Overuse and misuse syndromes in a classical guitarist: a case report

Background: This case report presents a 47-year-old classical guitarist suffering from long-standing overuse syndrome and misuse syndrome, compounded by cubital tunnel syndrome. The uniqueness of this case lies in the near absence of significant pain, despite severe motor dysfunction, and the successful multidisciplinary rehabilitation approach tailored specifically to the demands of professional musicians. This report adds to the literature by highlighting the importance of targeted rehabilitation in addressing both motor control dysfunction and nerve compression in musicians. Case presentation: The patient presented with chronic muscle fatigue, poor coordination of the third finger, and compensatory overuse of other fingers, leading to functional impairment during guitar playing. He also reported intermittent paresthesia in the fourth and fifth digits due to cubital tunnel syndrome. Clinical discussion: The patient was diagnosed with overuse and misuse syndromes alongside cubital tunnel syndrome. Surgical decompression of the ulnar nerve was performed, followed by a comprehensive rehabilitation program that included manual therapy, neuromuscular re-education, and the use of functional splints. After several months, the patient regained full motor function, strength, and coordination in the affected hand, allowing him to return to professional performances. Conclusion: The primary lesson from this case is the importance of early recognition and a multidisciplinary approach to treating complex motor dysfunctions in musicians. Combining surgical intervention with customized rehabilitation can lead to substantial recovery, even in chronic cases of overuse and misuse syndromes.