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Carpal Tunnel Syndrome - Is there a hope? #2882113
08/21/19 03:53 PM
08/21/19 03:53 PM
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Loga Offline OP
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Hi All,

I am in a very unfortunate situation. I graduated as a piano teacher this year. My story is not a classical one. I worked as an IT engineer for a long time, but my soul was always dedicated to the music. At the age of 33, I found an opportunity at a Musical College to get a degree beside work. Of course the requirements were the same as for the 'normal' students, but the lessons were on Fridays and Saturdays. Long story short: I applied, and 5 years later, I graduated. It was a very tough 5 years, but a very happy 5 years, too. I dedicated my life to this. After graduating I found a job opportunity as a piano teacher in June, and I also applied, and got it.
Unfortunately, and unbelievably, due to a stretching exercise, I developed Carpal Tunnel Syndrome. The next day after the stretching, I started to feel numbness in my thumb and index fingers, and partly in my palm between them. This was about 7 weeks ago, and since then my symptoms are constant. They come and go during the day, they worsens if there is a strong weather change, but about constant on the long term.
I read a lots of things on the internet, and became very desperate. The common opinion is that the symptoms will get worse by time, and the surgery is unavoidable. However, in the same time there are a lot of opinions out there that the surgery won't help many times, and in a few cases it even makes things worse. However, other opinions suggest that one should not postpone the surgery too long, because it reduces the chance of a full recovery.
I struggled a lot to be able to work as a musician, and now, right after I achieved it, my dream seems to collapse. It is needless to say in this forum how desperate and bitter I am. Right now the symptoms do not affect my playing abilities, but of course the numbness is very disturbing, and the whole thing makes me mentally down.

So if anyone have anything about this illness, could you please share your experiences? Have anyone had a CTS surgery as a pianist? If yes, what are the experiences?

I really appreciate any inputs regarding to the topic.

Peter

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Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882117
08/21/19 04:12 PM
08/21/19 04:12 PM
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Without more information, I would not assume you need surgery but would assume recovery will require significant rest, a slow return to activity, a revision of technics and egronomics. Physical therapy has improved so much in the past few years.

Today, stop using your piano and, computer keyboard, and smart phone. Then see a specialist doctor expereinced with pianists ASAP.

In my case, Taubman teacher sorted out my piano technique but there are plenty of other good options. It took me over a year for full recovery but today I hav zero pain and I can play for hours per day with zero fatigue.

A professional can advise you on optimal desk, chair, computer keyboard placement, mouse use, etc. And how to slowly start using again.

The smartphone is a killer for hands and arms also; I attended a class on "good use" so maybe your professional can help there.

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882118
08/21/19 04:13 PM
08/21/19 04:13 PM
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Hiya.

My mother developed this... in both hands. Probably genetic? It got worse over the years.

There are certain risk-factors which increases one's chances of getting CTS.

She eventually had an operation to relieve the symptoms and now it's as if it never happened in the first place.

Usually, they only do one hand at a time... but they did both of hers at the same time. It took about a month for her to feel normal. Whilst she's not a pianist, she's certainly just as capable now as prior to the operation.

If the cause is an injury and there's no underlying reason for it to occur, the right exercises and treatment can get it back to normal.


Learning to play. Consciously incompetent, which apparently is a good starting point. smirk
Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882126
08/21/19 04:35 PM
08/21/19 04:35 PM
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Finland
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outo Offline
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There is hope, but you should do all you can to avoid the symptoms instead of tolerating them, because if you feel the numbness, it will only get worse with time. If not too severe nerve damage and irritation can heal but it takes time and requires proper rest. And the longer you tolerate the symptoms without taking action the more you risk permanent damage.

I developed carpal tunnel after a combination of piano practice and too much computer mouse work trying to reach a deadline. This was about 5 years ago. I cured it by rest (a couple of weeks no playing and no pc work without a wrist support). Then I got a hand exercise ball and worked with it. I got physiotherapy to increase the movement and flexibility in the shoulder area so that the arm moves freely instead of just the wrist (which I can twist a lot due to being hypermobile). And most of all, I learned how to keep my wrist straight whenever my fingers need to work hard or repeatedly for long.

Maybe surgery would have removed some of the limitations I have, but I wanted to try to avoid it. I think in my case a very early intervention was essential to fast recovery. Now I have learned to notice immediately when the nerves are getting irritated and stop whatever I am doing and find another way. I avoid repetitive finger exercises if they are the kind that aggravate the wrist. I also try to avoid too much mouse use.

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: newer player] #2882135
08/21/19 04:59 PM
08/21/19 04:59 PM
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Richmond, BC, Canada
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Charles Cohen Online content
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Originally Posted by newer player
Without more information, I would not assume you need surgery but would assume recovery will require significant rest, a slow return to activity, a revision of technics and egronomics. Physical therapy has improved so much in the past few years.

Today, stop using your piano and, computer keyboard, and smart phone. Then see a specialist doctor expereinced with pianists ASAP.


+1.

Icing the wrist -- to reduce inflammation -- might also help. But rest, and professional advice, are both going to be very important. It's your future livelihood -- take it seriously.

It sounds like you caught this early, and it was the result of trauma (a "stretching exercise"), not overuse. I _think_ those are both good things -- but I don't have letters after my name.


. Charles
---------------------------
PX-350 / microKorg XL+ / Pianoteq / Lounge Lizard / Korg Wavedrum / EV ZXA1 speaker
Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882139
08/21/19 05:10 PM
08/21/19 05:10 PM
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Posts: 2,187
Dublin
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If this is the result of a single incident, as opposed a more general problem with your technique, you might just need to take it easy for a while. I've had both carpal and cubital tunnel problems. I have a physical problem that makes me prone to this. To avoid carpal tunnel problems,

I find it very important to move my thumb into place by the arm if possible, and to keep a loose wrist. If I don't do this, I get tingling in my right thumb. The bonus is that it makes a lot of difficult music much easier.

To avoid cubital tunnel problems, I need to be positioned well. I can practise for hours without any problem if I pay attention to these things. I have various into-inflammatory medications for another inflammatory condition, which I can take if I have a problem with my hands, but I don't need them.

Please don't take this as advice, but just as a more hopeful story.

Last edited by johnstaf; 08/21/19 05:18 PM.
Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882181
08/21/19 08:10 PM
08/21/19 08:10 PM
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DanS Offline
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Until you have a doctor's diagnosis, you really don't know what you have. Could be CTS could be something else. See a doctor asap and stop reading medical websites.

I thought I had carpal tunnel, had all the symptoms. Turned out to be a pinched nerve in my neck. Being more aware of my posture and strengthening my back and shoulders made a world of difference... you don't know until you know!

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882279
08/22/19 05:01 AM
08/22/19 05:01 AM
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Loga Offline OP
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Thanks for the replies so far.

Resting is a common suggestion, and I gave up practicing mostly in the last 7 weeks (1-2 exceptions when I wanted to try how it responds to practicing - not at all, as I found). I also applied icy covering.

As for the doctors, I already visited a few. They prescribed physiotherapy, and the therapist showed me nerve gliding exercises which I have to do on a daily basis. I also took a few ultrasound therapy. Beside, they suggested to fixing my wrist at night, but I read at more pages that this can be counterproductive.

They did a lot of physical tests by moving my hand, fingers, observing hand strength etc, but did not find any differences based on these.

I was on an ENG (measurement of nerve conduction) 2 weeks ago, which turned out to be negative - all values were in the "normal" range. The doctor told, there still can be a mild compression of the median nerve.

I will have a neurosonography next Tuesday - a very detailed ultrasound examination of the whole path of the median nerve. I think it should show the compression or inflammation.

I will report the results afterwards.

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882333
08/22/19 09:25 AM
08/22/19 09:25 AM
Joined: Mar 2011
Posts: 1,885
Philadelphia, PA
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jdw Offline
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Sounds as if you are getting the professional help you need. I sympathize with your distress about this, but there's lots of hope for full recovery, whether it turns out to be carpal tunnel or not.


1989 Baldwin R
Currently working on:​
Schubert, Op. 90 no. 2
Sinding, Frühlingsrauschen (Rustle of Spring)
Beethoven, Sonata no. 14 in C# minor (Moonlight)
Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882672
08/23/19 09:06 AM
08/23/19 09:06 AM
Joined: Jan 2010
Posts: 1,356
Queensland, Australia
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Good suggestions already. I've not had that, but other thumb, hand and arm and joint issues, mainly stemming around arthritis.

I finally went to a Taubman teacher for 2½ yrs and solved a number of problems. Good posture was probably the most effective - sitting considerably higher than I did previously. The other thing we worked on was trying to eliminate stretching and twisting. We worked on much more use of the sustain pedal rather than holding chords and long notes. We also eliminated some notes from big chords which were causing pain - eg in a run of 4 note RH chords for instance where the top and bottom notes were an octave apart, we dropped the bottom note. Yes, I probably couldn't do that if it was for an exam, but for almost all other purposes it isn't noticeable - and eliminated the pain, and actually I think sounded better because the transition between notes was smoother.

One other suggestion was to use a wrist support under the computer mouse - and that eased things considerably.


Alan from Queensland, Australia (and Clara - my Grotrian Concert & Allen Organ (CF-17a)).
Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882728
08/23/19 11:47 AM
08/23/19 11:47 AM
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London
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Post a vid of your playing. If there's a technique problem we'll spot it.

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2882951
08/24/19 08:09 AM
08/24/19 08:09 AM
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Toronto, Canada
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Can check with your doctor if physiotherapy might help. May have to wear a hand support brace for a few weeks before the injury to heal properly.

I once had an odd problem that started with the L for a few weeks and then moved to the the R before both hands returned to normal. I play violin with a music group so having full use of my fingers on the L is much more of a problem than the R. Even having pain on my R, didn't affect pulling a violin bow. The hands had pain but affected my violin playing when I pressed the strings to get the notes but didn't seem to affect my piano playing. Didn't get a diagnosis from a doctor so not sure what the problem was.

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2883198
08/25/19 06:48 AM
08/25/19 06:48 AM
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I am not a physical doctor. However, I am pretty sure you won't get a carpal tunnel syndrome from stretching exercises. You probably just irritated some finger nerves. This can be quite disturbing, but it usually goes away by itself after a few weeks or so. Keep on playing, but try to avoid tension as much as possible.

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2883205
08/25/19 08:01 AM
08/25/19 08:01 AM
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Moscow, Russia
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I am not a physical doctor either, but of what I know about carpal tunnel syndrome in pianists your situation doesn't look like the onset of this syndrome, but rather looks like a direct nerve damage because of overstretching. Carpal tunnel syndrome is usually a result of many months or even years of intense and technically wrong practice, mostly practice with tensed wrists, which is very harmful. And in your situation, if it's really the result of just one stretching exercise, it's probable that you have simply torn the nerves in your hand slightly when stretching too strenuously. If it's the case, it will take several months, probably up to half a year to heal, but you will have no problems after that. Just make sure that you don't stretch this place while it heals. You may need to wear a brace or a tape for some time to keep your thumb in safe position closer to your index finger.

And I strongly advise you not to hurry with surgery. My best wishes to you!

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2883206
08/25/19 08:02 AM
08/25/19 08:02 AM
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I've had carpal tunnel syndrome symptoms. Three separate periods in my life. The first was when I was around 40 years old. I was a computer programmer and was doing a lot of entering of data to test some software changes. I became aware that my hand/wrist posture at the computer keyboard was horrible. I bought a wrist support for work. Also I stopped playing piano for about 6 weeks. The symptoms subsided.

Then about 4 years ago, right after retiring I did a long road trip. I was driving west on Interstate 10 with torrential rain and semi-trucks all around me. I clutched the steering wheel for way too long and ended up with the familiar symptoms. After returning home I made an appointment with a hand specialist physician. He injected a steroid into my wrist . This took away the symptoms.

Then recently I was visiting Montreal. I was looking at my phone and didn't notice 3 steps down. I too a horrible fall. Soon I had the familiar symptom in my right hand. I went back to the hand physician practice. I got that steroid shot again.

One thing I learned from a hand specialist was that keeping the wrist in a "neutral" position is an important factor in avoiding the problem. I became more aware and followed his advice. Another thing is that if I feel that tingling in either hand (a familiar feeling if you've had the symptoms) I immediately get up and take a break. I'm retired now and spend 4-6 hours daily at the piano.

I've also learned, over time, to minimize the work the individual fingers have to do, particularly in the right hand. Using a slight rolling motion of the hand to assist the physical act of moving the fingers reduces the strain on the hand. Or something like that.

See a physician hand specialist. The ones I've seen give the steroid shot first, before doing surgery. Surgery should be the last resort.






Last edited by indigo_dave; 08/25/19 08:03 AM.
Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Iaroslav Vasiliev] #2883266
08/25/19 10:44 AM
08/25/19 10:44 AM
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Originally Posted by Iaroslav Vasiliev
I am not a physical doctor either, but of what I know about carpal tunnel syndrome in pianists your situation doesn't look like the onset of this syndrome, but rather looks like a direct nerve damage because of overstretching. Carpal tunnel syndrome is usually a result of many months or even years of intense and technically wrong practice, mostly practice with tensed wrists, which is very harmful.


Some people are born with tight carpal tunnels. When so, any sort of activity where the nerves are rubbed against the tight opening repeatedly or too long can aggravate the symptoms. Sometimes it happens overnight like in my case, sometimes it developes more gradually.

Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2883336
08/25/19 02:11 PM
08/25/19 02:11 PM
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Someone reading this thread may get some benefit from this. It's about hand rotation. Around 7 minutes in he illustrates the right hand rotation. I don' t necessarily grasp everything. And I read somewhere that he misdescribes some hand anatomy (IIRC). But there are ideas for changing hand technique for some advantage.



Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2883357
08/25/19 03:16 PM
08/25/19 03:16 PM
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Not too far North of Los Angel...
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Not too far North of Los Angel...
I had a mild form of it. I found that just letting my arm hang to the side of my body helped a lot.


When you play, never mind who listens to you. R.Schumann.

Casio GP-400
Schimmel SP-182T
Re: Carpal Tunnel Syndrome - Is there a hope? [Re: Loga] #2887984
09/07/19 08:05 PM
09/07/19 08:05 PM
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If you have had a positive symptoms and EMG have the surgery. It is very simple and straightforward. I am an amateur pianist and both hands were entirely numb besides my thumb. On March 2016 I had bilateral carpal tunnel release by the best hand surgeon in the USA Dr.Scott Wolfe at Hospital for Special Surgery and have been symptom free for three years. I practice 1-4 hours without sequella.


Serge P. Marinkovic, MD


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