Occupational diseases suffered by musicians constitute an area that is still unexplored, almost taboo. Many musicians have had to give up their instruments and go into conducting because they could not play any more. Others have simply retired.
The act of making music is one of the most stressful of activities. The conductor, Herbert von Karajan, set up an instrumental laboratory in Salzburg to evaluate the effects of music on the body. Being an experienced pilot, he decide to demonstrate that conducting "The Ride of the Valkyries" placed far more stress on the heart than landing a plane under difficult conditions. Professor Alfredo Somma, a plastic surgeon who specializes in pianist's cramp, set up the first music clinic in Italy inside the Conservatorio Piccinni in Bari, staffed by doctors who were also musicians.
Musicians have problems of sight and hearing, and other symptoms connected with the senses. There are also the back problems suffered by conductors who have to stand for hours on end. There are various nervous tics, the most common being stereotyped repetition of a particular movement. A tic that affects conductors, for example, causes them to turn the pages of the score constantly, even though they are not following it at all. There are violinists' tics and pianists' tics caused by incorrect posture. One pianist was hit by writer's cramp, paralyzing several fingers. It happens when the brain suddenly rejects the constant repetition. He was treated by a psychoanalyst and made a perfect recovery. Acute tendonitis in the shoulder which supports the instrument is a complaint dubbed "violinist's cancer". A type of obsessive phobia forces musicians to play the score in front of them because they are afraid of forgetting the notes. Stage fright is an extremely common syndrome that affects soloists at the moment they go on stage. An extreme case of neurotic disorder was the late Vladimir Horowitz, who did not play piano for years, trapped in the nightmare that his fingers might turn to glass and break if they came into contact with the keyboard.
Musicians are difficult patients, hypersensitive and delicate. Only those well versed in music can understand their disorders and weaknesses, their neuroses and the things they are touchy about. Just as a doctor treating silicosis must know all the problems involved in mining, a doctor treating musicians must know all the problems connected with music.