Strange left palm pain

[Rockin Mike]

I played bass for over 10 years, then took 15 years off...
Picked it up again 3 months ago with a passion, playing 10-hour days whenever I got a chance. I still remember things I used to play, but without the muscle tone I had 15 years ago I think my muse is writing checks my hands can't cash...

A couple of weeks ago I started getting a strange pain in my left palm, like an electric shock in a small (like 5cm) area at the base of my thumb right where my hand creases as I touch my pinky with my thumb. It only triggers when I fold my palm like that.

I went to the orthopedic doc. X-rays were normal, and he said it's not carpal tunnel syndrome but he doesn't know what it is. He said it might be a pinched sensory nerve but since there's no numbness and my strength is normal the motor nerves are OK. He didn't have an idea what to do about it.

Has anyone ever had this before?
If so what was the diagnosis?
What has worked to make it better?

I can play without pain if I wrap my whole hand around the neck, but there are a lot of things I can only do using the standard grip where the only things touching the neck are my thumb pad (on the back) and my fingertips (on the strings)

I'll probably try a wrist brace to inhibit that folding motion.

Thanks for any ideas folks may suggest.

[puddin tame]

tried playing on a different bass with a thinner or thicker neck? might be that your hands don't get along with your present instrument

[Rockin Mike]

Originally Posted by puddin tame

tried playing on a different bass with a thinner or thicker neck? might be that your hands don't get along with your present instrument

I have a Spector and a couple of Ibanezes, so I have both extremes of thick and thin. It happens on either bass.

It seems to be related to the hand posture combined with muscle tension, rather than stretching to reach around a thicker neck.

[pocketgroove]

I am inclined to agree with the pinched nerve theory - have you ever hit your elbow hard and felt the twinge run down your arm? The sensation you are describing reminds me of that. My only advice is to monitor it and check in again with the doc if it gets worse, and try stretching your hands before playing.

Good luck!

[fearceol]

Originally Posted by Rockin Mike

Picked it up again 3 months ago with a passion, playing 10-hour days whenever I got a chance.
.

I'm surprised no one has picked up on this. Could it be that you are simply over doing it after an absense of fifteen years ? Rest up, and ease off on the amount of time. Dont play through the pain. If you are playing for long periods, take regular breaks. Regularity is as important as actual time spent. "Whenever I get the chance" tells me that practicing is not a regular thing. To then come along and do a ten hour session is not good.

Another reason might be gripping the neck too hard, or not warming up with gentle stretches. Check your L/H technique and see if any corrections are needed.

[PerlNinja]

I get the same thing if I've been on a semi-non-stop programming binge; it's not carpal tunnel, as the doc already said, but it's mainly your hand complaining to take it easy. A little swelling here and there from the workout + folding your hand in that manner = pinched nerve

[Russell L]

First off, take it easy. You don't have to play ten hour days. And, it's ok to let the neck rest in your palm if that feels better. I do it alot, as well as using the standard technique. Whatever feels good and works, that's my way.

[wrench45us]

it does sound like overuse inflammation of some sort

you may wantto look into Alexander technique that some professional musicians use to combat repetitive stress injuries. I'vbe never fully understood it. It seems rather mysterious and guarded by certified teachers, but it does have to do with ergonomics and mostly learning to release unnecessary muscle tension.

[CDRhom]

It may be De Quervain Syndrome. I have it in my right arm and have to make sure I don't over do it.

De Quervain syndrome - Wikipedia, the free encyclopedia

[sammyp]

i've been playing guitar and bass for 25 years ...i get all kinds of little pains .....stretch your fingers and roll your wrist before playing and you should see improvment ....bass is a very physical instrument for the left hand so take care and limber up the left hand before you play!

[Rockin Mike]

Originally Posted by CDRhom

It may be De Quervain Syndrome. I have it in my right arm and have to make sure I don't over do it.

De Quervain syndrome - Wikipedia, the free encyclopedia

According to Wikipedia, De Quervain's Syndrome causes pain in the back of the wrist just below the thumb. My pain is on the palm side of my hand, so I don't think it's the same thing.

I had an EMG done and the technician (not the doctor) said it looks like there is a little diabetic neuropathy and a little median nerve entrapment (carpal tunnel syndrome) and whereas neither one is bad enough to cause symptoms in normal use, the combination of both along with the exertion of playing bass could be tweaking it enough to cause symptoms.

It's been getting a little better since I've been resting it. I started taking a B12 supplement, that's supposed to help nerves.

[1958Bassman]

Originally Posted by Rockin Mike

I played bass for over 10 years, then took 15 years off...
Picked it up again 3 months ago with a passion, playing 10-hour days whenever I got a chance. I still remember things I used to play, but without the muscle tone I had 15 years ago I think my muse is writing checks my hands can't cash...

A couple of weeks ago I started getting a strange pain in my left palm, like an electric shock in a small (like 5cm) area at the base of my thumb right where my hand creases as I touch my pinky with my thumb. It only triggers when I fold my palm like that.

I went to the orthopedic doc. X-rays were normal, and he said it's not carpal tunnel syndrome but he doesn't know what it is. He said it might be a pinched sensory nerve but since there's no numbness and my strength is normal the motor nerves are OK. He didn't have an idea what to do about it.

Has anyone ever had this before?
If so what was the diagnosis?
What has worked to make it better?

I can play without pain if I wrap my whole hand around the neck, but there are a lot of things I can only do using the standard grip where the only things touching the neck are my thumb pad (on the back) and my fingertips (on the strings)

I'll probably try a wrist brace to inhibit that folding motion.

Thanks for any ideas folks may suggest.

You can't go from sitting around to running marathons, either, and that's just about what you did by starting again practicing 10 hours per day.

Do you have a small, sensitive bump at the base of your thumb? That's from the extra stress you're placing on it and it may be a ganglion cyst. I have one that comes and goes but it sounds like it's not De Quervain Syndrome because that involves the two tendons that lift the thumb away from the plane of the palm.

[Nev375]

Originally Posted by 1958Bassman

You can't go from sitting around to running marathons, either, and that's just about what you did by starting again practicing 10 hours per day.

^this. Lay off a while. Playing bass should not hurt. If it hurts, give it a rest.

I'm currently recuperating from carpal tunnel surgery, so I often get very similar pains to what you describe. It's part of the healing/strengthening process.

[Rockin Mike]

Had an orthopedist interpret the EMG test today. He said I have carpal tunnel in both hands, though the symptoms are unusual. He gave me a cortisone shot in the left wrist and put it in a brace for 2 weeks. Might be able to avoid surgery since it was diagnosed early.

So, for the benefit of others who might have a weird electric shock sensation in the palm when gripping things, it could be carpal tunnel. I never found that symptom described for carpal in any of my googling, yet there it is.

Thanks everybody who replied with their experience and suggestions. You all are the greatest!

[Fergie Fulton]

Originally Posted by Rockin Mike

Had an orthopedist interpret the EMG test today. He said I have carpal tunnel in both hands, though the symptoms are unusual. He gave me a cortisone shot in the left wrist and put it in a brace for 2 weeks. Might be able to avoid surgery since it was diagnosed early.

So, for the benefit of others who might have a weird electric shock sensation in the palm when gripping things, it could be carpal tunnel. I never found that symptom described for carpal in any of my googling, yet there it is.

Thanks everybody who replied with their experience and suggestions. You all are the greatest!

Forgive me but i have followed this thread but never seen any need to comment until now. You seemed to have everything in order, even the EMG with the sort of results i would expect to see.
But would i assume you had the standard surface EMG, then if those results were inconclusive the intramuscular EMG ( you may have had both at the same time). From this i would expect a Neurologist to make a report and any conclusions to be read by the treating consulting, not an Orthopedist to interprete the results.
I can appreciate that an Orthopedic Surgeon specialising in hands may look to other specialists for a conclusive diagnosis or information to support a conclusion, but to go straight to cortisone this quick seems a bit radical.

I hope it all works out for you, good luck.

[Rockin Mike]

Originally Posted by Fergie Fulton

Forgive me but i have followed this thread but never seen any need to comment until now. You seemed to have everything in order, even the EMG with the sort of results i would expect to see.
But would i assume you had the standard surface EMG, then if those results were inconclusive the intramuscular EMG ( you may have had both at the same time). From this i would expect a Neurologist to make a report and any conclusions to be read by the treating consulting, not an Orthopedist to interprete the results.
I can appreciate that an Orthopedic Surgeon specialising in hands may look to other specialists for a conclusive diagnosis or information to support a conclusion, but to go straight to cortisone this quick seems a bit radical.

I hope it all works out for you, good luck.

It was just the surface EMG, and he is an Orthopedic Surgeon, not a Neurologist, but he does specialize in hands and arms and he seemed confident that the test results were clear. He's a good doctor. His practice (Jacksonville Orthopedic Institute) does all the sports medicine for the Jaguars, and this same doc did a rotator cuff repair for me a little over a year ago and I have 99% range of motion back in the repaired shoulder which is actually a very good result.

I did ask him to treat it aggressively because I'm trying to start a band and I want to get the health isssue out of the way before the band gets going.

I'll percolate about consulting a Neurologist. This is a darn strange symptom for carpal. Possibly there's more than one thing going on. Maybe I'll make an appointment on Monday.

[Fergie Fulton]

Originally Posted by Rockin Mike

It was just the surface EMG, and he is an Orthopedic Surgeon, not a Neurologist, but he does specialize in hands and arms and he seemed confident that the test results were clear. He's a good doctor. His practice (Jacksonville Orthopedic Institute) does all the sports medicine for the Jaguars, and this same doc did a rotator cuff repair for me a little over a year ago and I have 99% range of motion back in the repaired shoulder which is actually a very good result.

I did ask him to treat it aggressively because I'm trying to start a band and I want to get the health isssue out of the way before the band gets going.

I'll percolate about consulting a Neurologist. This is a darn strange symptom for carpal. Possibly there's more than one thing going on. Maybe I'll make an appointment on Monday.

I'm sure you know what is best for you and i would never ever interfere with someone who has you first hand, but i find it strange that the intramuscular test was not used to confirm or deny that cortisone would be a way forward.
Not saying the intramuscular test would make it beyond a shadow of a doubt, uit its information helps make the picture clearer.

The thing about sensation is it is a nerve response interpretated by the brain, pain for example is an emotion so its effect on us can greatly vary and can be controlled. Taking pain away from an injury does not stop the damage, it just removes the emotion of pain. Yes a patient feels better, but it is not adressing the cause of pain, so the damage can continue getting worse because the sensation of pain is dulled or removed. With cortisone shots you only have a few chances for them to be used effectivly so other less intrusive ways should be used first as i see it.
The splint to reduce the movement, with the use of ice to reduce inflamation may have produced the same results in the end as cortisone, but you would still have the cortisone as a back up if you see my point. Again you know the situation better than anyone, so it is your experience that must be used and accounted for.

In all these situations i always say "ask questions and lots of them". Any good respectable Doctor/specialist will answer them straight, they like to show off there skills and knowledge if you will, and take no offence in questions being asked.

Again good luck and i hope you up-date the situation with any new revelations.

[251]

Originally Posted by Rockin Mike

I played bass for over 10 years, then took 15 years off...
Picked it up again 3 months ago

<snip>

I can play without pain if I wrap my whole hand around the neck, but there are a lot of things I can only do using the standard grip where the only things touching the neck are my thumb pad (on the back) and my fingertips (on the strings)

I'll probably try a wrist brace to inhibit that folding motion.

Thanks for any ideas folks may suggest.

There is a nice smooth surface on the body of your Spector for your right forearm. If you press with your forearm, your body becomes a fulcrum & you can press the fretboard into your finger tips. It takes a little practice but, you can play with little to no effort from your left thumb.

+1 for taking it easy. You have strained something in your palm & it needs a rest to heal. Good luck.

[spigmu]

I seriously doubt the carpal tunnel diagnosis. I had a sudden mystery pain at the base of my left thumb and that's what the doctor said, after he took xrays and proclaimed nothing to see. After another month I went to a sports hand specialist who recognized a tiny pin sized bone chip, which he said was due to the bone losing a small fragment due to arthritis, hence there not being any trauma in the hand or banging of it that I remembered. He had me do a complete 180 from the CT routine I was on, which was exacerbating my hand's pain, and the discomfort disappeared in a two weeks.

Not that this is what you have, but I feel many doctors will use the carpal tunnel diagnosis much too quickly, before they've looked closely enough to warrant it. It's like spending 15 minutes with a patient complaining of fatigue and proclaiming they have chronic fatigue syndrome.

One thing I haven't seen mentioned is whether there is any swelling at the area or not. If you take over the counter inflammatory meds does it help? These both would indicate it is definitely NOT CT.

[Rockin Mike]

Originally Posted by Fergie Fulton

I'm sure you know what is best for you and i would never ever interfere with someone who has you first hand, but i find it strange that the intramuscular test was not used to confirm or deny that cortisone would be a way forward.
Not saying the intramuscular test would make it beyond a shadow of a doubt, uit its information helps make the picture clearer.

The thing about sensation is it is a nerve response interpretated by the brain, pain for example is an emotion so its effect on us can greatly vary and can be controlled. Taking pain away from an injury does not stop the damage, it just removes the emotion of pain. Yes a patient feels better, but it is not adressing the cause of pain, so the damage can continue getting worse because the sensation of pain is dulled or removed. With cortisone shots you only have a few chances for them to be used effectivly so other less intrusive ways should be used first as i see it.
The splint to reduce the movement, with the use of ice to reduce inflamation may have produced the same results in the end as cortisone, but you would still have the cortisone as a back up if you see my point. Again you know the situation better than anyone, so it is your experience that must be used and accounted for.

In all these situations i always say "ask questions and lots of them". Any good respectable Doctor/specialist will answer them straight, they like to show off there skills and knowledge if you will, and take no offence in questions being asked.

Again good luck and i hope you up-date the situation with any new revelations.

Fergie, thank you for you suggestions, they are very thought-provoking. I don't mean to disparage your ideas, but I'm curious, are you coming from a background of medical training, your own experience, general knowlege, or ?

As the doctor explained it to me, the cortisone was not just for pain relief (in the short term it's made the pain worse actually) but it's a strong anti-inflammatory. The cortisone, the splint, and the ice are all aimed at reducing inflammation and swelling. The swelling is not visible to the eye. It's happening inside the narrow ligament tunnel in my wrists. I understand that's normal in carpal tunnel syndrome.

The idea is, there's a vicious cycle in carpal. The median nerve runs through a narrow tunnel formed by a tendon. When that tendon gets irritated and inflamed, it presses on the nerve causing symptoms. The more you use it, the more it inflames and swells, and the symptoms get worse. They're treating mine by using cortisone and ice to reduce the existing inflammation and swelling, and the splint to reduce movement so I won't be re-irritating it while it's trying to heal up.

Based on the strength of your comments, and those of others, I will make an appointment to see a neurologist on Monday.