Warning: music can seriously damage your health. Irish orchestral players and other musicians are developing career-threatening medical conditions similar to those sustained by sportspeople, according to the country’s only performing-arts doctor.

While up to 80% of musicians have aches and pains because they do not warm up properly, about 5% develop a disorder called dystonia, which causes a rigidity in the muscles used to play instruments, says Juliet Bressan, the Irish representative of the British Association of Performing Arts Medicine (BAPAM), which has been treating musicians in the UK for 25 years.

Bressan, who also acts as medical adviser to the RTE medical drama The Clinic, treats at least one musician in her home a week, more during festivals such as Oxegen. She is linking up with the neurology department at St Vincent’s hospital, Dublin, which treats dystonia sufferers, to set up a specialist clinic for musicians.

Dystonia sufferers include Robert Schumann, the 19th-century German composer and pianist, and Gary Graffman, a concert pianist who played Gershwin’s Rhapsody in Blue on the soundtrack of Woody Allen’s Manhattan.

The first study in Ireland to examine how musicians are affected by repetitive movements and postures, published last June, concluded that almost 60% had more than one abnormality. Four of the 17 musicians tracked by the department of neurophysiology at Cork University Hospital had dystonia, which can lead to claw-like hands in pianists and string players, frozen jaws in wind and brass players, and paralysed vocal cords in singers.

“When you move, one muscle contracts and the other relaxes but in dystonia, that signal fails and both muscles contract and the hand goes into spasm,” said Niall Tubridy, a consultant neurologist who will run the clinic with Bressan. “If that happens often enough it can ruin your career.

“Our clinic will first treat musicians who have a problem and then we will set about raising awareness.

“Another strand is research. We are currently running MRI scans to check the differences between the brains of musicians and non-musicians with and without dystonia. We want to see if there is a wiring issue in the brain.”

Despite growing awareness of the price many musicians are paying for their art, there is a degree of secrecy about dystonia and other conditions in the music industry. Well-known virtuosos and jazz musicians have retired because of the disorder, Bressan says.

Alan Kelly, a piano-accordion player who once starred in Celtic Legends, a show similar to Riverdance, had been reluctant to discuss his battle with the syndrome. “It’s a taboo subject and often, if I bring it up, I will be met with a wall of silence,” said Kelly, who overcame the illness and now tours with Scots singer Eddi Reader from Fairground Attraction.

Kelly spent almost four years seeing chiropractors, osteopaths, physiotherapists and complementary-medicine practitioners before being diagnosed with focal dystonia. During that time, he had to turn down work because he couldn’t play demanding pieces. The 37-year-old keeps the condition at bay by travelling twice a year to the Institute for Music Physiology and Musicians’ Medicine in Hanover to get Botox injections in his dystonic muscles.

“During 2004, I was on stage playing a concert in France, playing a piece of music that I’d performed hundreds, if not thousands, of times before,” said Kelly. “I suddenly realised that I couldn’t direct my middle finger on to the keyboard. It felt like something was stopping it from moving. Gradually, the condition got worse and my confidence began to drain away. Nobody in Ireland seemed to have heard of focal dystonia and, after going to Germany, I felt more secure receiving Botox injections from someone who dealt with musicians constantly.”

BAPAM organises seminars for music students in Irish colleges to help performers learn warm-up exercises and recognise early signs of injury.

Bressan, who plays the clarinet, believes the Irish music industry must change its mindset if it is to prevent students and performers developing dystonia. Unlike in the UK and America, where professional orchestras have medical advisers, Irish classical musicians are encouraged to ignore pain, she believes.

“There’s a mistaken belief that if you don’t hurt, you’re not practising enough,” she said. “They are encouraged to be brave and play even if they are in pain.”

The new outpatient clinic will invite each of the country's thousands of musicians and music students for screening for injuries and conditions related to their profession, and to research why dystonia is more common in musicians.

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