title: Analysis of deep tissue hypersensitivity to pressure pain in professional pianists with insidious mechanical neck pain.
abstract: BACKGROUND
  The aim of this study was to investigate whether pressure pain hyperalgesia is a feature of professional pianists suffering from neck pain as their main playing-related musculoskeletal disorder.
  
  
  METHODS
  Twenty-three active expert pianists, 6 males and 17 females (age: 36 ± 12 years) with insidious neck pain and 23 pianists, 9 males and 14 females (age: 38 ± 10 years) without neck pain the previous year were recruited. A numerical pain rate scale, Neck Disability Index, hand size and pressure pain thresholds (PPT) were assessed bilaterally over the C5-C6 zygapophyseal joint, deltoid muscle, the second metacarpal and the tibialis anterior muscle in a blinded design.
  
  
  RESULTS
  The results showed that PPT levels were significantly decreased bilaterally over the second metacarpal and tibialis anterior muscles (P < 0.05), but not over C5-C6 zygapophyseal joint and deltoid muscle (P > 0.10), in pianists with neck pain as compared to healthy pianists. Pianists with neck pain had a smaller (P < 0.05) hand size (mean: 181.8 ± 11.8) as compared to pianists without neck pain (mean: 188. 6 ± 13.1). PPT over the tibialis anterior muscles was negatively correlated with the intensity of neck pain.
  
  
  CONCLUSIONS
  Our findings revealed pressure pain hypersensitivity over distant non-symptomatic distant points but not over the symptomatic areas in pianists suffering from neck pain. In addition, pianists with neck pain also had smaller hand size than those without neck pain. Future studies are needed to further determine the relevance of these findings in the clinical course of neck pain as playing-related musculoskeletal disorder in professional pianists.
authors: Forexpla Prevention Department, Real Conservatorio Superior de Música deMadrid, Escuela Superior de Canto de Madrid, Madrid, Spain.
authors: Marcela
authors: M
authors: Linari-Melfi
authors: Irene
authors: I
authors: Cantarero-Villanueva
authors: Carolina
authors: C
authors: Fernández-Lao
authors: César
authors: C
authors: Fernández-de-Las-Peñas
authors: Rafael
authors: R
authors: Guisado-Barrilao
authors: Manuel
authors: M
authors: Arroyo-Morales
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications / Q000503:physiopathology*; D009146:Music; D019547:Neck Pain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D009784:Occupational Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D017288:Pain Threshold / Q000502:physiology; D011312:Pressure / Q000009:adverse effects; D013314:Stress, Mechanical