hand pains

[keithjarrett]

Hi, I know there are thousands of threads about this topic, but I wanna know if I'm using the proper treatment.

My hands have been hurting in 2 weeks time now, and I first used Voltaren, which is some kind of anti-inflammatory medicine, and now I've started treating it with ice. The pain is in the wrists and under the fingers, mostly to the pinky side. What caused the problem must be the fact that eventhough it hurt, I never stopped, I kept pushing and pushing till I got it when I was practicing something, and this is the result I guess.

My method is to first put my hands in very warm water for 2,5 minutes, then put them in ice water for 1 minute, then 1 minute warm, 1 minute cold, 1 minute warm and finally 1 minute cold.

I wonder if this is the right technique, because now it feels like it hurts more than it did one week ago, and my hands feel kind of stiff.

Am I doing right?

[daniloperusina]

From www.tendonitis.net

"Tendonitis Treatment
With proper care for the area, the pain in the tendon should lessen over three weeks, but it should be noted that the healing of the area continues and doesn't even peak until at least six weeks following the initial injury.  This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together.  Scar tissue will continue to form past six weeks in some cases and as long as a year in severe cases.  After 6 months this condition is considered chronic and much more difficult to treat. The initial approach to treating tendonitis is to support and protect the tendons by bracing any areas of the tendon that are being pulled on during use. It is important to loosen up the tendon, lessen the pain, and minimize any inflammation. 

This can be done topically if a pain reliever has the ability to penetrate the skin barrier and contains anti-inflammatory agents. A topical formula that contains natural menthol will not only relieve pain, but dilate the blood vessels. This allows for relief of the tendonitis, without causing any stiffening of the tissue.
.....................
Ice can relieve inflammation, but will constrict the blood vessels and further stiffen the tendon.  Cortisone injections can reduce inflammation, but unfortunately are very caustic and can cause a weakening of the tendon structure and a create more scar tissue."

etc etc

But have you been to a doctor?

[counterpoint]

What caused the problem must be the fact that eventhough it hurt, I never stopped, I kept pushing and pushing till I got it when I was practicing something, and this is the result I guess.

Yes, I guess too.

Whatever you do to cure the pain, you should pause your playing for some weeks, until the pain has gone away. Then you should be very careful about every unpleasant feelings you have while playing/practising. Don't overdo practising. If it hurts, something is wrong with your "technique"!

[keithjarrett]

Yes I stopped playing immediately, and won't play until it doesn't hurt anymore.

Daniloperusina, what tendonitis.net is saying is that I should use anti-inflammatory medicine instead of ice?

I haven't been to a doctor, but will see a physical therapist next week.

[miguelcatalao]

You should counsult a doctor...

One should never play with his health specially related to you main tools!

Hands ears and eyes, are so important that you can never be too carefull.

Also phisically, Tendonitis is not the only problem affecting the hand! How can you really know what threatment you shoukd do, when you simply don't know really what is the problem?

If you love your music, stop playing, stop that threatment and GO SEE A DOCTOR RIGHT NOW!

[keithjarrett]

The problem with seeing a doctor is that it can take months of waiting, and most doctors don't have a clue, they have to be specialists in the field to tell me something I don't already know. But like I said, I will go see a physical therapist next week. Hopefully they can help me.

[notturno]

You should still see a doctor anyway, preferably an orthopedist.  Tendonitis by itself is not a terrible thing, but swollen tissue may eventually start pressing on the nerves and this can cause some serious problems for you.  That is, tendonitis can be treated fairly easily but nerve damage is much more serious.

Are you also having any pain in the elbow?  Sometimes pain in the ring and pinky are from compression to the ulnar nerve, which runs through the elbow.

A few years ago, I had pain and numbness in the right hand.  This was partly due to carpal tunnel syndrome in the wrist and partly due to nerve damage in the elbow.  The wrist was fixed through anti-inflammatory drugs and physical therapy.  The elbow required surgery and physical therapy. I feel for you man.

It's good that you are pursuing physical therapy.  I am a big believer in PT and doctors tend to avoid suggesting it because they don't believe in it and it can be rather expensive.

Here is one of many posts about hand pain that you might find useful:
https://www.pianostreet.com/smf/index.php/topic,20122.msg220315.html#msg220315


There may also be something wrong with your technique that is contributing to these problems.  There are lots of posts on the forum about hand position etc., and I'm no expert on this.

Good luck.

[keithjarrett]

thanks for your replies, but I've pretty much read everything on this forum and other forums about hand injuries, and almost everyone says you should use ice on it, but no one describes how. So what I'm wondering is, should I continue with the hot water-cold water approach as I described above, or should I use ice packs for 20 min, should I skip the ice totally and only use warm water, or what should I do?

[zheer]

. So what I'm wondering is, should I continue with the hot water-cold water approach as I described above, or should I use ice packs for 20 min, should I skip the ice totally and only use warm water, or what should I do?

   Most of the time pain and injury are the result of over practice or faulty practice, even going for a long walk can cause some sort of injury or pain. The hot water and cold water thing, ice pack Ibuprofen all provide temporary relief. Most pianists believe in strengthinig or stretching ,it is this belief that results in pain. So the only way to avoid hand injury due to piano playing is through learning and aproaching the piano in a different way, some learn this, others already know this from birth. Good luck.
      ITs a little like sport injury.

[keithjarrett]

The hot water and cold water thing, ice pack Ibuprofen all provide temporary relief.

So basically, it doesn't matter what method I use to get rid of the pain? I've heard that the body heals faster when it doesn't feel pain, so whatever method I use to mask that pain will help?

[zheer]

So basically, it doesn't matter what method I use to get rid of the pain?

    It does matter, some method have side effects.
          It is possible to creat music on the piano with-out having to suffer from any kind of physical injury or pain. All it takes is the will to discover a method that is pain free, some very well known pianist suffer from hand injury and obviously many other pianist never deal with hand injury during their career.

    You mentioned masking the pain or ways to get rid of the pain,well that is temporary, it's  not easy to explain over the net, but the most practical way of avoiding hand injury (or any other injury) is through conciously re-examining how we use our hands .

[keithjarrett]

Yes, right now it pains whatever I do with my hands, although it feels a little better today. So I'll have to wait until the pain is gone, and then develop a new technique at the piano.

[valor]

I hope you dont mind if i barrow your thread for a while keith, im having hand issues too. Last night i was practing a run when my wrist began to ache. so i stoped playing.
Soon i felt a snapy feeling in my wrist, just bellow the 5th and 4th finger and above the ball thing in the wrist. I tried rotating my forearm and i felt the same snapy feeling except it was worse (it felt as if i could crack it, like fingers). Later my fingers begam to get stiff and when i tried to make a first i felt a snap in my thumb too. So, did i mess my wrist up and have to go see a doc? or will this go away eventually? Also, is it bad to crack your wrist/ fingers?

[keithjarrett]

Of course you can borrow it valor! I went to see a physical therapist yesterday, and she said that that crack in my wrist didn't matter at all. However, I read in another thread someone who said that if the wrist cracks, you've got a torn ligament, but his post is the only one I've seen saying this.

[amanfang]

I'm thinking that heat might make it feel better but won't help the swelling.  The ice/cold will help the swelling as will ibuprofen.

[valor]

I did a search on what you said keith and i think your right. I read somewhere that symptoms of a damaged ligament is cracking, i guess i should go see a doctor.

[keithjarrett]

Can you post and say what the doctor said about the cracking when you've been to one? Thanks.

[hic]

go see a doctor and find out wats happening. If it's not something that can serverly damage your hands, then get treatment for the problem and then go to a hynopist for the pain... It works

[thalberg]

Active Release Technique works for tendonitis.  It cured a friend of mine and did good things for me, too.

Go to activerelease.com to find a practitioner in your area.  It's really very helpful.  They basically massage muscles while moving them through their range of motion and breaking up scar tissue and stuff like that.

[emill]

Hi,

As already mentioned, hand pain is likely due to over practice or improper technique or both.  The general courese of treatment are as follows:

1. REST - do not attempt to continue as this will just worsen things.  Give it at least 2 weeks of full rest and make sure you now know what you were doing wrong and how to correct it properly before resuming.

2. Cold or Ice treatment - this is best in the initial phase of the problem in order to reduce swelling and inflammation which sets in rapidly. The initial phase is the first 24 hours. Ideally done 2-3 times, about 20-30 minutes per session.

3. Hot or Warm treatment - best done after initial phase swelling has subsided and this is often 36 hours and thereafter.  Hands can be soaked in warm water, 20-30 minutes, 2-3 times a day.  While soaked, gentle movement in full range of motion of wrist can be done. Also, open and closing motion of fingers.

4. An anti-inflammatory drug should be taken - Ibuprofen 400mg with breakfast and supper for 5 days then reduced to 1 tablet with supper for another 5 days will be fine.
Even lower doses of 200mg, 2x/day for 5 days, then 1 tablet/day on next 5 days will do for many.  Make sure to take with a full stomach to avoid some form of gastritis.

Worked fine for me.  Good luck!!

[valor]

I'm seeing the doc next week so i'll post what he says then. I have a question for you Keith, or anyone else who had hand injuries before, Did you get a burning feeling between your 4th and 3rd finger and on your 4th fingers knuckle?

[keithjarrett]

Hm, I really don't know, I usually only feel pain in the wrists, until I try to play the piano, then I start feeling pain under all my fingers, I guess it leans most towards the 4th and 5th finger. It's been a month now and it feels better, but it's not over yet. I have been exercising for two weeks and I will try acupuncture this week.

[valor]

I saw the doc, she said that it'll eventually go away and that i should wrap my wrist and use it as little as possible and if the cracking in my wrist doesn't go away by next week they'll have to take x-rays.

[keithjarrett]

My wrist cracked too, but it only took me about a week for it to stop cracking, don't know why it cracked and why it stopped, but I'm glad it did. It still cracks sometimes though, but not all the time and not as loud.