I have a SERIOUS HAND INJURY. Does anybody know what is the matter?

[musicioso]

Hallo dear people,

I have some very strange problem with my right hand. Sometimes I play piano very well, i have a lot of power and control over my hand and fingers; the speed is so high that i cant believe it's ME playing. But the same day, some hours later, my hand can get very stiff and the speed is like a child playing. The piano keys feel very heavy to my fingers, and yes, i also feel pain in my fingers and forearm.
My right hand is colder than the left hand most of the time. The stretch is lesser than the left hand. My hand tends to make a fist; it takes more effort to open my right hand comparing to the left hand.
When i lift up my shoulder and let it fall down, i feel an electric shock in my wrist.

At some days these symptoms are more severe and some days less.. It even can be different after several hours.

I have been to many hospitals and clinics, and talked to several physician. They did a lot of research such as MRI-scans, X-ray and so on. But they found NOTHING.

And now i dont know what to do. Sometime i feel so good, that i practice the piano for 3 or 4 hours, and then i have times that i have to stop practicing after 15 minutes because i feel like my right hand is paralized.

Do you guys have any idea what the problem is? Do you know any other pianist who had this kind of problem? Do you have any idea what i should do?

It is possible that i injured myself by playing piano in a wrong way, tendenisis? RSI? Or something in this category?

[stevebob]

No one could accurately diagnose your condition via the internet, and the best advice for anyone with a medical condition would normally be to see a doctor.  It’s unfortunate that you haven’t been successful in finding diagnosis and treatment, but you should be certain to see a physician who specializes in the injuries and disorders that affect performers.  If there are no such specialists in your locale, a doctor who practices sports medicine and treats the injuries of athletes would be the next best alternative.

It would be irresponsible even to guess what is causing the symptoms you describe, but one possibility  that might be implicated (in addition to those you’ve mentioned and probably many other potential sources of such a problem) is called focal dystonia:

https://en.wikipedia.org/wiki/Focal_dystonia

I mention it because it's relatively unfamiliar to most people and because numerous musicians have suffered from its effects.  Awareness of tendinitis and carpal tunnel syndrome is widespread, and we should probably be equally conscious of focal dystonia.

In any case, best wishes for a prompt diagnosis and a speedy recovery.

[ted]

Sorry to hear about this, especially the inability of professionals to diagnose the problem. Of course, I don't suppose there is any reason why somebody could not have more than one type of injury at once, which would be very confusing.

There is nothing to stop you conducting your own correlation experiments. For instance, no harm could possibly come from slowing your playing down and playing more lightly for a few days to see if any benefit ensues. You could try different techniques, not bizarre ones, just perhaps slightly more curved or flatter fingers, less or more wrist, that sort of thing, depending on how you usually play.

Keep a playing diary and note which pieces and playing forms you work on each day, how you play them, how easily and well you play them and what your playing mechanism feels like. Do this in considerable detail. Also note other activities you pursue which use your right hand, just in case these have some influence. Does it improve with rest ? Get worse with rest ? No difference ? Does taking short breaks have any effect ?

Until a qualified diagnosis is made there is much you can do yourself to detect any patterns of cause and effect. Over the years I have had several nuisances to do with my technique whose underlying nature I have never known, but which I gradually got rid of with patient attention to detail.     

[mad_max2024]

From what you describe, it sounds like a nervous problem. I don't think playing the piano caused it.

Like people already said, there is no way you can get an accurate diagnosis over the internet. The only way is to do tests with qualified professionals until you can find the problem.
I would advise you to check with a neurologist if you haven't already.

Getting a group of family or friends that you can talk to and will help you through it would be good as well. If you are a frequent piano player, having a condition that hinders it can be very emotionally draining.

[chopinsmaster]

What you describe does not sound like the ordinary results of too much piano playing. I agree with mad max in that it sounds more like a nervous problem than anything else.
However, for the chance that it is something related to piano playing, do what ted said. Play more lightly for awhile to see if anything changes and keep a journal ("Its a journal not a diary!" ) of what you play. Because even if it is actually a nervous problem, there is still a chance that it is related to piano in some way. Possibly not even from playing too much or too hard, rather some specific type of motion. Keeping a playing journal could help discern if this is a possibility.

[musicioso]

stevebob, Ted, mad_max2024 and Chopinmaster...thank you all for your reply.

As I said, I have to 6 physicians, and they did a lot of research, it took 2 years, but they found nothing. The could not find any nervous problem. They also made MRI scan from my brain to see if there is a problem in mt 'head'. But still they found nothing.

I dont expect anyone to diagnose my condition on this forum. But I am so desperate right now. Maybe there is a chance that some of you know someone who has/had the same problem and found what the problem is.

I am not a pianist, nor I make a living by playing piano. I play piano, keyboard and harmonium (the one from India) as an amature. But believe me, even as an amature, playing music is one of the most important things in my life. Right now i am learning Fantasie impromptu, Rachmaninoff op. 23. no. 5, Moonlight sonata first movement and Chopin nocturne in C sharp minor. I also play piano arrangements of movie soundtracks and some pop songs that i love. My dream is to be able to play La Campanella, Fledermaus from  Johann Strauss, Rage over the lost penny, some of the Chopin etudes, ofcourse after some 10 years of practicing. I am willing to practice 3 or even four hours a day, but i can not do that due to this problem i have with my right hand. And indeed it is very emotionally draining.


But anyway, i am not giving up, even if i didn't have my right hand at all, i still would play WHATEVER i COULD play, as there is nothing in this world more beautiful than music.

Once again thank you all for the comments..

[scottmcc]

there is a neurologist named Oliver Sacks who has written a number of books about rare or interesting medical conditions.  in one of his books (and now i forget which, sorry), he describes a multi-year ordeal he had with a wrist problem in which he saw dozens of doctors and got conflicting advice from all of them.  this was even more bothersome to him because he is a medical professional, and supposed to be able to at least find a specialist who can give him decent advice.  he eventually did find the answer and had a successful surgery though.

anyway, I would suggest you seek out another opinion, from someone who specializes in things that are less common.  most physicians (myself included) focus on the more common diseases, but what you are describing is unusual at best.  and of course, as many others have alluded to, there is no way of diagnosing it over the internet.  good luck--it sounds quite frustrating!

[mefy]

You may just have accumulated a lot of muscle tension in your back and shoulders that is blocking the nerves to your hand. I've been dealing with a similar problem for years and I've finally been able to get some relief.

What I do is just sit still and focus on any sensation of pain. Instead of ignoring the pain or try to make it go away, I try to increase the sensation as much as possible. It may start as a general area of discomfort but after a while it will become a very sharp needle-like sensation. At that point I can start to feel it move through the muscle. Once it reaches the end then the whole muscle relaxes, the pain goes away and I can feel sensation returning to my hand. Then after a few seconds, another muscle will start to give out a pain sensation. I just focus on it in the same way to release the tension.

[pianist1976]

Sorry but I'm not a native English speaker, so when you talk about "physicians" I guess you are referring to traditional medical doctors. Is it?

Well, why don't you give a try to alternative medicine? Look for a good physiotherapist, osteopathist  homeopatist or even an acupuncturist. There are many techniques like Shiatsu and others. Maybe a good professional can find your problem and recommend to you a good therapy such as stretching exercises or some beneficial sport such as swiming, or yoga (beware that I'M NOT RECOMMENDING YOU STRETCHING NOR SWIMMING NOR YOGA, I only post this as an information of some possible therapies that many of the physiotherapists do but only as an information, not as an advice. I'm not qualified at all to give any kind of medical advice and I don't even know you in person. I think it's better to wait until a professional gives you his/her advice ).

[natsmusicpath]

My experience with music injury (I've got permanent damage) has taught me that regular doctors know nothing about it and have no idea what we go through. One doctor said if it hurts then stop. Your body is telling u to stop. I couldn't explain to him that I was a university music major with huge performance dreams and a passion to keep playing. Then I was lucky enough to find a specialist in Toronto and Hamilton Ontario. His name is dr. Chong. And I can't remember his first name which I guess isn't that useful to you. Anyway people travel from all over to see him. He is a musician himself and developed injuries. He then became a kiniesiologist and specializes in music injury. He uses I think it's called biofeedback(?) to help you figure if and when tension develops when u tire and he videotapes the computer graphs that come up for u to watch. It's excellent.

There's also a book out there called You Are Your Instrument and I can't remember the author. There's also a video with it. The author is a violinist I think in new york and she battled an injury. There's a lot that we pianists don't realize is going on when we practice extensively.

Good luck

[rafant]

In these times of overuse of computers, try to realize if you have acquired some bad habits: Do you sit at the computer for hours, without taking rests? Do you lay your right hand on the mouse continuosly even when you are not using it? Do you let the low-palm or near-wrist area lay on the desk for long time? Do you observe that the computer keyboard causes some pain?

Those are areas profusedly irrigated by nerves. If one press that nerves as I said above, the hand becomes awkward.

Try to do the following during some weeks: Change the mouse to the left hand (it's easy, ignore the feeling of awkward at first attemps), donīt let the hands to lay on the desk for long periods,  and then see if you observe some improvement in the simptoms you mention.

[musicioso]

Thank you everyone for your advices and tips.

I am trying to find a physician that can help me.

I will let you know..

[feneon]

Musicioso,

I am so sorry to hear about your right hand. Having had very bad fractures of my left radius and ulna with serious complications including neuropathy for which after 9 months I am still in hand therapy with no guaranteed outcome, I greatly sympathize with your distress and earnestly hope for your complete recovery.

When you mentioned that sometimes you are able to play at lightning speed and practice for 3 or 4 hours, I immediately thought of what I've read about focal distonia, and wondered if you also spend much time in very slow practice of the same pieces that you are able sometimes to play very fast. In focal distonia, too much very fast practice can result in rapid neural impulses from the brain blending together, counteracting each other, and eventually resulting in pain and/or paralysis.  It can certainly do no harm to play only very slowly for several months and see if that helps. The above is a very general explanation, but you can find more information on the internet

Meanwhile, I hope that you will also continue to seek expert medical advice. Dr. Michael Edward Charness at Brigham and Women's Hospital in Boston, Massachusetts in the United States is an expert on focal distonia and peripheral nerve disorders. He is himself a pianist and specializes in treating musicians. Even if you don't live near Boston or even in the United States, your physician may be able to arrange a consultation. Dr. Charness' email address is mcharness@hms.harvard.edu.

Best wishes,

Feneon

[feneon]

Musicioso,

Sorry. I misspelled the term focal dystonia.

Feneon

[stevebob]

Focal dystonia?  Wow, who knew.

I hope Dr. Charness is aware that his e-mail address has been posted publicly.

[nearenough]

Leon Fleisher, Gary Graffman, Murray Perahia have had hand problems so try to find out what they did and to which doctors they attended. Possibly try warm water soaks to "loosen" things up, then play, and do the other experiments and suggested here. Don't injure your hand like Scriabin and Schumann did.

[jlsheeha]

This sounds eerily familiar.  When I was around 13 I began seriously pursuing the piano.  Instead of practicing a few hours a day, I was practicing between 5 and 8 hours a day.  I also was learning repertoire that was becoming more and more advanced.  I too began experiencing issues with my forearms essentially locking up on me which had the added effect of causing my hands to lock up on me as well.  In my case, I described my issues to my piano teacher and she told me she didn't know what was happening but that she knew a teacher that probably would be able to help.  I began studying with a teacher that had a PhD in pedagogy and an extensive background in technique issues and she essentially "retaught" me how to play.  I was approaching the instrument with unnecessary tension in my arms and hands that I wasn't even aware of.  As the music I learned became more technically advanced, these issues were amplified and rendered me almost immobile. 

Long story short... it has been 15 years since then and I have virtually no problems now.  I can challenge myself technically with just about anything and read my body in a way to understand how I need to technically approach the music I am learning. 

Maybe your issue is not a medical one but a result of bad technical habits?  Perhaps you should try different teachers until one is familiar with the issues you are describing and can offer solutions for changing the way you play.  Also, I highly recommend contacting a myofascial therapist for addressing the causes of the pain and the tension you are experiencing.  A good one will be able to recommend a more holistic approach, such as reducing caffeine (as caffeine can add to muscle tension), stretching, etc. to help you find the right combination.  If you are unfamiliar with myofascial therapy here is a link to explain:

https://en.wikipedia.org/wiki/Myofascial_release

Most importantly, if you are feeling pain do NOT push yourself to play.  Doing so can cause more serious damage.  I know how frustrating it can be when you have a real issue and no one seems to know what the problem is.  Hopefully by finding the right expert to resolve the issue you can move forward with playing the piano pain-free.  Best of luck!

[keyboardclass]

That really sounds like focal dystonia to me.  As the above post says, it's a really informed teacher you need.  Doctors are useless with this condition unless you count botox injections (which is a prety desperate measure).

[musicioso]

@ jlsheeha, keyboardclass, nearenough, feneon, Rafant, natsmusicpath, pianist1976, mefy, scottmcc, chopinsmaster, mad_max2024


Thank you all for you kind words and ideas you gave me. I really appreciate it.

I will try to find a piano teacher who knows more about piano injuries, maybe he can help me.

PS: I am living in Netherland. Is there someone from Netherland at this forum? Does anyone know a piano teacher in Netherland who can help me?

[keyboardclass]

I'm a member of this organization www.isstip.org.  It's growing but I don't think we have anyone in the Netherlands yet.  Could I suggest you post a video?  Something may come to light.  My teacher famously worked with many injured pianists with great success - it's a slow process of re-education.  To be honest though, and I've heard this from many medical specialists, a small number of patients have their genes going against them - not much can be done if they wish to reach the very highest levels of accomplishment, but that is very few.

[davehorne]

@ jlsheeha, keyboardclass, nearenough, feneon, Rafant, natsmusicpath, pianist1976, mefy, scottmcc, chopinsmaster, mad_max2024


Thank you all for you kind words and ideas you gave me. I really appreciate it.

I will try to find a piano teacher who knows more about piano injuries, maybe he can help me.

PS: I am living in Netherland. Is there someone from Netherland at this forum? Does anyone know a piano teacher in Netherland who can help me?     

musicioso, sorry to hear about your problem.  I was asked by someone in another forum at another site to contact you.  I've sent you a private message.  I'm not a doctor but I have had problems in the past which were solved after I studied with a concert pianist. 

Rather than rewrite what I've written several times at other sites, read the private message I sent you and tell me what you think.

All the best, Dave Horne  ... also, this will probably be my first and last post here as I already spend too much time online ...

[avanzant]

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