Gettting depressed over pain issue

[mahlermaniac]

I wish I could figure out the trouble with my wrist and elbow pain, which had onset after I started playing, but now is pretty much occuring elswhere in life whether or not I'm playing piano. I took 2 one week breaks from piano and the pain never really resolved. Some carpal tunnel syndrome going on to, which I'm treating with swimming, braces, ibuprofen, and changing my work setup to a more ergonomic design.

I've had two instructors and two doctors both tell me to go ahead and keep playing, since breaks never really cleared it up anyway. I've been told my piano playing technique is fine. When this first happened, I never even had pain WHEN I played, I didn't feel tense, just started up afterwards. I'm currently reading "What Every Pianist Needs to Know about the Human Body" but I haven't really had any major revelations there.

I'm just so frustrated. I wish I could give up the piano, but even in spite of it all I get so much joy out of playing. Maybe wish I had never started at this point, though . I don't know if there's something more going wrong medically, though I'll be following back with my doc in a couple weeks to check. And yes, I stretch to warm up. I do just about everything everyone's suggested at this point.

[ajspiano]

Can you post a video of your playing, clearly showing not just your hands, but also your bench height and distance from the piano etc.

Show playing that includes different kinds of difficulties eg. some scales, some chords, some arpeggios etc. consider showing your hands from the side, and from above also.

Describe the pain in more detail, is it associated to certain pianistic figures or just a generalised as soon as you sit down kind of thing.

[iansinclair]

It would seem to me -- and I'm just sounding off, having no real knowledge! -- that if you took a couple of one week breaks from piano and the pain didn't really change, and have as you say, had your teacher look at your technique and say that it is basically OK, then...

It isn't the piano.  The only times have had some problems which I can clearly relate to piano is if I go really wild practicing some very repetitive, very fast passage.  Then yes, some pain in the finger muscles (upper part of the lower arm, not the hand at all) which is simply tenseness, and goes away if I just stop and "shake out" the hand.

I would be inclined to look at some other factor, which would be there anyway.  And the first place I would look would be your work setup.  I don't, obviously, know what you do, but I can assure you that particularly if you work at a computer extensively, wrist pain is almost a given.  Not only check your work setup to make sure that your hands are really relaxed, that they are at as natural an angle as possible, and that they rest in such a way as to not put pressure on the wrist.  Also, if you are doing repetitive hand work, like keyboarding (we called it typing in my day...) that you take breaks.  Frequently.  Even a few minutes every 15 minutes or so can help.

Another possible work problem (you see, I really don't know what you do!) is if you work with vibrating macinery a good deal, or if you have some very repetitive assemble type job.

But look at the work setup.

I doesn't sound to me as though the piano is your problem, so keep that up and don't despair!

[mahlermaniac]

I'll work on getting a video up later, it'll be a few days.

I'm a physician assistant so I treat patients. All of our charts are on an electronic medical record, so a lot of typing. I don't actually use the keyboard too much when I'm in with a patient except to type in the billing info and prescriptions, etc. It really is a bad set up, small keyboard, etc. Though the pain never really started until this last month. I have an ergonomic keyboard and mouse ordered; may have to raise my seat height too, I'm not sure. Also going to try a little more cushioning on my piano bench. I don't think I'm too low, but I'll give it a shot anyway.

[andreslr6]

Another detail too, although it may not be the problem or you already know it (but anyways, saying it again doesn't hurt ), is that people do care about warming up but forget about the cooling down. That's been a problem with me always, after I'm done practicing my hands and arms are all warm and if I'm not careful with abrupt temperature changes, I get into a lot of pain, and I know it's not a technical problem with my piano playing because I get this pain in my knees as well. But anyways, keep an eye in the cooling down process as well, wear gloves or wrist bands for cooling down after you're done practicing. A main reason for getting tendonitis is precisely not being careful with that.

[mahlermaniac]

I guess I'm not really sure what kind of cooling down I should be doing. I only play for 10-15 minutes at at time these days, doing very easy pieces or practice.

[andreslr6]

I guess I'm not really sure what kind of cooling down I should be doing. I only play for 10-15 minutes at at time these days, doing very easy pieces or practice.

Just avoiding abrupt temperature changes is enough I believe, like avoid exposing your hands, arms and wrists to a cool air after you've been in a warm closed place, etc.

[iansinclair]

I don't actually use the keyboard too much when I'm in with a patient except to type in the billing info and prescriptions, etc. It really is a bad set up, small keyboard, etc. Though the pain never really started until this last month. I have an ergonomic keyboard and mouse ordered; may have to raise my seat height too, I'm not sure.

Good start.  It can take several years for problems associated with keyboard use to show up.  May I also suggest that you get wrist pads for both the computer and for the mouse?  They can help a good deal.  It may take some time for the problem to go away.  Being a physician's assistant, I am sure you aware of potential problems with long term ibuprofen...

I have arthritis (I'm entitled to it at 70 plus) and I agree that both warmup and cool down are very helpful.  My usual routine is to warm up with really simple stuff -- typically some more or less popular music such as songs from musicals or the like.  Then practice, but never more than an hour at a time (and, as I noted in an earlier post, I may take a break in there to "shake out" some tension), then cool down -- which I do by improvising on other popular songs; just sort of fiddling around at the keyboard.  For perhaps 5 to 10 minutes.  Works for me.

[mahlermaniac]

Oh, ok. re: temperature changes, I usually play at home at night so that's a non issue. The exception is lessons once per week which I just started, so I'll bear that in mind those days.

Like I said, my sessions (except for practice session) are never more than 20 minutes at the absolute most nowdays. Kind of feel like I'm spending more time on warm ups and treatment than playing :/

Yeah, good reminder on the ibuprofen, I'll be careful. I'm just so nervous about the prospect of surgery or injections down the road. I want to avoid it at all costs.

[kujiraya]

I'm so sorry to hear about the effects of your wrist and elbow pain.

You mentioned having seen 2 doctors about your pain issue and that you work as a physician's assistant. I just wanted to make sure that you are being fair to yourself, and that the 2 doctors that you've seen are not at your place of work. This is necessary in order to get a truly objective and independent opinion, as it is possible that the carpal tunnel syndrome may require surgery and therefore time off work, and it is possible that this could be a Workers Compensation issue.

I also agree with the need to move and shift the body and the bum positions around the piano stool while playing the piano. I was having a lot of difficulty playing the L hand octaves in Chopin's Polonaise Op. 53, but yesterday I just moved the piano stool closer to the piano and I found that this significantly reduced the tension I would get while playing those octaves.

[andreslr6]

I also agree with the need to move and shift the body and the bum positions around the piano stool while playing the piano. I was having a lot of difficulty playing the L hand octaves in Chopin's Polonaise Op. 53, but yesterday I just moved the piano stool closer to the piano and I found that this significantly reduced the tension I would get while playing those octaves.

On a side note, that as well is related, try also adding leaning towards your left side. My teacher pulls me to whatever side whenever he notices I start having problems, for example playing scales on the highest octaves, he pulls me towards my right side and everything starts working. The reason is to correct the elbow position because as you start playing away from the center your elbows naturally lower or rotate awkwardly, leaning your body towards your hand corrects that position and removes any tension and problem. Same goes if your hands are on the opposites, the farther they are from themselves the more your body has to lean forwards to maintain the elbow position.

[mahlermaniac]

honestly I am starting to feel like playing the piano is a dream I should just give up on. I feel like I am trying everything and it's not getting better. My husband is understanably getting sick of hearing me complain.

[outin]

honestly I am starting to feel like playing the piano is a dream I should just give up on. I feel like I am trying everything and it's not getting better. My husband is understanably getting sick of hearing me complain.

Don't give up! Piano playing is healthy for you when you just get everything sorted out. When I had my wrist trouble the first time I really feared that it is something that I cannot fix, but it did and I am fine now. I needed to change both the way I use the computer and the way I play. There's another thread about this, maybe some of the suggestions there might be uselful:
https://www.pianostreet.com/smf/index.php?topic=49601.0

Your playing may look fine outside but you may still be having some  tensions. Stiffness may begin on your shoulders/elbows as well.

Low wrists (both on a computer and piano) and overcurling  and also keybedding were the worst things for me. To fix the low wrists I actually had to sit very far a way for a while, to force my hands to be really long and my wrists up. It was hard because my shoulders were stiff and it took all my strength just to keep the arms up on the keyboard. Sitting a bit higher helped in the beginning. After exaggerating it for a while I have finally found a comfortable sitting postition. I think we are all so differently shaped and in different condition that sometimes what is considered a good position just does not work.

[chopin2015]

I get pain in my knee where ive had surgery, only if i hike for a long time. Otherwise, i run and do everything else with no problem. Perhaps you should accept that you cannot practice for long and cant take on physically challenging pieces for a while. Just ease up but dont stop. If it hurts a lot, break. Start doing yoga and eating healthy. Never play after work or if tired.

[maczip]

There is a chance that all your complaints are due to capal-tunnel-syndrome. Have the nerves been measured? Have you tried splints or cortisone-injections?
Good luck

[drazh]

hi
ever done EMG &NCV study of hands?. there should be a major problem and should be found.
i read somewhere in this forum the problem was bad sleep habit with wrist under the chin. try to find out what your problem is  it should not be the poor piano
thank you

[mahlermaniac]

Never play after work or if tired.

Well, I don't have time to play in the morning. I have to be to work by 7:30. Tired, well, I always am, a consequence of having two young kids

As for the previous posts about carpal tunnel: yes I know I have it. But generally conservative treatment is preferred first, so I'm trying that now. I hope to avoid injections or surgery if possible. Especially since I have no paid time off built up at work yet, and can't afford to be off.

[kujiraya]

My opinion is that you need to re-frame your relationship with your pain. It seems to me that the way you are portraying this pain at the moment, the main effect that it is having on you, is that it is stopping you from playing the piano. I can imagine why your husband might be getting sick of your complaints to him, because, in his thinking, if your pain is stopping you from playing the piano, then just don't play the piano anymore, and the problem is solved!

However, I notice that you've said that, even when you've stopped playing the piano for a week, the pain just kept happening. Even now, when you have the pain is entirely unrelated to whether you've played the piano or not. So, if you were to dispose of the piano entirely, your pain is likely to continue occurring. What other aspects of your life would your pain be likely to affect, with the piano hypothetically out of the picture? Would you be able to work effectively and earn an income, and continue to look after the family and the kids?

It seems to me that the piano-playing is just being framed as the most optional, arbitrary and disposable extra-curricular non-core activity that you are currently doing, so it becomes very easy to view the piano-playing as the trouble-making, dirt-digging disturber of public peace.

If you re-framed your relationship with your pain to leave your piano-playing entirely out of the picture, would you be able to say to your husband, "Hey Hubby Darling, my arm and wrist pain is so bad now that I'm worried how I'll be able to keep working and keeping the family together for very much longer."

I hope that if you re-framed your pain with the piano-playing out of the picture, then you might be able to look at it more objectively, address it more effectively, and gather your family and friends to support you more seriously.

[chopin2015]

Well, I don't have time to play in the morning. I have to be to work by 7:30. Tired, well, I always am, a consequence of having two young kids

As for the previous posts about carpal tunnel: yes I know I have it. But generally conservative treatment is preferred first, so I'm trying that now. I hope to avoid injections or surgery if possible. Especially since I have no paid time off built up at work yet, and can't afford to be off.

Do you wear the braces during the day? I recommend wearing braces all day and all night or any time you are not playing piano. I do the same. Its not a big deal and it feels good.

[mahlermaniac]

I wear the braces during the day when I can, which is at lunch time at work, and if my daughter is napping. It's hard to change diapers with the brace on.

Yes, it is affecting work. New electronic medical record system and I'm having a lot of trouble keeping up. I just started using a dictation system today, so I'm hoping that will help alleviate some of the stress. It's affecting pretty much everything in my life, it's just snowballed so quickly it has thrown me for a loop.

I'll be trying accupuncture next week, and I hope to line up some massage therapy as well.

[outin]

I'll be trying accupuncture next week, and I hope to line up some massage therapy as well.

If what you have is carpal tunnel, I actually found these very useful, although was sceptic at first. I used them every day for 3 weeks or so and the symptoms never returned:
https://www.handmasterplus.com/

[chopin2015]

I wear the braces during the day when I can, which is at lunch time at work, and if my daughter is napping. It's hard to change diapers with the brace on.

Yes, it is affecting work. New electronic medical record system and I'm having a lot of trouble keeping up. I just started using a dictation system today, so I'm hoping that will help alleviate some of the stress. It's affecting pretty much everything in my life, it's just snowballed so quickly it has thrown me for a loop.

I'll be trying accupuncture next week, and I hope to line up some massage therapy as well.

You should really wear brace all the time and during sleep(except diaper and bathroom time), otherwise stop complaining. You will damage nerves permanently if you take no care in how you work and how you relax. Seriously.

[mahlermaniac]

Wow, rather a harsh response. Yes I was complaining, I admit. I just love playing to much so this has been frustrating. Why do you not understand that I cannot physically do what I need to do and wear the brace 100% of the time. I CANNOT PHYSICALLY do everything in my life with the brace without putting serious stress on the opposite arm that way, and since that one is mildly strained too, that's dangerous.

I AM taking steps to get this treated. It came on so quickly, it's not like I was ignoring a problem. It has just snowballed within a short amount of time. I have ordered an ergonomic keyboard and mouse set for work, it comes in tomorrow. I started using a dictation system to help relieve the stress. I am swimming, I am going to have acupuncture next week

[mahlermaniac]

Actually, I'm hoping the ergonomic keyboard will be able to enable me to type and wear the brace; the laptop keyboard doesn't allow for it, but hopefully the new setup will.

[outin]

I am not sure the brace is an answer. I see my colleagues wear them and the problem always persists or comes back after a while. I wore one for a few days when the nerve flared up but I then started doing hand exercise and I am fairly certain that was the thing that actually helped. My carpal tunnel symptoms never recurred.

I'm a bit sceptic of medical treatments too, because most people don't seem to get any permanent help, except with surgery, but it's not completely risk free either.

[chopin2015]

I wear a brace on my right hand all day except practice. It helps maintain pain and minimizes wrist movement which is good. I think the brace is more for protection, rather than it being the best way of treatment. I would like to know about the excersizes you were doing, though. Op, were you fetting inflammation in the muscles at all, such as tendinitis?

[outin]

I wear a brace on my right hand all day except practice. It helps maintain pain and minimizes wrist movement which is good. I think the brace is more for protection, rather than it being the best way of treatment. I would like to know about the excersizes you were doing, though.

I used the exercise ball in the link above and with the piano I practiced using the palm muscles more and the arm muscles less.

Yes, the brace is good for reducing the pressure and protect from further damage, but I assume that even with the brace on you can still irritate the nerves, if you continue the fingerwork. I may be wrong but I think the only permanent and safe solution is to learn a more efficient and less stressful way to type/play/whatever.

One doctor just told me that if have such symptoms my carpal tunnel is too small and probably I should not play the piano or I must have surgery...like he could tell just by looking at my wrist for 5 minutes? I suspect a good physiotherapist is a better person to consult than a doctor when in the early stages. Should still be possible to fix without drastic medical procedures.

[justholgate]

This may be a long shot but.
 I work as a carpenter and spend a lot of time with a nail gun and the repeated shock has at times caused pain in 4th finger to the point i could hardly close my hand.
 Went to a chiropractor for another problem and mentioned this pain to him.
 He checked a few places and then used small "gun like thing" to give taps to back of my elbow.
The pain left almost immediately and has not come back. Note not all that hang a sign that says chiropractor are any good, actually few in my experience. This one uses "Torque release technech.
or he recommended  cranio sacrul therapy for My wife, and she says it sounds like thoratic outlet syndrone.  Google it.
Just from her experience with pain in her hands. to the point where gradually  she couldn't use her hands. Now after 3 treatments No pain.
Look it up it won't hurt.
Mike