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Carpal Tunnel Syndrome ( CTS ) Info

Discussion in 'Technique [BG]' started by Fergie Fulton, Oct 6, 2012.


  1. I had a CTS scare. My hands felt weak and felt like they wanted to fall off. My third doc suggested the nerve conduction test which showed nothing at all and the weakness went away on its own
    But any problems I ever got with my hands or wrist always came from texting on the phone or using the computer too much or "incorrectly"
    During my scare I read a bunch of books on musicians injuries, over use and I really think with good technique and a good balance between rest and playing its usually other things like computers and cellphones which lead to "issues" with a lot of people and we never really reach the real cause!
    BTW my NCT was not really pain full far as I can remember . maybe because I didn't have CTS?
     
    Fergie Fulton likes this.
  2. I am in the same boat. I had CTS surgery (arthroscopic) about 4 years ago. When the swelling had gone down, the initial results were promising... But within a year, I was getting the familiar pins and needles, swelling, weakness and pain again.
    TBH, I don't think I'll bother again for a while... I can manage the pain and swelling with medication and rest... Maybe one day I'll get the surgery re-done, but I don't think I'd go for arthroscopic surgery again.
    A few people told me to not get it done as it wasn't a proven technique, but the surgeon was adamant that it would be fine. Guess I should not have listened to him!@
     
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  3. joebar

    joebar

    Jan 10, 2010
    the problem in my case was that I returned to work after 12 weeks post-op.

    I really inflicted more damage to my hands after the surgery.
    I should never have returned but everyone tells you are fine, these are normal feelings etc...
    I left my job as a tradesman march 27th of this year and have never returned.

    I am still healing and have some specialist appointments in December; I still have an ongoing work related case for these hands.
    I have had minimal compensation.

    when the day comes where I return to work, I will be starting over- a fresh direction at 44 years young.
     
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  4. HypersoulRocks

    HypersoulRocks Supporting Member

    Jun 7, 2011
    Houston,TX
    I did my right hand in September, having my left hand done next week. I did a gig 15 days after my surgery. The wrist muscle is still sore, but I'm stretching it and using a weight as per my doctor. It's nice to not have stabbing pain and to actually have sensation in my fingertips again.
     
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  5. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    CTS surgery was a great success for me and I'm playing as much as ever since both wrists were released. However, as an RA sufferer, tendon problems are ongoing, including regular "trigger finger" issues. I've found that continuing to wear wrist braces at night keeps these tendon problems at bay without cortisone or other intervention. I just thought I'd share in case any other CTS sufferers have these ongoing problems.
     
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  6. joebar

    joebar

    Jan 10, 2010
    I should update-

    it turns out that I had a lot of scar tissue in my left wrist that would not go away; it was what was causing the pain-the scar tissue inflamed the nerve constantly.

    believe it or not, I found out that exercising the wrist broke down the scar tissue, but not in the way you would think-

    I returned to bodybuilding and of all things, bench pressing fairly heavy broke the tissue down considerably-I would never have thought that. it made my wrists stronger. also-heavy deadlifting (an old perennial fave of mine) also contributed to overall strength in the hands.

    as of October of 2015-i found a new career as a postal worker and the job is very physical but doesn't aggravate old injuries at all.

    I am delighted with the results lately.
     
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  7. mrpackerguy

    mrpackerguy Supporting Member

    Jul 3, 2004
    Madison, Wisconsin
    My issue is not with my left hand, but rather my right hand. Generally 3-3.5 hours into a 4 hour gig, I get numbness and pain in my hand with my finger technique. Fingers find they can't move. I've rightly or wrongly attributed it to resting my right arm on the top of the bass and maybe cutting off some circulation to my fingers from a point on the underside of my forearm about midway between my wrist and elbow. I dunno. I've gone to using a soft or rigid splint on that forearm depending on how the arm and fingers feel with limited success. I can't imagine its CTS because there is no numbness or pain at any other time. I find it really difficult to consciously keep a technique going with my right arm that keeps it off the top portion of the bass for any appreciable length of time. Wondering if anyone else has experiences this and has found a way to compensate
     
  8. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    I assume you're using a rounded top bout, not a sharp edge. I find the (Fender-style) relieved bout helps vs. any sharp edge. Ibuprofen is recommended to me to avoid finger cramps and I think it helps, but I still "lock up" on occasion. I use wrist splints at night, prevents trigger finger issues. Check your "nerve response" (test required) to be sure it's not CTS, since that's a whole other can of worms. I actually still get that problem at times it in both hands, even after CTS release surgery. That's my list ...sucks getting old!
     
  9. mrpackerguy

    mrpackerguy Supporting Member

    Jul 3, 2004
    Madison, Wisconsin
    Agreed. Yes, I'm talking about the rounded bout. Main bass is a Lakland Skyline Glaub, but no intent to implicate any bass as at fault obviously.
     
  10. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    How low is your bass on its strap? What angle is it at (relative to vertical)? Are both wrists fairly straight? I learned that if your bass is too high, it leads to acute wrist angles. If you keep your bass at a medium height and at about a 45 degree angle it eases these ergonomic impacts. If you know all this already, sorry!
     
  11. Fergie Fulton

    Fergie Fulton Gold Supporting Member

    Nov 22, 2008
    London-NewYork-Paris-Munich-Braintree
    Retrovibe Artist rota
    Hi mrpackerguy, such things need a medical diagnosis, and nerve conduction tests are best.
    If you want to revue your technique, check out the video for some key points to check out and maybe address.
    First off i would suggest your arm runs along the front of the instrument, not on top of it.
    But see a medical professional for a diagnosis.

     
    TomB likes this.
  12. Phe

    Phe

    May 30, 2005
    Oulu, Finland
    I had an open surgery two months (and one day) ago. My playing is better than ever, but I still can't play with pick very long. I got a cramping pain in my thumb muscle if I play with a pick.

    Other than that I've been doing the stretches and squeezing a soft ball to retrieve my powers. How long have you guys had pains and stiffness in your hands after the surgery? I'm pretty sure I'm recovering just fine, but my thumb problems worry me. What if they nicked my thumbs nerve? They told me there is a chance, albeit a small one.
     
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  13. Fergie Fulton

    Fergie Fulton Gold Supporting Member

    Nov 22, 2008
    London-NewYork-Paris-Munich-Braintree
    Retrovibe Artist rota
    Hi Phe, glad to hear evrything is going well.
    Your thumb is the most complicated of the fingers as it is opposable.
    Think of it like a flag pole with all the cables holding it up, the pole can be moved in any direction and plane, by altering the tension of the cables....your thumb works on the same principle, the tendons that link it are the cables on the flag pole.

    Squeezing the ball is just part of it, you are only working your thumb in one plane, flexion, but you also need to work it in extention.

    Two good exercises are
    1/ Use an elastic band around the outside of the thumb, forefinger and middlefinger at about the base of the nail.
    Just open your fingers and expand the elastic band, hold for 10 seconds then release. Do this as 20 repetitions till it becomes easier to do. If you struggle cut the repetions down, or cut down the hold time.

    2/A bucket of sand, or similar container, just put your all your finers together in a point, work it into the sand to the wrist, then open them wide, remove and repeat. Do this one until the hand tires.
    Count the amount you can do and seek to improve on it each time.
    Remember the number you tired on and compare how the hand feels at the same point, over time that you should seek to double it, then double that number again.....if that original number if it was in double figures.

    F.
     
    Phe likes this.
  14. Nev375

    Nev375

    Nov 2, 2010
    Missouri
    I got Carpal Tunnel after about a decade of playing mostly 12 string bass. I tend to play chords at home even in 1st position on the E string. That takes a lot of pressure to hold down 9 to 12 strings at once across a wide neck.

    My symptoms manifested in numbness in 2 fingers and thumb when I played. Also very prone to hand cramps and eventually the numbness and tingling got to be permanent. I avoided treatment for a. lack of insurance coverage/money and b. fear of not being able to play after surgery.

    Eventually I got insurance coverage and was able to seek tratment. It was looking like I wasn't going to be able to play anyway, so...

    When it was confirmed that I would need surgery I specifically asked my primary who my best option option for a surgeon was and that I was willing to drive across state if I had to. I wanted someone with experience because I'm a musician. He sent me to a guy 100 miles away.

    The surgery ended up being very simple and routine. I followed my excersize instructions to the letter religiously.

    In 2 weeks I was starting to play 4 string again but with a little discomfort. In 1 month no discomfort at all on a 4 string. By 6 months my strength was back to 100% and was able to play 12 string better than ever before without any pain or numbness getting in my way.

    So I highly recommend getting the surgery and being done with it ASAP if you know you have it. But DO try and be selective in getting a surgeon if possible.
    ____
    edit: slight disclaimer. Since this time I have rediscovered the 4 string and hardly use the 12 string at all anymore. I also developed and built a 9 string baritone for that kind of sound because I'm gravitating toward narrower necks these days. Though the 9 string was sort of inspired by my experience with carpal tunnel, it is purely a choice and is not necessary for me to avoid playing the 12.
     
    Last edited: Feb 18, 2016
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  15. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    Congratulations! This is all good to hear, and it echoes some of our earlier comments in this thread, but it reminds me to say to folks new to the issue: make sure you get the nerve response test and the right diagnosis before moving ahead.
     
  16. Rimbaud88

    Rimbaud88

    Sep 3, 2014
    CZ
    The last saturday I was playing long time on my bass and after two years of playing I am feeling a pain in the wrist and while moving with my thumb. My friend told me he had the same problem, then he visited a doctor who told him to stop playing the bass for ever because the problem would get back everytime you play the bass again.

    Do these syndrom mean that my bass playing is over?
     
  17. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    It's not likely. Visit a doctor who specializes in hands.
     
  18. earlysecond

    earlysecond

    Jan 26, 2016
    I wanted to add that learning proper stretching techniques AND applying them BEFORE a practice session will help. Proper technique should prevent. If it hurts or feels unnatural probably should warn us that it is not healthy.

    I am NOT a medical professional but I work in healthcare and have seen many changes and experienced must frustration with patients and providers over the last 20 years.

    Your first, best resource for muscle and skeletal (I am including soft, connective tissue issues), in this day and age is NOT necessarily going to be your primary care doctor. You many not have to start there either. I will reveal my bias right now. I am in a business development role for a local partner of a national physical therapy company. I work with primary care providers, therapists orthopedic and other specialty surgeons. I wanted to share some brief advice for pain you experience which lasts longer than 2 weeks:

    Aging is NOT an acceptable diagnosis, reason excuse. . . it is dismissive medicine. Yes we age and yes many of us have abused our bodies for years BUT that does not mean there is no hope. I just posted in another suspected CTS thread where a primary care provider told a patient to simply quit playing bass and typing on a keyboard and the condition would get better. . . simply put, you have a crappy provider and he or she is not and advocate for your care and basically just dismissed you! Find a better provider, what one is not good for much of anything you will ever need!

    YOU are responsible for your healthcare and your healthcare costs- you must be your own advocate. Many of us do more research on a new/used car or a bass guitar than we do on our condition, insurance coverage or processes and timelines to healing- those days are over. Your health insurance cost MORE than your car payment and you are getting far less from it in the last many years. Know the plan, know the costs, know your rights, know the benefits, know the copays and know the deductibles. BE an informed consumer and be an advocate for you!
    Find a provider who will work with you, educate you and stick by you for more than the average 7 minute office call. If that is all you are getting go somewhere else. Do not leave an appointment until it is all explained and you fully understand your condition and options for treatment.

    YOU are responsible for getting better. After you seek help and find a provider you trust, listen to them! Do what you are told, following the dosing regimen for meds, rest the prescribed time after procedure, do the therapy exercises at home and get better. If you have no real desire to get better or you get more attention by being sick. . . .please doctor yourself, the system cannot bear the cost of anymore game playing. A good portion of healing is in your head. If your pain causes you to not want to work OR your desire to not work causes you pain. . . .there is a likelihood that you are wasting everybody else's time and resources. . . .please step out of my way so I can receive appropriate medical care and get back to my job! YES, there are tragic cases, especially in industrial settings where there are career ending situations. God bless those people. There is a safety net for them. But if your low back pain keeps you from working then please do not allow me to see you bent over washing the car on Saturday in your driveway as I will call you out! Probably much like you, I perform at least part of my daily job duties (driving for me) where I am experiencing pain. The pain I have is largely the function of weak ab muscles which poorly support my spine because I am overweight and an not currently exercising, by doctors orders, due to a neck injury. There is a theory in the psychology of the practice of medicine. It has many names but I have most commonly heard it referred to as "secondary gain" This means that you get more of what you want or think you need (love, time, attention, time off work, others who will pick up your slack at work and at home) AS LONG AS you are sick. Typically, patients who experience secondary gain, even innocently at first, by the care of those who love them. NEVER fully recover. . .because to do so would NOT benefit them! Think about it!

    Where upper body injuries to the Neck, shoulder, elbow, and hand are concerned, wouldn't it make sense to rely on a provider who treats these types of issues ALL day EVERYDAY? The first rule of medicine is to do no harm. This means the most conservative approach is the best. Before increased doses of over the counter meds and LONG before a single dose of any med on which you may come to rely. .. .seek out a qualified physical therapist. Treating and working with your doctor to get you an accurate diagnosis is what therapists do everyday. In your area, there is likely a very specialized therapist who has additional training AND treats CTS (if that is even your best or most accurate diagnosis) everyday. This provider is a Certified Hand Therapist (CHT) and they have treated and helped more patients get over pain and, more importantly prevent re injury, than most primary care providers and even orthopedic surgeons, even hand surgeons in some cases.

    In most cases, your insurance company will not even permit an MRI or Surgical constult until you fail therapy as a first line tool.

    In many states and with most insurers, you can walk into a physical therapy clinic without a prescription from primary care doctor and been seen for up to a month! Any therapist who knows their business is going to let your Primary Care doc know whats going on LONG before that though,

    Is surgery the final outcome? YES for many people INCLUDING my Certified Hand Therapist. They are not anti-surgery, in fact they will refer you to a great hand surgeon when that is the only way out. Any Surgeon worth their degree will have to admit to you that surgery makes scar tissue, which can be problematic AND NO surgery alone will provide any promise that the patient will not have to have future surgeries. THIS is because, after surgery we must learn how not to ever create the same repetitive stress injuries again which requires a full education that you do not get with just a surgery!

    OK so this became much more detailed and preachy than I had ever attended. I was Shocked by the amount of posts related to assumed cases of CTS, many which are self diagnosed. Really my take away is that we all need to do a couple of things:
    • Be an informed consumer of healthcare services AND the providers we allow to treat us
    • Determine how badly we want to get better
    • Start conservatively with treatment OR you risk a worse outcome
    • Find a great team of healthcare provides who work with each other, are respectful of you and your needs, are compassionate but not afraid to be honest, who are not dismissive
    • Never accept a diagnosis of "aging" as the final word. At the point you do, you have conceded life and should go pile up in a ball and wait to pass to the next life
    • Work hard to get back to the conditioning you have enjoyed
    • Most Importantly- GET FIXED UP but learn how to AVOID RE-INJURY!!

    All meant FWIW to you from some guy who does not treat but watches, studies, asks, observes and receives services like you do!

    Brent
     
  19. edervjo

    edervjo

    Nov 19, 2009
    Santa Rosa, Ca.
    I have been seeing a chiropractor for neck and shoulder issues on my LEFT shoulder, 30+ years of playing bass does have it's effects. But my Chiro has done wonders, and I practice all the aforementioned stretches and exercises as mentioned before in this thread. It makes a huge difference. It is the Brachial Complex, the nerve group extending from the neck, across your shoulder and under your clavicle that controls your hands and arms.
    But then, in September I started have shoulder pain in my RIGHT side, and it ramped quickly to the most excruciating pain I have ever felt in my wrist, forearm and hand, my thumb and index finger became paralyzed, and the tips of my fingers all went numb.
    I am also a bicycle mechanic by trade, so this condition knocked me out of work, as well as out of playing. My Chiro was perplexed as X-rays showed perfect alignment, and no amount of trigger point therapy would help either. My GP doctor approved an MRI, which showed a bulged disc on my C6, but on the LH side.??
    So my Chiro started a decompression therapy to address that, but it still didn't help. I saw a specialist, she thought it was CTS, splinted my wrist and elbow called it good. It was not. The physical therapist said it was more likely my AIN, the motor nerve that branches out from the Median nerve in your forearm which controls your thumb and index, she suggested getting a EMG test, but you have to wait 3 weeks from the onset of symptoms. Did that (all the while in stinging pain). EMG test is where they stick needles into the nerves, and "listen" for the quality of conduction. It turns out it was never the bulged disc, nor was it CTS, but a condition called Parsonage-Turner syndrome (PTS), or Brachial Neuritis. They say it's an auto- immune response that attacks the nerves, usually up in the shoulder area, effecting the Median and/or the Ulnar nerve all down the line to your hand.
    It is also often mis-diagnosed as CTS, as it mimics many of the same symptoms, but there is no actual nerve impingement. At first PTS was said to be very rare, but just this summer I found a research paper suggesting it is 50-80 times more common than first thought. The prognosis is usually 9 months to 2-1/2 years, for full recovery(!!!)

    Brachial Neuritis: Background, Pathophysiology, Epidemiology

    Of course I was devastated, as I ordered a $5K Torzal from Jerome Little 2 years ago, specifically to avoid such things, and be able to play into my old age. (I am 52) It is to be ready in January......shaging irony......

    BUT.... after 2 months the pain is receding, and I have some use of my index finger back, it is just my thumb and palm that are numb/tingly with needle pain and a bit in my finger tips. The RH thumb sticks out like I am permanently hitch-hiking, just now beginning to be able to move the tip(distal) of it, and fully extend my arm. they have me doing texture therapy, touching rough surfaces stimulates the nerve regeneration apparently! Also I have found that playing actually helps, I can only figure that since I have been a bassist for so long, that my brain and that nerve pathway are well established.
    I will keep you all posted, and expect some awesome pics and a thorough review of the Torzal in the next few months.
     
  20. TomB

    TomB Supporting Member

    Aug 24, 2007
    Vermont
    Wow, thanks for sharing, and best of luck with recovery. It makes CTS sound like a walk in the park!
     
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