Piano World Home Page Forums Our Most Popular Forums Pianist Corner Need info on carpal tunnel syndrome

I have been babying my hands for years and getting along ok kind of. Lately the prickling and numbness has increased a bunch. Luckily I can still play and it hasn't affected my ability and I just try to ignore it while performing or anything else as far as that goes.

I recently had another nerve conduction test. A few years ago it was considered moderate. This time it is diagnosed as severe.
The doctor is referring me to an orthopedic surgeon.

Don't know if he is just wanting to do surgery or try a more conservative approach like wearing splints and physical therapy.

Would like to especially hear from anyone with first hand experience, (no pun intended), regarding surgery success or problems and splints and physical therapy.

Thanks

Scott

Not sure if I have carpal tunnel or not but I get cramped hands day after practice. My left hand thumb aches all the time when playing and both pinkies get sore easy. Recently the backs of my hands have tingling pain. A few years back a surgeon said surgery was the only way - I ignored that advice. I started physical therapy round four years plus ago and still play with only mild pain sometimes. I play piano, guitalele, and baritone ukulele. I 83 years old. IMO a visit to a good physical therapist about once a week is what you should try.

I’m in medicine and would urge you to take advantage of your surgeon’s expertise, as s/he will be able to evaluate your specific case. If it helps you to be more comfortable with your decision, a second opinion can be very helpful. You could even seek another opinion from a physical therapist or non surgeon physician. All of these will be much better informed to advise a patient they have examined than even the best orthopedic / hand surgeon answering an online query. I wish you the best, and I am very optimistic the issue will be resolved.

I've had Carpal Tunnel Syndrome in the past, in both hands. I had the release surgery in both wrists, a different times, both as out-patient procedures. That was over 10 years ago. The surgeries got rid of the symptoms. Since then, I've continued playing and studying piano, improving gradually. Basically, there were no downsides to the surgery, apart from the recovery time. I followed the surgeon's post-surgery directions closely, and waited about a month after surgery before trying to play the piano with the operated-on hand.

IMO, the most important thing is to consult with, and have the surgery done by, a surgeon that specializes in hand surgery. Not a general orthopedic surgeon. I was nervous enough about losing any capability in my hands that I wanted the best care possible.

Best of luck!

Surgery always has risks. Why not to try physical therapy first?

I prefer Dhuls professional advice above. Consult with specialists who can provide guidance after a detailed history and examination.

If I were you I would consult a specialist in piano technique and injury, while you are talking to those whose specialty is hand surgery. I had a different RSI (ulnar tunnel rather than carpal tunnel). It was technique retraining that enabled me to get back to playing, after I tried other things like physical therapy. The teachers of Taubman technique at the Golandsky Institute are great at this in my experience, though I know there are others.

I know surgery for carpal tunnel is simpler and usually more successful than for the ulnar nerve problems I had, but I agree with Iaroslav,--there are always risks. Also, some people find that if they go back to their old playing habits after recovering from surgery, problems may recur.

I have a healthy respect for doctors (like my husband and son), but their expertise is in the structures and functions of the body, not in how to move at the piano to prevent or recover from injury.

I hope you won't be offended at the idea of looking at technique--pianists sometimes hate to hear this! No offense intended--playing injuries happen to great players.

Fwiw there are risks to not addressing the issue long term, chiefly permanent nerve damage. Trust the professionals and if you worry, get a few opinions.

You need to fix this now. The time for alternate therapies was years ago when you first started feeling it. Now it's at crisis mode and your options are disappearing.

Under the English health system in my area you only get carpal tunnel surgery after 3 steroid injections. These injections in most places GP can do.

It may be asking about that if you have a long wait before seeing a specialist. If you have to do to surgery can be done under local anaesthesia. Peripheral nerves do regengerate so please ignore scare mungering.



I would suggest your orthopod specialist is best one to ask. Pianoworld forum is not the place to ask about this.

Thanks for the input, much appreciated. I've already gotten a few ideas that I want to check into such as acupuncture, MRI on my upper back as I understand CT can come from pinched nerves in that area, cortisone shots to name a few. I just want to know all the right questions to ask when I see the specialist. Hope this helps others who may be in the same position. Scott

The first question I would ask: my nerve conduction results went from moderate to severe. Can you explain the significance?

Second: If I delay surgery and try other therapies, will there become a time that it will be inoperable?

What therapy would you suggest and why?

Have you consulted a physiotherapist? If not, I would suggest you get one! My father, who was been lately suffering from lack of flexibility and numbness over his hand, has had great relief from pain. Though just one month had passed since he started the treatment, he feels great to change with strength and control over his hands. I am glad we had taken the right decision of approaching a registered physiotherapist than undergoing any operation.
Hence, I would strongly recommend you to pay a visit to an expert physiotherapist. Wishing you a healthy and speedy recovery!

Here is a related but not identical question — and this applies only if the recommendation is to pursue surgery rather than trying more conservative measures first.

What are the risks of delaying a surgery?

This is a broad question, but as dhull100 mentioned, the risk of permanent nerve damage may mean that although a surgery is possible down the road, it may be more likely to be successful in helping you regain more sensation and strength if the surgery is done sooner. This will depend on the specifics of your case.

If you have any doubts about the recommendations of the orthopedist, you should look for a 2nd opinion, but I’d take the recommendations very seriously. The orthopedist should be able to sort out whether additional studies like the neck MRI are needed- usually the combination of your physical exam and the nerve conduction results mean that the an MRI is not necessary (the diagnosis is clear from the exam and nerve conduction studies).

Dude, don’t ask an Internet forum, ask your doctor. Your health is too important for amateur advise.

IMO it's perfectly rational to ask about other people's experience while also consulting doctors. We shouldn't assume anyone who asks such questions on the forum is seeing this as a substitute for medical advice. In fact, it's clear from the OP's first post that active medical consultation is ongoing.

Thanks for all the input. I find this helpful while preparing to see a hand doctor next week. Any other comments welcome. Scott