Background: Musculoskeletal symptoms are reportedly common among musicians. Flautists may be at high risk of symptoms, due to their asymmetrical playing posture.

Aims: To determine the prevalence and incidence of musculoskeletal symptoms among flautists.

Methods: A systematic search of four databases, with reference and citation lists of included studies, screened for additional studies. Included studies were assigned to the Oxford Centre for Evidence-based Medicine levels of evidence and critical appraisal was performed using a previously published tool. Data extracted included the country, sample size, data collection methods, response rates, sample demographics and data pertaining to the prevalence or incidence of musculoskeletal symptoms among flautists.

Results: Seven studies (evidence levels 1 and 3) were included. These were at moderate to high risk of bias. There was wide variation in the populations and the types of musculoskeletal symptoms investigated. Lifetime prevalence of any musculoskeletal symptoms of any duration varied from 15 to 95% depending on the populations and symptoms investigated. In schoolchildren, this was as high as 79%, and 95% in university students. The upper extremities were most commonly affected, with minimal differences in the prevalence of symptoms between right and left sides. Due to the differences in the types of data collected, different groups of flautists could not be directly compared.

Conclusions: The lack of studies with high evidence levels and low risk of bias in this area precludes a clear understanding of the prevalence and location of musculoskeletal symptoms in flautists, although current evidence suggests that the prevalence is high.