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Aleviating carpal tunnel pain while still playing

Discussion in 'Jazz Technique [DB]' started by SRawl, Feb 15, 2019.


  1. SRawl

    SRawl

    Oct 5, 2018
    Jonesboro, AR
    I recently found out I have carpal tunnel in both hands. I've been able to identify the problems in my technique for my left hand and with my bow that have helped cause this problem, but I can't figure out what I'm doing wrong with my pizz (for jazz especially) that's causing so much pain. I was wondering if anyone has some tips or advice to help the pain subside. I'm taking a hiatus from gigs right now but that's only a temporary option. All advice is greatly appreciated!
     
  2. geoffbassist

    geoffbassist UK Double Bassist Supporting Member Commercial User

    Jul 17, 2006
    UK
    Founder - Discover Double Bass
    I’ve had the carpel tunnel release operation in both hands so I know a bit about it. Are you getting numbness as well as pain and have you specifically been diagnosed with carpel tunnel syndrome?
     
    TomB, DrayMiles and Chris Fitzgerald like this.
  3. SRawl

    SRawl

    Oct 5, 2018
    Jonesboro, AR
    I've been diagnosed with carpal tunnel for both hands. There is numbness, but I'm also feeling pain up my forearm. It's most likely caused by the pressure being applied by my carpal tunnel passage. I did get checked for tendinitis in both hands and that came up negative.
     
  4. Eric Hochberg

    Eric Hochberg

    Jul 7, 2004
    Chicago
    Make sure your string height is low, you have little scoop in your fingerboard and your nut isn't too high. Lighter strings may help, also.

    Personally, I wouldn't play through pain.
     
    DrayMiles, the_Ryan and geoffbassist like this.
  5. buldog5151bass

    buldog5151bass Kibble, milkbones, and P Basses. And redheads.

    Oct 22, 2003
    Connecticut
    Get to a doctor. What I did was wear a brace 24/7 for a month, which seemed to do the trick.
     
    Max George likes this.
  6. SRawl

    SRawl

    Oct 5, 2018
    Jonesboro, AR
    I've been to the doctor several times, I've been wearing braces and taking medications but it's not quite doing the trick. I've heard nothing but horror stories from musicians who got surgery at the hospital near by, they've all said surgery made things worse for them. So I'm trying to find an alternative.
     
  7. Tom Lane

    Tom Lane Gold Supporting Member

    When I had "tennis elbow" in my left arm, I found that nothing short of not playing for 6 to 8 weeks, multiple daily stretching, and then adjusting my technique worked. In my case, I learned to use my arm weight to hold the strings down, which required me to hold my elbow higher than I would normally do, but I heard my first classical teacher's voice in my ear "keep your elbow up". Good advice for the right arm too.
    You need to give your body time to recover from its trauma, and then you can start again. How long? Depends on your age and your health.
    Haven't experienced it since then and I regularly play in TP for an hour a day, so... worked for me; YMMV.
     
    DrayMiles and ErikP.Bass like this.
  8. ErikP.Bass

    ErikP.Bass Supporting Member

    Nov 23, 2004
    Rest is your bet bet. Chances are there are other things you’re doing in your day to day that are exacerbating the situation as well. Take time to focus on ear training and find someone who can help you evaluate your technique so you can address the root cause. Take care and good health!
     
  9. DrayMiles

    DrayMiles

    Feb 24, 2007
    East Coast
    Good advice all around...

    I have experienced similar issues and imho... I would...

    Completely stop playing until the pain stops...

    Then observe what causes you pain whenever you do play, and stop doing it obviously.

    Obviously seek medical help from several sources.

    and (I suspect this is important) whenever you take a break from playing, and startup
    again, pay attention to how long you're able to play without pain. Time it, analyze it, and
    that should be your red flag. Rest and refrain from playing once that period improves over time.
    It should be a natural and organic process. This is just my opinion... It's a long process, but in tandem with anti-inflammatory medications, rest, and listening to your body, I don't see many alternatives... In fact, sometimes a more experienced player can notice things about your posture you can't...

    Pain is your body's way of saying "what on earth are you doing to me?"

    I repeat, I'm no doctor, but I've sadly been sat across from a Dr. who was advising cortisone injections, surgery,
    and similar procedures... I decided to not play for awhile, and then I listened to my body to tell me when I could. I'm still listening, but there are cats out there playing in their 80's and 90's, I'm sure they've been through similar concerns. They found a way to keep playing and I'm sure you can too...

    But, once you do... Your body will remind you if you get too reckless...

    Good Luck,

    D.
     
    Last edited: Feb 16, 2019
    oldNewbie, SRawl, Seanto and 3 others like this.
  10. fu22ba55

    fu22ba55 Gold Supporting Member

    Apr 16, 2009
    I had cubital tunnel syndrome in my left hand, and the only thing that cured it (after two different doctors and 6 months of PT that didn't work) were these cheapo Flex-Ex exercisers. Use one color twice a day 'til exhaustion.
    The book Conquering Carpal Tunnel Syndrome also helped me better understand the Fascia.

    But I'd defer 100% to Geoff Chalmers advice if he already had the surgery.

    For playing through, I did heat for 10 minutes before playing, and ice for 10 minutes after playing, a TON of ibuprofen (probably an unsafe amount), and wrist braces on my wrist to enforce safe wrist position while playing.
     
    hdiddy and matthewbrown like this.
  11. Chris Fitzgerald

    Chris Fitzgerald Student of Life Staff Member Administrator Gold Supporting Member

    Oct 19, 2000
    Louisville, KY
    I can't speak to the medical side of the equation, but on the technical side Dray's advice above is excellent. Every single time I've experienced recurring pain from playing any instrument, it turned out there was a root cause that could be sussed out and fixed. In my case, the two main culprits were always:
    1) tension in the hands and wrists
    2) unhealthy angles of the playing mechanism, which usually meant too much wrist flexion and/or radial or ulnar deviation (this page is a simple basic description of these terms)

    In all cases, the two points above were inextricably linked. You will have to rest to get to the point where it is safe to play, and when you do, look for anything that takes your wrist out of what the page above calls the "neutral position". As Tom alludes to above, what happens in this kind of technical evaluation is akin to the the old "dem bones" song, where you start at the fingers and work your way back to what controls them (the wrist), then back to what controls the angle of the wrist (the elbow), then to what controls the elbow angle (shoulder), and then finally on to the final two links (spine and hip).

    I've mentioned it many times in my teaching, but I was first made aware of the power of this chain by my piano teacher back in college, a truly remarkable woman half my size whose sound was easily twice as powerful as mine. For years, when I would get all mucked up on a passage she would stand behind me and choreograph my elbows to help me get my wrists in the right position. At first I thought she was kind of nuts, but I quickly learned that she was actually brilliant and teaching me something that I would use the rest of my life.

    Hopefully you will be able to find a bass teacher who can help you find the same sorts of solutions. Best of luck on your journey!
     
    nutdog, hdiddy, oldNewbie and 3 others like this.
  12. s van order

    s van order

    Oct 4, 2012
    Delaware
    There is a simple (but not cheap) device called C-TRAC that over time gently stretches the transverse ligament in your wrist which is the ligament that is cut in release surgery. There is the link if you want to read about it:

    Non-Surgical Carpal Tunnel Treatment | CTRAC by Carpal Doctors LLC

    I have used it and it does loosen things up. But, I strongly recommend you discuss with your doctor before buying and trying it. If your symptoms are not severe and the device does not make them worse perhaps it will help you avoid surgery. Best of luck treating it!
     
  13. s van order

    s van order

    Oct 4, 2012
    Delaware
    Last bit of assistance is a manual by Dr. Richard Norris who is a specialist in treating musician injuries. He worked out of Bethesda when I saw him many years ago. Here is a link:

    https://static1.squarespace.com/sta...8875/musicians+survival+manual+norris+(1).pdf

    There is good advice in there about breaking practice time into smaller blocks and first trying "phantom" playing before playing the instrument. If playing "air bass" causes symptoms to appear or get worse, you really know you should lay down the instrument and heal. It all seems overwhelming but the guide can be helpful.
     
  14. salcott

    salcott Supporting Member

    Aug 22, 2007
    NYC, Inwood.
    You're in Arkansas, right? Contact the U of A sports department and find out who they use for hand surgery.

    I found this link after a short Google search:
    Wrist & Hand | Advanced Orthopaedic Specialists | Fayetteville, AR
     
    Last edited: Feb 16, 2019
    SRawl likes this.
  15. unbrokenchain

    unbrokenchain Supporting Member

    Jun 8, 2011
    Black Mountain, NC
    fu22ba55 recommended the flex-ex things, I'm sure those work but I just use rubber bands for the same exercise. It's supposed to build up the muscles that work the opposite way (opening the hand) to balance out the over-used ones. I'm only 34 but I ended up with bad carpal tunnel in my right hand after working a computer-based lab tech job for one year (a computer mouse is apparently not something our hands have evolved to use... I now can't use one with my right hand at all), seems silly considering all the power tools I've used and various dumb things I've done with my hands, but it's really no joke. Chem degree or not, no more computer for work for me! If it's not playing music I'll take the shovel and pile of gravel, easier on my body than the clickity type click, I'm not joking.

    I keep a rubber band around my wrist and roll it onto my hand to exercise while I'm driving or other downtime. It seems to help.
     
    powerbass likes this.
  16. dhergert

    dhergert Gold Supporting Member

    Jan 17, 2018
    Blue Zone, California
    I'm just a yearling with the double bass, but I've played other stringed instruments for about 50 years. Plus during that time I've had a 35 year career involving constant typing, from which I retired last year. So I've been lucky.

    I did have one on-the-job wrist and upper arm situation where I needed some medical help, that was provided by an occupational therapist... The OT emphasized good body mechanics, using joint posture that provides the most strength by using as naturally straight angles as possible. I followed that advice and did some exercises that help, and for typing I made sure that any pressure points in the area are not in constant contact with hard surfaces. That took care of that.

    One of the other things that the OT told me, and that I've studied a bit since then, is that research indicates that carpal tunnel syndrome is more likely a congenital condition than an acquired condition. There are some published medical research studies that discuss this point if you're interested in looking them up online. But the implication is that if you have the congenital tendency for CPS, it doesn't take much repeated stress to make it happen. So there again, using good body mechanics is very important.

    I do often look at some of the joint angles that I and various other players of the double bass (and other instruments) use and wonder. I love the sounds and techniques employed, but I hope for all of us that we are not causing our own problems.
     
  17. powerbass

    powerbass

    Nov 2, 2006
    western MA
    Carpal tunnel syndrome can be isolated to nerve compression in the wrist, it is also associated w/several other factors like diabetes, it is important to review or rule in/out all these factors w/your MD, hand specialist etc. Nerve compression (entrapment) can happen higher up in the elbow, chest (thoracic outlet) and cervical spine (brachial plexus). "Double crush syndrome" is an associated condition, people w/CTS can have nerve entrapment in other sites along the nerve pathway, esp if CTS surgery fails to reduce symptoms - they didn't look upstream. EMG testing can determine where along the nerve chain compression is happening, this is pretty standard eval for CTS. As for non surgical treatment it is worth finding a really experienced physical therapist that specializes in treatment of CTS, thoracic outlet and double crush. Physical fitness is really important - are you overweight, smoke and have poor self care habits? Do you exercise regularly - stretch, walk, yoga, strength train? Reviewing your posture and how you position your body while playing as well as in other aspects of your life is essential. Since this is about nerve compression, massage therapy and stretching can be really effective to create more soft tissue/nerve mobility. Emotional tension, anxiety and depression can contribute to CTS. Rest is important but these other self care habits are essential.
     
    Last edited: Feb 17, 2019
    oldNewbie and unbrokenchain like this.
  18. Up and Away

    Up and Away

    May 16, 2015
    Did I miss something? I have been diagnosed with having carpal tunnel syndrome(CTS) but the last couple of posts refer to CPS,is it the same thing?Please clarify.Thanks.
     
  19. dhergert

    dhergert Gold Supporting Member

    Jan 17, 2018
    Blue Zone, California
    That was my mistake, sorry. My reference was intended to be to carpal tunnel syndrome (CTS).
     
  20. econista

    econista

    Mar 24, 2019
    check out this amazing product that is chiropractor recommended for helping to prevent carpal tunnel from playing bass/guitar www.stringedbean.com i went from going numb in minutes to being able to play for hours when i installed mine!
     
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    Primary TB Assistant

    Here are some related products that TB members are talking about. Clicking on a product will take you to TB’s partner, Primary, where you can find links to TB discussions about these products.

     
    Apr 18, 2021

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