Carpal Tunnel Syndrome

[Lenam909]

This post was a little hard to place; it's not exactly about technique. But anyway..

A couple of weeks ago I began to feel that only slight pressure on my forearm, such as when leaning on an arm rest while sat down, caused pins and needles in my thumb, index and middle fingers(left, fretting hand). For the last 4 or 5 days I have felt a constant tingle/numbness in my thumb, and when the pad of my thumb rests on the back of my basses neck there is slight discomfort, sort of like when you bang your thumb and it still aches a few mins later. I've got a bad feeling that this could easily be carpal tunnel syndrome. If that is the case, then I have two questions for the talk bass community:

-To anyone who has/had carpal tunnel syndrome, did you experience muscle weakness in the affected hand? If so, how did that affect your playing?

-In which hand is a bass player more likely to develop carpal tunnel syndrome, fretting hand or... the other?

Perhaps a new section on the forums for similar issues would be a good idea...

[Fergie Fulton]

There are many reasons why you experience this, CTS is in your mind because it is associated with such symptoms. But so are many other conditions, quite trivial and simple conditions, easily treated with simple drugs and rest.

What you need to do is see a doctor or medical profesional.
A simple neuralgia may be the problem, or an old injury coming to light.

The hands and in particular the finger tips have lots of closely grouped nerve endings, thats why you have such sensitivity to pressure, pain, hot, cold etc, its the finger tips job to recognise these things. So when some thing is not right you will feel it at the nerve end, even though the problem may be in you neck.

Think of it like a hose pipe, when the water comes out the end you see the effect, when it stops you see the effect...but the water did not stop because the end of the hose was at fault, it maybe some where else along it path, so looking at the end of the hose will serve no real problem..unless the blockage is there. But that is always the first place we look because that is where we first see the effect of no water.

[joebingo]

Originally Posted by Lenam909

This post was a little hard to place; it's not exactly about technique. But anyway..

A couple of weeks ago I began to feel that only slight pressure on my forearm, such as when leaning on an arm rest while sat down, caused pins and needles in my thumb, index and middle fingers(left, fretting hand)

Probably not carpal tunnel. If I remember rightly, the carpal nerves do not serve the thumb, just index, middle, ring and little finger. Is it effecting your elbow at all?

Originally Posted by Lenam909

-To anyone who has/had carpal tunnel syndrome, did you experience muscle weakness in the affected hand? If so, how did that affect your playing?

Yes I did experience muscle weakness, as well as pain most of the day and night. When there wasn't pain, I was experiencing pins and needles/complete numbness. I couldn't play until it cleared up, which took 6 months.

Nip this in the bud mate, seriously.

[Fergie Fulton]

Originally Posted by joebingo

Probably not carpal tunnel. If I remember rightly, the carpal nerves do not serve the thumb, just index, middle, ring and little finger. Is it effecting your elbow at all?
Nip this in the bud mate, seriously.

Sorry but false information concerning CTS.

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel - a narrow, rigid passageway of ligament and bones at the base of the hand - houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized.

Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.

Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Most likely the disorder is due to a congenital predisposition - the carpal tunnel is simply smaller in some people than in others. Other contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; overactivity of the pituitary gland; hypothyroidism; rheumatoid arthritis; mechanical problems in the wrist joint; work stress; repeated use of vibrating hand tools; fluid retention during pregnancy or menopause; or the development of a cyst or tumor in the canal. In some cases no cause can be identified.

There is little data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Repeated motions performed in the course of normal work, or other daily activities can result in repetitive motion disorders such as bursitis and tendonitis. Writer's cramp - a condition in which a lack of fine motor skill coordination and ache and pressure in the fingers, wrist, or forearm is brought on by repetitive activity - is not a symptom of carpal tunnel syndrome.

If you have any doubts see a medical profesional, sooner rather than later.

[countrybassist]

I had a similar issue years back with my right hand. Ended up being a disc in my neck.

[Turock]

I had carpal tunnel surgery on my right (plucking) hand with the exact symptoms as the OP.

[Turock]

I never realized how much it had gradually affected my playing until after the surgery. I only had the surgery because after a few minutes, I had no feeling and could not even tell if I was plucking or which string I was on.
The best way I can explain it is, besides the loss of feeling, it was like a rubber band had been holding me back and once cut I could fly on the bass. It was more than six months after surgery before I had the strength to play for longer than about 15 minutes.
They may use lasers or something today, this was more than 20 years ago, and surgical techniques have probably improved.
The surgery was the best thing I have done for my playing, but I would look for other methods first.

[Jack Kowalski]

Post from Dr. Jack Kowalski (doc & ex bass player): Fergie Fulton (see above) has it right regarding CTS in general. I would just add that the median nerve becomes irritated from the tendons rubbing against it in the tunnel. This is most pronounced when the wrist is flexed (bent). Much like pulling a wire through a small opening is hardest (on the walls of the opening) when you pull hard at an angle to the axis of the opening. Watch your wrists. Any kind of repetitive finger action with finger pressure when the wrist is bent is causing this problem. For me it was using Classical thumb-behind-neck position and then bending wrist to reach E and A strings. You can get away with this on a Classical because depressing the nylon strings requres almost no pressure. Keeping the right wrist in neutral position is generally less of a problem regardless of whether you use a pick or your fingers.