Piano-related finger pain that's not healing

[avocado10]

I'm posting here because I'm getting desperate, dejected, and am really hoping to find other piano students who may have had a similar experience. I've seen several doctors and so far none have been very useful, so I'm hoping to find some first-hand experience from other piano players.

I suffered what I believe was a piano over-use injury. I bought a new piano around two months ago, and started playing very intensely after not playing for several years. Roughly two weeks of intense playing later, I started experience a lot of pain in all my fingers. It was (and is) primarily a throbbing pain along the fingers and fingertips, and a bit of soreness in the palms of the hand. I figured I was playing with too much tension and bad technique, so I stopped completely and waited for my hands to get better. In the meantime I started looking for a teacher that could help improve my technique and doing my own research on reducing tension while playing.

Fast forward two months and several doctor visits and I'm still unable to play. The pain is definitely not as bad as when I first injured myself, but it seems to be extremely slow to heal. First, it's a constant, irritating soreness even when I'm not playing the piano (typing, cooking, tying my shoes). Second, there seems to be this cycle where I don't touch the piano at all for 2-3 weeks, feel a little better, play (very lightly and as relaxed as I can be) for 30ish minutes, and then wake up the next day with the pain completely back again.

It's extremely frustrating and demoralizing, especially when piano is currently my main source of stress-relief, and I'm starting to have this nagging fear that I might never be able to play again. 

I've seen a hand doctor who told me that he didn't know what was wrong and that he doubted piano could cause injury (which I disagree with.) I've also seen a rheumatologist, who told me it was unlikely that I had arthritis as a 20-something year old, but recommended I get a checked up on it. Early results seem to show nothing serious, although I still have some more follow-ups. I've also seen a physical therapist, but who didn't know much about musician injuries and just suggested that I rest and massage my hands some more.

Some friends have suggested that maybe I just have to wait even longer for my hands to heal ("maybe a couple of months") which is awful to hear but still better than imagining some kind of permanent underlying issue. The idea that I might not be able to play again makes me feel physical sick.

I'm looking for some encouragement and hoping to find someone who may have had a similar experience in the past.  Similarly, are there people who specialize primarily in musician related injuries that can give better advice than the doctors I've seen?

Hoping for some help and advice.

[attempt3]

my best advice is for you to rest for the while as your hand heals, practice on your other hand in the mean time. Don't go overboard and cause more serious injury. '

good luck with your healing

[quantum]

Hi and welcome to Pianostreet,

Have you seen doctors specializing in performing arts medicine?  Sports medicine would also be another possibility.

I do know at least one pianist with hand arthritis which seems to come and go.  Although it can cause great discomfort at times for her, she is able to go on playing. 

Have you considered singing as a second instrument?  It could provide an outlet of musical expression on the days where your hands need a rest.

[ranjit]

Most doctors are not aware of pianist-related injuries. Carpal tunnel is one of the most common injuries that occur due to piano playing. Ignore anyone who says that playing the piano can not cause injury -- that is flat out wrong. Try to find a doctor who knows about injuries which affect musicians.

Maybe check if your hands are tense normally? A common suggestion is to raise your hands above your head, and then let them drop naturally to your side. If you are still young, it's rather unusual to injure yourself on the piano (unless you are consistently attempting to play difficult repertoire with really poor technique), so it may well be something else.

I have heard similar stories from pianists, but don't really know how to find doctors who specialize in injuries related to musicians.

[lostinidlewonder]

It would be interesting to experiment if you still get pain on a unweighted keyboard as well. Practice easier pieces, don't tax your energy so much, listen to your body.

[debussychopin]

I'm posting here because I'm getting desperate, dejected, and am really hoping to find other piano students who may have had a similar experience. I've seen several doctors and so far none have been very useful, so I'm hoping to find some first-hand experience from other piano players.

I suffered what I believe was a piano over-use injury. I bought a new piano around two months ago, and started playing very intensely after not playing for several years. Roughly two weeks of intense playing later, I started experience a lot of pain in all my fingers. It was (and is) primarily a throbbing pain along the fingers and fingertips, and a bit of soreness in the palms of the hand. I figured I was playing with too much tension and bad technique, so I stopped completely and waited for my hands to get better. In the meantime I started looking for a teacher that could help improve my technique and doing my own research on reducing tension while playing.

Fast forward two months and several doctor visits and I'm still unable to play. The pain is definitely not as bad as when I first injured myself, but it seems to be extremely slow to heal. First, it's a constant, irritating soreness even when I'm not playing the piano (typing, cooking, tying my shoes). Second, there seems to be this cycle where I don't touch the piano at all for 2-3 weeks, feel a little better, play (very lightly and as relaxed as I can be) for 30ish minutes, and then wake up the next day with the pain completely back again.

It's extremely frustrating and demoralizing, especially when piano is currently my main source of stress-relief, and I'm starting to have this nagging fear that I might never be able to play again. 

I've seen a hand doctor who told me that he didn't know what was wrong and that he doubted piano could cause injury (which I disagree with.) I've also seen a rheumatologist, who told me it was unlikely that I had arthritis as a 20-something year old, but recommended I get a checked up on it. Early results seem to show nothing serious, although I still have some more follow-ups. I've also seen a physical therapist, but who didn't know much about musician injuries and just suggested that I rest and massage my hands some more.

Some friends have suggested that maybe I just have to wait even longer for my hands to heal ("maybe a couple of months") which is awful to hear but still better than imagining some kind of permanent underlying issue. The idea that I might not be able to play again makes me feel physical sick.

I'm looking for some encouragement and hoping to find someone who may have had a similar experience in the past.  Similarly, are there people who specialize primarily in musician related injuries that can give better advice than the doctors I've seen?

Hoping for some help and advice.

Is there any video of you playing piano , would like to see in detail how or what you may be doing something particularly that gives you pain or intensifies pain for you. There may be some alternative ways on approaching/attacking the keys on a piano. I have had an issue w 'arthritic' type pain in my right pinky when I first played but it was how I was trying to voice chords and hitting the key more in a jamming sort of fashion, which gave it tremendous pain even if i just touched it on a pillow. I since then adjusted how I attacked keys with my pinky (and angle of wrist ) and never had issues with it since.
Not saying it is the same issue as yours, but I am sure there can be a solution or workaround to what you are experiencing .

[genedan]

I have chronic hand issues, in that my tendons are no longer attached to my knuckles, which is something I guess I just had to control as I believe the issue is genetic (my sister has the same problem - oh yeah and if anyone else has this issue do send me a PM - my doctors seem to be pretty stumped on what this is). I gave up viola and piano in college due to this and took 10 years off. I'm sure I could have returned a lot sooner, but I was occupied with other things like my day job and I got really in to weight training over that time, which I think helps a lot.

When I came back I only played literally a 2 octave C-major scale the first day. I originally wasn't serious about returning but I added maybe 30 seconds to 1 minute to my practice time each subsequent session. I avoided back-to-back days and sometimes took a week or two off. Eventually I worked my way up to the point where 3-4 hour practice sessions are normal.

If I've taken a break from the piano (say, a month or more), I can't just play at the same intensity as I did when I left off or I'll risk getting an injury. Your hands are just like any other body part and they lose fitness if you've taken a long break. In the same sense that even if you've previously been running marathons, you shouldn't start out running another one if you've taken several years off. I guess I've heard of people running marathons without training, so I guess every person is different. My body is not like that and I would get stress fractures if I tried doing that.

Soft tissue injuries can take a really long time to heal. I had some foot tendonitis that took a year to heal for instance. I don't think there's a need to jump to conclusions thinking you are doomed, but I think for now you should just wait until there's no more pain and then very gradually work your way back up with easy material. I think you should probably continue your PT or find a more specialized therapist who treats musicians.

For me, the warning signs for me aren't really pain but maybe some swelling when I wake up and then I get a strange sensation that my keyboard computer is too small for my hands. It's hard to describe but that's when I know I should take time off.

[ocpianocare]

Avocado,
I too have recently had some disappointing wrist and finger pain. Mine is clearly an over use issue and an over 60 thing. My pain is mostly in the wrist on the side opposite the thumb, and the tenderness seems to radiate to the middle finger and down towards the elbow along very specific tendons. I believe it's referred to as TFCC by doctors which ranges from violent trauma to mild pain due to over use.  I've been dealing with it for over 4 months and I seem to be making some progress. Nevertheless, here are some lessons I've learned.

1) I'm tall and my bench fully extended did not really put me high enough.  My elbows, with my shoulders fully relaxed, were below the keys. I flipped the mechanism of the bench (Jansen Artist) and this gave a more comfortable height with relaxed shoulders.

2) A piano teacher referred me to the work of Dorothy Taubman. and this lead me to find a very interesting article. SUMIKO MIKIMOTO’S PIANO METHOD: A MODERN PHYSIOLOGICAL APPROACH TO PIANO TECHNIQUE IN HISTORICAL CONTEXT. (I tried to attach this file)

3) From this reading I became aware of how much tension I had in my hands while practicing. I just have a tendency to lock up my wrist and hands and this will be very hard to change after years of poor habits.

4) A friend who plays Viola professionally ( and Part time Physical Therapist) recommended complete rest and management of pain and swelling.  This included hot and cold treatments to reduce swelling and then increase blood flow. I also wore a wrist brace (Mueller) for awhile, but only at night while sleeping, per the PT's direction. The hard thing was that when I thought I was resting I was still playing for an hour. So I was still aggravating it.

5) For immediate pain relief and to reduce inflamation. I found that nothing beat Voltaren (Diclofenic Sodium) as recommended by the PT. Apparently, Ballet dancers covet this stuff by the barrel.
 
6) The hardest thing is rest. As soon as I started feeling a little relief I started playing more. I need to deliberately repeat this. The only treatment options are rest, steroid injection, surgery. Rest seems like the most likely to succeed albeit slowest path.

7) I learned that this is a very common thing for pianists and other musicians. Unfortunately, the answers are not all that satisfying.

I hope this helps in one way or another.

Be well.
Jim