Carpal Tunnel Syndrome is one of a class of injuries called
RSI's (Repetitive Stress Injury). It's true that typists and computer
users are often affected by RSIs, but so are factory workers and anyone
else who performs repetitive actions in their job - including musicians.
In general, the injury occurs over time, when you have forced
your hands or arms into unnatural contortions over and over again. Nerves
and tendons become irritated and extremely painful. At first, the pain
only occurs when you are doing the repetitive action, but as the damage
increases, the pain can become chronic, severely limiting your motion.
It's important to know that injuries like Carpal Tunnel
are cumulative. Once you begin to feel pain while playing your guitar,
you need to make changes to prevent further damage. People with advanced
RSIs have been forced to change careers, no longer able to work without
pain, and causing a serious and costly problem in their lives. Imagine
never being able to play because of the pain.
So what to do if you have begun to feel some intermittent
pain while playing? It's a good idea to scrutinize your technique, and
see which motions seem to be putting stress or tension on your hands or
wrists, and even your shoulder. It's unnatural to your body's anatomy
to perform repetitive tasks using your wrists and hands, but not using
your upper arms (tasks like typing or playing an instrument). The long
nerves in your arms can be irritated, especially at the joints. You need
to refine your troublesome techniques by slowly retraining yourself to
play with less binding hand positions. You also need to stay in decent
shape, so take up some mild exercise if you need to strengthen your body.
Once you are using correct form, your pain should disappear. Just make
sure not to over do it by keeping your practices to a modest amount of
If you already feel the pain even when you are not playing,
things have unfortunately advanced to a more serious state, meaning you
have caused more damage to your nerves. You should probably see a doctor
at this point. RSIs of this caliber are extremely painful and hard to
recover from. My injury, caused from working on the computer, advanced
so far I was in constant pain day and night for several months, and was
afraid I would no longer be able to do this sort of work. (Thankfully
I was able to heal well enough to continue, but it was a long process).
I'm not a doctor, but here are some things that helped me
with my injury:
1. Keep your hands and wrists warm. Your movements will
be smoother and less troublesome if you warm the area up before working.
Warm water, blankets, heating pads, etc. will help you keep warm. Another
favorite of mine is to fill an old sock with uncooked rice and tie the
end shut. Heat in a microwave for a minute or two. Makes a great hand
warmer. (Also great for stiff muscles).
2. Sometimes an ace bandage or wrist brace from your local
pharmacy can help you avoid painful motions, used during work or other
3. Try to balance your repetitive motions with activities
that use your upper and lower arms, as opposed to just your hands and
wrists. I used to go out and sweep my garage floor with a broom several
times a day. The long sweeping motions helped heal the pain and balance
the workout load on my nerves.
4. Be careful taking pain medicine to keep working. It may
stop the pain, but it will not stop the progress of damage you are doing
to your body. In fact, numbing the pain can lead to increased damage if
you play longer than you should because you aren't feeling it.
5. Use hydrotherapy. One thing that helped me tremendously
was a hot tub. The combination of warmth, free movement, and massage really
helped me treat the painful areas.
6. Some people swear by herbal supplements for treatment,
and others end up going the route of surgery to remove the pressure on
their nerves. Hopefully, you will use proper technique and avoid such
a serious situation.
The bottom line is, RSIs are serious, and as a musician,
you are a prime RSI candidate. You also have a lot to lose if you are
afflicted with a serious RSI. Use common sense while playing, and in your
daily life. Be aware of how you are positioning your hands and wrists,
and correct positions that create pain, tension, or stress. Make sure
to allow rest periods and other physical activities to balance out your
load and keep you flexible. Above all, don't try to bully your way through
once you have pain. It won't work. You have to let the nerve heal, and
continued work will cause continued irritation. Once it heals, you can
go back to playing, with improved technique to avoid future injury.
The main thing to do after a Carpal Tunnel Release (CTR) is RELAX! During
the operation, the ligament under the skin was transsected to release
the median nerve. After that, the fascia was closed with sutures, then
the skin - and that is all. It takes about 2-3 weeks for the entire thing
to heal up. The only thing you should absolutely do during the healing
period is keep moving all your fingers and wrist so it all heals with
lots of slack. Do not worry about the wound falling apart - boy is that
rare, ESP in the absence of a wound infection. Infection is also rare.
By the way, CTR is almost totally successful in 97% of cases - i.e., all
cases where there is no complication of significance.
Robert M. Cohen, MD (neurosurgeon)