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Hello
I don't know if I can get help here, but given my condition I at least want to try. Since the beginning of the year, I have had pain in both arms that occurs no matter what I do. All everyday activities become a problem, for example eating with a fork or brushing my teeth, and obviously playing the piano is no longer really possible (I completely stopped for a long time then I tried to play simple pieces again a few minutes a day, then stopped again).
My problem is that no Doctor has been able to link my symptoms to a specific illness or injury. I have no disability: I can perform all the tasks I want, I have no pain that appears at the moment I perform the gesture. The pain appears only after, a few seconds or minutes late. I also don't have precise points on which a strong pressure triggers pain. For example, I can go play tennis or play a difficult piece on the piano (I worked on César Franck's prelude aria and finale before having problems and I could still play the difficult passages, the pain only coming after). However, I would have several whole days of severe pain to remind myself that it is best to avoid. Another strange aspect is that the pain passes from one arm to the other and is never present simultaneously in both arms. Sometimes even, if one arm hurts too much, I just have to do something with the other arm to change where the pain is. The pain sites are the same in both arms, but only one site is activated at a time: three sites on the wrist, above the hand and on the right and left edges, and two at the elbow, at the tendon and at the very bottom of the triceps.
Since I am a statistician, I work on the computer all day doing programming. I continued despite the pain for a while, but for about a month I've been using speech recognition software, and I haven't touched a keyboard or mouse since (except for a few seconds to activate the software at startup time). Apart from the sadness of not being able to do the activities I love (not playing the piano for a day was exceptional for me for many years, and now I don't even count the days without playing anymore), my contract cannot be renewed because I work 10 times slower than before.
I know a lot of people here have had various arm injuries, so I would like to ask you if anyone has ever seen similar symptoms and would know what disease I have.
Thank you for reading me

I think you have carpal tunnel syndrome. At this point it sounds severe, so go to see an orthopedic hand surgeon. In the mean time rest, ice, and NSAIDs (ibuprofin or naproxene sodium).

It is impossible to diagnosis over the internet; in addition your post does not provide details about what testing has been done. Have you seen a neurologist? Has an EMG to diagnosis carpel tunnel syndrome been done? There needs to be a full work up completed

I had an elbow and wrist ultrasound, it was the only medical examination I had. Every doctor I saw remained on the physical examination, and all went towards the hypothesis of tendonitis, but which was invalidated by ultrasound. The symptoms don't really fit tendonitis, let alone carpal tunnel syndrome, which I've discussed with the doctors quite a bit. What was surprising to everyone was the fact that I could do any task with my hands, and that the pain that followed was so unsystematic. Also, at no time do I lose control of my hands, which does not suggest nerve damage. I haven't had a moment of tranquility for a single second since it started, and despite long moments not to use my arms at all (for about a month, I've kept to the vital minimum, while doing in a cautious way the few gestures I still make).
I'm not looking for a real diagnosis on a forum, it would be unrealistic, just, if someone feels they recognize symptoms similar to a disease they know, I'd like to explore the possibilities. I'm not sure how it works elsewhere, but here doctors ask the patient for tests, not the other way around. In my case, I would probably have to find other doctors, but my experience is always the same: I make appointments, I wait weeks, the Doctor looks at me for five minutes, lends me symptoms I don't have, deduces that it is tendonitis, and sends me home without a solution.

Although you say you don't have "nerve damage" per se, do you think it's possible you've trapped a nerve, say in your neck or upper spine or shoulders? So in a way, a similar situation to something like sciatica, but in your upper body instead.

Perhaps get an Osteopath or Sports therapist to have a look?

That was my first thought as well.

If the pain you experience after doing some activity is because one or more muscles are "locking up" (fully contracting, and staying that way) then you should do some research on Chronic Exertional Compartment Syndrome (CECS), which generally matches what you describe. For some people, CECS is specific to one particular motion/activity; for other people, ANY activity using the affected body part/region generates a crisis-level response, involving intense swelling and muscle contraction, intended to immobilize the damaged part of the body. Symptoms gradually subside, hours to days after the event. For some people, avoiding the activity that caused the problem for some period of time (usually months) is enough to cure the problem. For others, CECS can last for years, if untreated. Unfortunately, the usual treatment is surgery, although it's very invasive and has all the risks that all surgeries have.

Not all doctors know about CECS, and fewer still know that it can affect the arms. It's primarily known as a lower body problem associated with long distance runners. For upper body CECS, it can occur in people who use their hands heavily, and it seems that a particular risk factor is the combination of heavy/constant hand use along with frequent wrist extension: motocross racers are quite prone to CECS, and I suspect there are many, many pianists with this problem (I am one, unfortunately).

Despite being called a "Syndrome", the fundamental problems are the same friction-based things that are linked to all sorts of other arm/hand ailments. That is, when things can't slide easily, inflammation occurs (as a warning to you that things aren't perfect). If you keep ignoring your body, swelling and muscular immobilization occur. Worse yet, these responses can lead to other problems: locked flexors can cause your extensors to lock, e.g.). So it is best to not look right now for the root cause of your situation, but instead deal with the symptoms (inflammation, potentially chronic muscle contraction). In other words, when your house is on fire, you put out the fire first, then find the cause after.

Regardless whether you have CECS, or some combination of other things, I would suggest the best way to proceed (given your lack of progress with doctors) is to take Zaphod's advice, and go see a sports physiotherapist--NOT a physiotherapist who deals with workplace or car accident injuries, or people who have had a stroke. A sports physiotherapist will be generally be much better equipped to help because they deal with maximizing performance, whereas rehabilitation physiotherapists tend to concentrate on simply regaining a lost ability. Doctors are best for things that are broken.

Some quick tips: deep tissue massage on your hands/arms/shoulders will almost certainly be very useful and educational, if painful. Never exceed the maximum prescribed dosage of ibuprofen (advil); it's strongly associated with liver/kidney disease. Never try to stretch your arm muscles to cure the problem. Do some kind of full body, low impact exercise very often, since your upper arms, shoulders, back, neck etc are also being affected to some degree (and therefore making your arms worse). And drink lots of water: remember, friction (between tendons, muscle, bone, connective tissue and nerves) is the real problem here, and water is an important lubricant (and btw, coffee/tea don't count as water due to their diuretic effect).

I agree with deep tissue massage. In my experiences with tendinitis and tight muscles, massage has helped more than anything else. I hope you can get some answers.

Actually I understand this to be a myth.

With both tea and coffee, the amount of water contained in them far outweighs any diuretic effect they may have. They are actually a very good source of water.

The only exception to this may be a very "short" version, for example a very strong Turkish coffee which hardly contains any water.

Yes, you're right--there are some differences in how water/coffee/tea affect hydration, but they're not statistically significant (at least according to the 1st research article I found on the subject...)

Igor,

My son-in-law's father has been suffering from severe pain in his lower legs and feet. Doctor was not able to diagnose the problem and pain relief was becoming ineffective. He was sent to a consultant who arranged a full body scan. The scan revealed a lung tumour which this week has been found to be non-malignant. He had been sent to a neurologist who in consultation with the cancer consultant determined that his immune system had somehow got cross-wired in its attempt to attack the tumour. Instead it it was trying to do something to his legs and feet.

I'm not suggesting that you have a similar situation but this might make you aware of how symptoms can have apparently unrelated causes. I hope you get a satisfactory resolution.

Below is an example link and is not specific to the above:

https://bottomlineinc.com/health/neuropathy/mysterious-pain-or-numbness-in-your-arms-or-legs

Ian

+1. I don't think that it's hand/arm problem, it may be a sign of other infectious, neurologic or oncologic condition. I would recommend to do thorough blood testing, brain scan, full body scan.

If you had visited exotic countries before your symptoms have appeared, be aware that rare infections and parasites often cause strange symptoms.

I really hope you can find out the cause.

I followed some advice proposed here: I had an electromyogram (which showed a problem with the ulnar nerve of my right arm, but it corresponds to a pain I had for several years, according to the neurologist it does not correspond to my symptoms), blood tests (nothing), I saw an osteopath (who told me that I had cervical blockages, but despite these manipulations, nothing has changed). The neurologist offered me pain medication (antidepressant type), but for my part I don't take these things until someone understands what I have. I don't really know what or who to talk to anymore.

It doesn't seem like your doctors have put you through the full gamut of diagnostic tests yet. You may want to be more assertive with your treatment/diagnosis, and remind your doctors that living with the pain and not knowing its source is unacceptable, and then specifically ask for some of the tests mentioned at the above link. After all, if you are covered by health insurance, they should do what is needed to be done to solve (or at a minimum, properly diagnose) the issue. That is after all, your implicit compact with your health insurance company/entity - that the insurance is for managing your health and it doesn't sound like the inconclusive results obtain so far, are accomplishing this.

That would point us very directly at the spine. As the vertebrae move, they pinch on one side or the other, but not both at once, at least not yet.

Today is actually my first day back in the office after neurosurgery (L2-3 and L4-5 laminectomies on 8-20) for severe spinal stenosis. My pain would shift from side to side, but being lumbar, it was in the legs. When it got really bad, it would hit both sides at once.

My diagnosis was based on an MRI of the spine. Look for an experienced neurosurgeon, and keep working on it until you get results. It only gets worse, so waiting isn't a good idea.

Hi John,

I think I remember you commenting when I posted about my lumber stenosis and subsequent operation in March 2017. One tip I offer is that if you are using a walking stick consider using two. After my operation I used one stick for a month and developed a limp. My physiotherapist told me to use two sticks after the limp disappeared. My lumbar back has fully recovered although stenosis remains in my cervical spine which has not been operated on.
Igor, don't give up investigating your problem. I too spent years hitting a computer keyboard for many hours each day and poor posture was significant in my developing my spinal problems.
lan

Hi, Beemer --

I've not used a walking stick. I had been walking five miles a day prior to surgery, and am almost back to doing that again. You're right, maintaining symmetry is a good thing.


-- J.S.

Look up "Clinique des musiciens". They aren't the only one (Coralie Cousin is another name I heard many times, apparently very reputable). if it's anything related to piano playing, they're the most likely to find out what's happening. There's also Dominique Duliège in Lyon, who works with doctors and specialize in working with musicians through gerda Alexander's Eutonie.
Marie-Christine Matthieu is also a pretty well known name for professional musicians. She's pretty much touring orchestras and conservatories in France.

Wow! Just before my op it took me 30 minutes to walk 150 yards. After the op and and for two weeks I could only walk the distance between two street lamps. Now more than a year later I can walk 5 miles but so pleased to get home to my piano.

Ian