Music may soothe listeners, but it can be murder on the players. Bruised lips, sore hands and ringing ears are dangerous occupational hazards for musicians, and other performers suffer too.

Many doctors don't see it that way, says Dr. Alice G. Brandfonbrener, director of the Medical Program for Performing Artists.The sore neck of a violin player, injuries actors suffer during stage fighting or a singer's lung pangs are hardly emergencies, but they are typical of serious pains that can affect performers' livelihoods, she said Friday.

"Musicians' problems are not obvious, most of them, and have been kind of dismissed by physicians in the past as being part of the neurosis of the musician and, therefore, not real," said Brandfonbrener, whose program is one of about 18 similar efforts nationwide.

It is the only such program with a full-time physician, she said.

Lola McIntyre, 35, a pianist and teacher from the Indianapolis area, said her hands were practically crippled by swelling and pain when she arrived at Brandfonbrener's office three months ago.

McIntyre said she had visited three other doctors who prescribed medicine that did not work. One one doctor even told her she might never perform or teach again, but hand-strenghthening exercises and a modified practice schedule suggested by Brandfonbrener brought dramatic improvement, she said.

Mainstream doctors commonly tell ailing performers: "`Go home and rest, and don't play,' and that just is not going to happen," Brandfonbrener said, since few can afford to miss work.

The 5-year-old program handles about 600 patient visits a year and about half are one-time visits, she said.

Two-thirds of the patients are musicians and the rest are dancers and theater people.

McIntyre said her injury wasn't unusual. Several of her students left school with serious performance-related problems, she said.

Brandfonbrener, a 59-year-old internist who also plays piano, is studying the physical problems of orchestral musicians under a $20,000 grant from the National Endowment for the Arts.

She also serves as senior editor of the Philadelphia-based journal "Medical Problems of Performing Artists" and co-editor a new medical textbook by the same name.