS: A convenience sample of 31 university music students with moderate to severe musculoskeletal pain and 31 pain-free music students, matched in age and gender, were included in the study. Both groups were examined physically and completed biographical, music-related, and psychological questionnaires. Perceived pain intensity was assessed with a visual-analogue scale (VAS), and depression and anxiety symptoms were assessed with the Beck Depression Inventory II (BDI-II) and the Hospital Anxiety and Depression Scale (HAD). Music students with pain received a series of 12 sessions of musician-specific physiotherapy, while controls waited for the same amount of time for retesting. RESULTS: On the 10-cm VAS, music students with pain reported an average improvement in pain intensity from a baseline of 6.25 (SD 1.95) to 2.7 (2.03) after the intervention, while the controls (music students without pain) did not change. Furthermore, music students with pain indicated higher depression and anxiety scores as compared to the control group before and after therapy. After intervention, music students with pain with higher BDI-II scores demonstrated clinical improvement concerning depression, but no significant improvement in mental health was found in the pain group taken as a whole. CONCLUSION: Physiotherapy was effective in reducing pain symptoms in music students affected by chronic musculoskeletal pain. However, physiotherapy did not improve mental health in pain-affected music students. Additional psychotherapeutic interventions may be needed to support music students with psychological comorbidities such as depression and anxiety.