I am a very busy guitarrist right now, involved in a jazz big band, a jazz combo, and I’m expected very shortly to give a classical guitar performance. I’m more than a little worried about a pain I’m feeling in my hand. I intend to go see a school doctor about it tomorrow (I don’t have insurance and can only afford to go to the school medical guys, but I wonder if they’ll even have a specialist who will know how to treat it), but I’m hoping to get some expert advice here on what I can do until tomorrow.
Last week I began feeling a nerve-like pain around my palm area closer to my pinky side. At times I even felt pain in my elbow which certainly seemed to be related. I stayed off it as much as possible and it did seem to get better but I felt I had to practice last Fri and Sat, and now the pain is back, though in a different place - now it seems to be concentrated in my pinky and it is a little swollen. I’m not going to play at all until it heals, but what can I do for it? I have been massaging it and soaking it in hot water figuring that might loosen up the muscles and help the blood flow. Is this correct? Can I do anything else?
Advice will be greatly appreciated.
It’s probably a pinched nerve. I’m enjoying one of those myself. Here’s what the Dr. told me: apply an ice pack for 20 mins. then allow the skin to warm naturaly for 1 hr., then repeat as needed. Applying heat makes it feel better while your doing it, but the cold releives the pressure from the nerve.
Another possibility is tendonitis. Violinists and pianists sometimes suffer from it, and playing the guitar uses very similar muscle groups in the arms and hands.
You should definitely have it checked out, because continued heavy playing could aggravate it and make it worse. Also, a specialist might be able to advise you on avoiding this sort of thing in the future. Do you have a guitar teacher you can discuss this with? He/she might have a better idea of what’s going on.
Good luck at the doctor!
A chiropractor told me once that a good way for musicians to protect against hand injuries (such as carpal tunnel syndrome) is to exercise the muscles that dont get used. Take a rubber band and put it over your fingers. Then, expand your fingers so it streches out the band. Do this repeatedly until tired. Do both hands this way, once or twice a day. Supposedly this strengthens the muscles that don’t get used and balances everything out. Hope this helps.
I am an amatuer fiddle player and several years ago had repetitive stress injury to my left hand. I had to stop playing for about 8 months for it to heal. In my case it was the muscles in my forearm that were injured … these are where the muscles are that actually move your fingers. Ice and taking anti-inflamatory medicine such as asprin or Aleve was helpful. It is important to be instructed in the correct way to apply ice. And you should be aware of side effects of taking anti-inflamatory medicines, especially if you do so for an extended time. Do not exceed the recommended dosage on the package.
I believe that my problem was trying to play faster than I am really capable of. I was trying to keep up with other people who could play faster than me.
Your description of the pain sounds like Carpal Tunnel. This is an area on the underside of your wrist sort of where you would buckle a wrist watch. (In fact, if you wear a wrist watch it might be helpful to not wear it on that wrist until it is better.) A bunch of tendons and nerves go through a restricted area here and if the area gets inflamed it can result in the symptoms you describe. This is the area where you would want to apply ice. The first couple times you ice up this area you may find the cold unbearable but you will find that it becomes less uncomfortable after several repeats. Again, make sure you are properly instructed in applying ice. Namely to get the area cold enough withour getting frostbite and how long to keep ice on it.
The idea of exercising with rubber bands sounds like a very bad idea to me. Don’t do this unless a doctor instructs you to do so.
But there are some stretching exercises you can do that will help prevent this in the future. A doctor or physical therapist would be able to show you them.
You may also want to re-examine your technique to be sure you are not putting undue stress on your wrist. Unless you go to a doctor that specializes in injuries that musicians get he won’t be much help. A teacher, especially one that has had a similar problem, would be a better bet.
Oh, I just remembered one more item that was very helpful. A splint for my wrist to restrict its motion. This lets the muscles relax and the inflamed area heal faster. You’ll be able to buy one at a drug store. Even if you can’t wear it during the day just using it a night while you sleep will help. In fact, you wouldn’t want to wear it 24 hours a day or the muscles would cramp up.
Ifubrophen works for me for minor things like that it has anti-imflammation properties.
One more thing to consider. If this is the hand you use on your computer mouse then this may be the primary cause of your pain rather than playing the guitar. If so, try a different shaped mouse and/or learn to use the mouse with the other hand and switch off.
I have been using ice periodically since yesterday. It does feel a little better today.
Damn! I hope not. As I understand it, carpal tunnel is a major problem as opposed to a minor one.
Well, I’m off to the school doctor, though I certainly doubt anyone will have any particular expertise in dealing with hand injuries of guitar players.
Actually, the problem does NOT sound like carpal tunnel to me. It sounds like CUBITAL tunnel. Carpal tunnel, I believe, would affect your thumb and the inside of your hand. The nerve you are probably having trouble with is the one that runs across your elbow and down the outside of your arm. Surgery for cubital tunnel involves re-routing the nerve over your elbow to a different location. Sounds fun, huh?
This kind of pain can also be caused by a problem with your NECK. The nerves that run down your arms obviously begin there. So if you’re looking for a posture/form correction you might want to start there. Probably won’t hurt in any case.
I have a weird bit of advice for you. If you go to a physician for this problem, do NOT let them give you an EMG – a test wherein needles are jabbed into the muscles up and down your arms and then electrified until you scream. After having this procedure done, I was told that it very rarely provides any useful information and an MRI is a much better diagnostic tool in this case. The test was way too painful to go through it for no reason.
As a classical guitarist, this is one of my fears. I have had several other guitarist friends develop carpal tunnel/repetitive motion disorder. It typically started with a numbness and would progress to severe pain though not necessarily in any bilateral position (could just as easily happen on the outside of your hand/wrist as the inside).
Anyway, this sounds like it could be a technique issue. I have had many students who I have had to correct hand positions. If you are bending your wrist backwards while playing with either hand then prolonged motion will do you injury. If any part of your muscles/tendons ache it should be on the bottom part of your forearm not the top. The muscles there are significantly stronger and capable of dealing with more stress than the ones on the top.
Not knowing which hand is giving you trouble I will jump to your right hand (the strumming/plucking one) first. Assuming you are either doing some type of fingerpicking style jazz (since you mentioned that you played classical as well) and are having pain on the outer part of your hand I would venture to guess that you are resting your elbow/forearm rather heavily on the body and pinching a nerve as others here have suggested. This is typically easy to spot if you have an indentation or line on your arm from the marks where you had been pressing. If this isn’t the case, I would check your hand position when playing. You want your wrist to be as straight as possible making one long straight line from your elbow to your knuckles with your fingers able to “grab down” towards the strings. Those are the two biggest positioning problems with the right hand that I have seen when I was still teaching regularly.
Now for the left hand (or the fretting hand… not sure if you do the wrong handed playing). Again, you should have your wrist as straight as possible; although, this isn’t necessarily possible on an electric guitar. For the electric guitar, with your palm up you should be able to turn your wrist back towards your body and make a fist. Again, this is using the stronger portion of your arm rather than the week backside. If your thumb wanders out over the top of the neck then you are not doing this properly. That is very bad technique and can cause all types of problems inlcluding severe hand pain especially down the ulna side (the bone next to the radius which is the forearm bone that connects to the thumb). It also will slow you down in quick passages though repeatedly straining and practicing that way can make it seem to go away. This is the biggest “nono” I see with electric guitarists. It also crosses over to classical guitar, but the seated position one uses to play usually forces the right hand into better technique.
To reiterate, you want to keep your wrists on both hands as straight as possible. If there is any bending then you want it to be in the direction of your palm. This can be emphasized by you making a fist with one hand and then tightly close it and move it down in the direction of the palm. That should be really easy. Now do the same thing and move your hand upwards. Tightly close your fist. That should be significantly more difficult.
I would still go to the campus doctor or whatever to have it checked out. If there is a problem they will put you in braces and limit your playing/practice. Even then, the problems will return until you modify your technique.
Good luck and HUGS!
PS. Don’t listen to handy. Aspirin/ibuprofin may help alleviate the pain but in so doing with continued playing you are likely to injure yourself even more severely.
He DID instruct me to do so (and said it’d be good for others too), hence my saying
If you would like to talk to him, you may reach him at:
13740 Research Blvd., Suite U-1
Austin, TX 78750
Perhaps he can help you, as he deals with this kind of thing all the time.
Numbness and pain involving the 4th and 5th digits is usually due to ulnar neuropathy [UN] or C7/8 cervical radiculopathy (pinched nerve in the neck). It can also be due to a neurovascular disorder, called "thoracic outlet syndrome [TOS]. Carpal tunnel syndrome [CTS], usually causes numbness of the first 2-3 digits, but a C5/6 radiculopathy can cause the same symptoms. The main difference between the peripheral neuropathies (CTS & UN), and the radiculopathies, is that the radiculopathies usually show sensory changes proximal to the wrist creases.
Tendonitis can present with numbness and tingling that really does mimic neuropathy. The best way to demonstrate neuropathy is with nerve conduction study and EMG.