There’s plenty of material in the literature about musculoskeletal disorders (MSDs) in the archaeological record. What there is very little of however - perhaps surprisingly - is material specific to archaeologists who themselves have MSDs. This is quite some oversight, given that MSDs are not uncommon in archaeologists who have spent part of their careers digging, and that there are serious career implications for archaeologists having any kind of physical disability of illness, whether it be participation in digging, field-walking, driving, running a fieldwork camp & kitchen, and all kinds of dexterous work.

Archaeologists face many of the same barriers as professional musicians (see below) when ‘suffering’ with MSDs, and in attempting to access care - such as the misunderstandings, diagnostic uncertainties, and our own reluctance to ‘make a fuss’ lest we be considered not up to the job. We are expected to get on with repetitive weight-bearing tasks or make way for someone else, a model only recently being challenged by, for example, the Enabled Archaeology Foundation (see Resources, below)..

The human body is flexible, but it’s not built to last. Existing disabilities, hidden disabilities, and inflammation - which may not even be apparent during someone’s early fieldwork career - can be exacerbated by the increased wear and tear on the body. Osteo-arthritis, osteoporosis, plantar fasciitis and chronic synovitis have all seemed pretty common among my friends and acquaintances in the archaeological world over the years.

Excavations and Fieldwork Can be Competitive Arenas

As with or orchestra musicians, performance can be everything. Students want good module marks, and promotion to supervisory status means better economic opportunities in a competitive and stressful world of curcuit digging and job applications.

So, it's no wonder that MSDs — a reality for so many of these professionals — are not openly discussed. Physical pain is often pushed aside, unexpressed, until one day the suffering gets to be too much, the ability to play is impacted, and all the effort to keep things under wraps and under control culminates in burnout.

The the one relevant account that I found was published by the Chartered Institute for Archaeologists (CIfA) is a case in point. The author chose to remain anonymous to discuss their life as an archaeologist with rheumatoid arthritis (RA). They were also nervous about disclosure at work. ‘I did hesitate over whether to disclose my condition to my employer’, they write, noting also that ‘where people with RA feel their condition is having a negative impact on their work this can result in anxiety and poor mental health and in the early days I certainly felt this way’. Luckily this particular archaeologist had a sympathetic employer who was not only in tune with UK equalities legislation, but to some degree was well ahead of the curve, and reasonable adjustments have been made. It’s worth a read here. (The link on CIfA’s own website appears to be broken. Ironically.)

A Comparator Case: Professional Musicians

Anne Maugue is a post-doctoral researcher and plays the flute in an elite orchestra. She raises awareness about MSDs in professional musicians, including the associated psychosocial risk factors. "If caught early enough, this pain can often be successfully treated.

"You’re a violinist in a major symphony orchestra. It's Sunday night, 8 o'clock, and you've just come off the stage. A few minutes ago, you felt a sharp pain in your right arm — a pain that is now, already, overwhelming. The conductor accused you of not being focused, of not concentrating. You know that you have another rehearsal in just a few hours, Monday morning. So, what do you do — other than hope that the pain goes away by then? Where can you turn to get help?"

Pain is far from anecdotal. In professional orchestras, its prevalence over 12 months is between 41% and 93%. "An elite athlete has a full training staff they can turn to. An elite musician, on the other hand, usually only has their general practitioner — and that's assuming the musician even reaches out to get treatment to begin with.

"The fact is that most of the time musicians only care about the pain when it becomes chronic, when it causes discomfort that affects their playing," says Maugue.

How, then, does one evaluate this problem? In a Danish study, musicians rated the musculoskeletal problems they had experienced in the preceding 7 days. When the researchers compared those reports with findings from a clinical examination, they found that the examiners were not able to identify which musicians had reported problems. Why? Because a diagnosis does not reflect the severity or the impact, both of which are subjective.

This Archaeologist’s Tale - Persistent Pain and a Paradigm Shift

This has also been my experience - that the damage present in the body is not always immediately apparent on examination by a doctor (either by a GP or specialist such as a rheumatologist), and even after MRI imaging there can be a disconnect between mild to moderate visible damage and the very significant pain levels felt.

In my case, after many years of medication, physio, hospital treatment and diagnostic imaging, I was referred to an NHS ‘persistent pain service’.

There I am learning a new model of thinking that is predicated on new research on the nervous system. This shows that for some people, often those with careers in certain occupations where they have been required to undertake certain strains upon their bodies in a regular manner, there is a possibility - nay, a real likelihood - of developing a condition known as a ‘over sensitised nervous system’ or ‘heightened neural sensitisation’. In this condition, a stimulus - most usually acute damage - sets off signals which are hugely amplified by the time they land in the brain. The pain is severe, irrespective of whether or not the damage is. And the pain takes up residence there, along with the fear it generates, and becomes chronic.

Even mild degenerative disc disease of the spine can genuinely feel agonising and debilitating, especially during a flare-up. It’s real. For the brain, it’s real. Toes and feel can feel as if they are being repetitively stabbed with hot needles and frozen ice shards. It’s not a happy place. Being able to talk about this openly without feeling regarded as a hypochondriac has been genuinely healing.

Is It Good To Talk?

I think it is. Persistent pain teams can provide a comforting holistic blanket of psychology and physiotherapy, retraining both brain and body to work better and rely less on medications and other substances and more on physical therapies, mindfulness and understanding.

It will be extremely helpful if this new paradigm could be accepted by those issuing guidance on field practice, and by the employers acting upon it, rather than sticking with the rigid framework of diagnostic scans, GPs’ fit notes and letters from rheumatology consultants.

And excavation directors, archaeological consultancies and other employers have a role in encouraging this without prejudice. We need to get archaeologists of all ages and degrees of ableness to talk more about their own aching skeletons and muscles without fearing they’ll be shown the door.

It’s in our bones to want to ‘be cheerful’ and ‘enjoy life’. And we deserve to be able to work as part of that. I’m not throwing in the old trowel quite yet.

~~~~~

Resources & Sources

The Enabled Archaeology Foundation website is a valuable resource, established by the late Theresa O’Mahoney

The Chartered Institute for Archaeologists has published one anonymous case study by an archaeologist with rheumatoid arthritis

Stéphanie Lavaud, 21 April 2023, ‘Musculoskeletal Disorders Prevalent in Orchestra Musicians’ in Medscape (online edition Sunday, May 28, 2023) - with thanks to musician Anne Maugue for her contribution

Most NHS Trusts in the UK publish information on their persistent pain services, such as this one which contains a good explanation from the Royal Devon and Exeter NHS Foundation Trust about heightened neural sensitisation

Roman Mosaic Images

The Merry Mosaic from Hatay - see here for an introduction and here for further reading

Roman musicians mosaic - see here for a basic introduction at ancientromanartarchitecture.weebly.com, and here for a slightly better quality but partial image from Sonia Halliday with catalogue details