Carpal Tunnel

To my great depression I might now be suffering from CT - but maybe not. A few weeks ago a heavy carton I was carrying slipped from my grip and, in an attempt to prevent it from falling I tightened my grip - BUT it fell! The result was great pain in the left forearm muscle probably due to the tighten grip and nothing in the grip. After about a week I noticed CT effects beginning but only when I attempted to rotate my left wrist. Is this CT? If so, what now?

It doesn’t hurt while holding and playing the flute but a few minutes after practice it REALLY hurts to rotate the wrist.

Thoughts?

Thanx, BillG

[ This Message was edited by: billg on 2003-02-16 07:39 ]

I don’t know enought about CT
to say with authority, but it
sounds like something else–
an injury to the forearm
due to the experience you mentioned.
There are professional ‘hand
therapists’ who specialize
in this sort of thing.
You might see one.

Are you doing lots of
repetitive motions, etc?

Bill,

I’d see a doctor. For the almost nothing it’s worth, it doesn’t sound to me like Carpal Tunnel either, which I have had some experience with, and which complicated my comfort when I was first learning the flute. (For a short stretch I even had to play with a brace because my wrist hurt so much.) My teacher gave me this reference for some useful exercises, but you may have to resign yourself to resting your hand for a while. Rest more than anything else helped me over my wrist pain.

http://www.mindspring.com/~shin-on/handcare.html

Carol

Hi Bill
I’m just back from the doctor - I have RSI in my left thumb/wrist as a result of playing flute (I don’t think there’s anything else that could be causing it). I have anti-inflammatories, a referral to a specialist, and I was advised to 1)wear a wrist support/brace while I play, and 2)relearn how to hold the flute so I don’t do further damage (I’m 20). If you have any doubts, or if this is ongoing, go to the doctor. I know of at least 10 musicians, all under 30, who have chronic recurring tendonitis and RSI - it’s not a pretty picture. If you catch it now you can deal with it.
Good luck!
Deirdre

Bill,
I have CT, my left arm is the biggest problem.
The symptoms that I had were the first three fingers going numb after repeated lifting, pushing motion, etc… The numbness was followed by a VERY painful burning sensation in my wrist and forearm. According to the doctors that I saw these were classic symptoms.
That said, from what you describe, your injury sounds more like you stretched the tendons and/or the ligaments in your wrist. I have had the same problem that you are describing and the injury came about in the same manner. After my first flute lesson I didn’t think I was going to be able to drive home because the slightest movement of my arm was so painful. This type of injury can take a very long time to heal with reoccurrences.
The above are MY experiences and may or may not relate to your situation.
The bottom line is you should get it checked out by someone that is qualified to give an opinion. If surgery is recommended get more that one opinion. Always remember that half the doctors out there graduated in the bottom 50% of their class and those that graduated in the bottom 10% are still called Doctor.

Hi : Thought I’d reference you to this topic from the archives: Small Hands Help

I’m glad you visited your doctor.
MY experience is that
a) I still feel the effects, after almost one year
b) yes, rest is the best treatment, although that’s not very encouraging (the more I have to hand-write, the worse my wrist feels at the end of the day) If you’ve really injured yourself, I can promise you this is not going to go away anytime soon
c) I wake up every morning and the first thing I do is take either 3 aspirin, or 1 Aleve (depending on how much my wrist hurts when I get up)
d) My wrist is very important to me, as I assist in surgery and I need it to be strong, so this is not the least bit funny to me, thus I hate to hear about other’s injuring themselves
e) Surgery is less of an option for me because I don’t have time for the required downtime ~ and YOU probably don’t either
f) Yes, the thought about doctors is a very valid one!!! See a good neurosurgeon, but be prepared to hear that it will take a long time to heal this injury, if you’ve really hurt yourself

Anyway, that’s my thought on the matter.
I envy everybody who plays their flute without pain, at this point. But it doesn’t prevent me from playing. :slight_smile: Oh, and I did use a wrist splint for awhile when playing, and it does feel better that way. FWIW
Mary

Hmmm…can’t join in to tell about any physical ailments resulting from playing music. I have found that woodwind and string instruments are simply wonderful for keeping the fingers and hands nimble and youthful not to mention the great health effects for the mind. The only health problem I could imagine contracting from playing music is lung cancer caused by the morons who insist on smoking. No amount of money could convince me to play in a bar or pub where smoking was permitted.As to doctors, I see many around here as being dope pushers, nothing more, nothing less. Music is the best medicine.

Fluter_d, what’s RSI?

N, ?

There are sites about Repetitive Motion
Injuries and related maladies, some
especially for musicians.
What I’ve learned, I think, is that
it pays to get info from many
sources and to come to understand
the malady oneself. Also effective
remedies that work for you
may not be known to physicians
and therapists–there is a fair
amount of ‘lore’ out there
about this sort of thing, among
sufferers, a lot of it is now
on the net.

We have also had a lot of
discussions here about this,
too, though they precede
many of us, and a search would
be a good idea.

I’m glad people have had good
experiences with physicians.
I have had many experieces
with physicians, and I do
not necessarily have a good
opinion of them. As said,
I think it’s good to try to
understand these things
oneself. I’ve also had
not so good experiences
with physical therapists,
though they are better,
in my experience, than
physicians–certainly less
dangerous.

The human body appears not
to have been made to play
musical instruments, though
the human soul definitely
wants to, at least for
some of us. So difficulties
like these are likely to
follow us or find us sooner
or later–best to learn
about them now. Good luck!

RSI = Repetitive Stress Injury; is often caused by computer keyboard use with insufficient hand/wrist support. It can become chronic. It’s not really a good thing to have!
Deirdre

Ouch. I imagine stretching is always prescribed, but I haven’t had to deal with RSI or carpal tunnel syndrome yet (knock on wood), so I don’t know. I wish I had something of substance to offer here. I hope my sympathies and good wishes will do, somehow.

N, wincing

My experience with carpal tunnel syndrome was that numbness in the hand and fingers was a regular symptom. The wrist support brace was a huge help. You can pick one up in any well stocked drugstore (or even at Wal-Mart) without a prescription.

I believe the origin of my problem was drumming, not flute or fife playing. I had tendonitis in the elbow and shoulder as well as the carpal tunnel syndrome. Physical therapy and various braces have straightened it all out.

I’d definitely see a doctor, and see if they refer you to a physical therapist or a physiatrist. Don’t waste your time or money on a chiropractor, though.

Thanks N :frowning:

Jim, my problem seemed to be triggered by typing, and doesn’t hurt especially if I play flute, but rather isn’t getting better… it’s just not fair!
Maybe Dale should start a new forum - for people who have been injured by music/musical instruments… :wink:

Edited because I forgot to add … or musicians :slight_smile:

[ This Message was edited by: fluter_d on 2003-02-15 22:42 ]

Deirdre, have you tried the wrist brace? Or a split keyboard for typing? Or even just a wrist rest pad in front of your keyboard. If typing causes or exacerbates the problem, you have to change the way you type!

Jim - I literally went to the doctor today. My wrist got sore about 3 weeks ago - triggered, I believe, by 2 days of pretty intensive typing - and is still not moving properly. This is just beginning for me - I had a bout before Christmas, but that just lasted for a week or so. My wrist does not hurt all the time, or specifically when I play flute, but my movements are constricted, and from time to time, when I pick things up, etc, I get shooting pains (but nothing bad enough to warrant any painkillers at this stage). So I’m just a newbie to this… I’m really interested in dealing with this problem now, rather than in 5 years when it’s become chronic. The next month is going to be crazy in terms of playing, so I’ll be getting and wearing a brace then, and possibly getting physiotherapy, and after that I’m going to have to look at changing the way I play. It will be an interesting process, I think.
Deirdre

It may be a good idea
to switch to voice operated
computer software–Dragon Naturally
Speaking is a good program.
Not typing is a very good idea,
I think.

Lots of people
have problems because they
sleep with their arms
scrinched up and their
wrists bent. A wrist brace
and also a brace at the
elbow at night can be
very helpful. You don’t
want your arms ramrod
straight, either.

Hand therapists aren’t
physicians, but physical
therapists who specialize
in problems concerning
hands and arms. I’ve found
them more helpful than
physicians and ordinary
physical therapists.
Physical therapists tend
to prescribe and build
arm braces that nobody
can wear. The principal
reason to get a
reference to a hand
therapist from a
physician may be
insurance coverage.

Tart cherry juice
concentrate, about two
tablespoons a day,
seems to be very
effective at damping
inflammation–I think
I’ve said that earlier.

There already are
sites for people who
are getting into
hand, wrist, and elbow
problems by playing
musical instruments.
There is a fair amount
of info on such sites
about how to play
without hurting oneself. Best

There are many different types of repetitive strain injuries, and carpal tunnel syndrome is not the most common by a long shot; as other people have advised here, you should go see a doctor. There’s a very specific test for carpal tunnel. Wrist pain does NOT necessarily mean carpal tunnel; there are several other injuries that can lead to pain in the wrists and hands.

I suffer from thoracic outlet syndrome (one of the most common RSIs, much more common than carpal tunnel), and it got bad enough at one point that I had to quit my writing job as I couldn’t type for more than 2-3 minutes without my right hand going completely white and numb. I recovered over 5 years by using voice-recognition software and receiving intensive physical therapy, massage therapy, and lessons in the Alexander Technique. These injuries are usually permanent and you have to work for the rest of your life to avoid triggering the symptoms. For example, if I use a mouse with my right hand, my symptoms reappear almost immediately.

In addition to following your doctor’s advice, you might want to check out this book: “The Musician’s Survival Manual: A Guide to Preventing and Treating Injuries in Instrumentalists,” by Richard Norris. Published by the International Conference of Symphony and Opera Musicians in 1993. Looks like it’s still available from Amazon:

http://www.amazon.com/exec/obidos/tg/detail/-/0918812747/103-3230382-0323062?vi=glance

Norris is a flute player himself, although his solution (using a redesigned head joint with a bend in the barrel) isn’t practical for us wooden flute players, and most silver flute players I know who have tried it don’t like it. But he does have some good general tips and advice on avoiding and treating RSI.

One note on Jim’s response above about hand therapists: The only concern I have about this is that some RSIs, such as mine, are felt in the hand but the actual cause is somewhere else – in my case the shoulder and the pec minor muscle. So treating the symptoms at the hand itself does nothing to address the actual problem. All the pain and numbness from my RSI was in my right hand, and yet my massage therapist and Alexander Technique teacher never touched my hands. They worked on my shoulder and posture, and alleviated the problem that way.



[ This Message was edited by: bradhurley on 2003-02-16 08:59 ]

For what it’s worth, hand
therapists do the same thing,
and for the same good reason.
A problem experienced in the
hand or wrist may well be caused
by a problem elsewhere.
So ‘hand’ therapist is
a bit misleading–these
folks specialize in problems in
the hands, wrists, elbows
and shoulders, and are well
aware that pain in one place
may be caused by a problem
in another. The approach is
holistic, as it should be.

I’ve run into lots of bonehead
physicians and it seems that
problems like these, which
profit most from a very practical
approach–adjust how
you live and do these exercises,
etc–are what they do least well.

Of course it’s just my experience,
but I’ve had a lot of it. If
I may switch limbs, about 12 years
ago I started having very bad
pain in my knees. I went to
an orthopaedist who counselled
surgery. It didn’t add up and
so I went to another who also
counseled surgery. I went to
a third who counseled surgery: he said
‘We can’t give you a new knee,
but we can give you a better knee.’

I went to a fourth orthopaedist who
said: ‘Take off your shoes and walk
around the office.’ He said ‘Your
flat feet are catching up with you.
You’re pronating and your quads
aren’t strong enough to control
the knee. Why don’t you get on
an exercise bike for a few
weeks and see how you feel.’
So I did and the pain went
away. There was nothing to do
surgery on.

A few years ago I pulled a left shoulder
muscle swimming, so I stopped
working out. Also I started
playing a jumbo acoustic guitar.
Several weeks later I was in
frightful pain in my right
shoulder, could hardly dress
myself. Went on for months.
I went to a doctor who declared
himself baffled: ‘The mystery
ailment!’ Finally I realized,
I was muscle bound–the muscle
in the right arm had grown
stronger from playing the big
guitar, but it had shortened from
lack of other exercise. The
remedy was to stretch the
muscle–so I began to
do stretching exercises and
in a few weeks the problem
was gone.

I will leave out analogous stories
concerning more serious ailments.

Generally I have to figure
things out for myself.
I started suffering from
cubital tunnel syndrome,
in the elbow, about a year
ago. I went to a physician,
who told me how to
live with it and sent me
to a physical therapist who
told me to do exactly the
opposite of what the
physician said. This in
the same world renowned
hospital. Then I went to
another hospital where a
physician applied a painful
therapy that made things
worse. She sent me to a
physical therapist who made
me an arm brace that was
unwearable and exacerbated
the problem.

Finally I decided that I had
to solve the problem myself,
so I started doing research,
much of it on the internet,
also Jim Wasson, who then
was active on this board,
was quite helpful–a very
sensible physical therapist
suffering from similar
problems.

I shepherded a severely disabled
woman through decades of medical
treatment, and in my opinion
there is a lot of unecessary
surgery, there are many mistakes,
there are plenty of incompetent
people practicing, and there
are a fair number of dishonest
and/or mentally ill physicians.
At the same time I think
we have the best medical
establishment on earth.

So I figure that if ever it pays
to be a smart consumer it’s
when it comes to medical
services. It’s useful, when
you have a malady, to learn
about it; often you will soon
know more than the physicians
and therapists. When the
malady involves limbs, etc.
the most practical, least
theoretical and most
down to earth practitioners,
are often the most
helpful.

For what that’s worth. If
anybody’s experiences have been
more positive than mine,
I’m glad of it. Best

Bill,

I’ve had capital tunnel (RSI) and my wife has had carpal tunnel sydrome.

First, I agree that you should see a doctor, preferrably someone experienced in treating injuries (as opposed to illnesses).

I agree with Jim, be a smart consumer. This starts with expectations and relationship with your doctor. He/she can’t know everything. He/she may be able to lead you to someone who know’s how to treat your injury if he hasn’t had a lot of experience with it. Hand and arm specialists would be my guess, but you may need the advise of a good neurologist (not a neural surgeon) if there is nerve damage. Again your hand/arm specialist should be able to suggest some one.

In most cases of RSI, along with pain you get tingling or numbness that points to nerve damage. In both our (Peg and I) cases nerve damage was because other damage to tendons and muscles went untreated for long enough that the swelling from injured tendons damaged the nerves. The sheaths around the nerve fibers developed scar tissue which cut off the nerve, hense the tingling and numbness that went with the pain. But nerve damage started with injury to tendons that was agrevated and prevented from healing due to repetative stress. My capital tunnel saw imediate relief after surgery to remove the scare tissue; the 90 percent loss of feeling became 10 percent loss. I had a good surgeon, good orthopedist, good neurologist (lucky I guess).

They started with me taking responsibility for my own health. They were there to help, but my health was my own and it was up to me. They insisted that I learn about repetative stress injuries and that I take steps to promote healing and prevent re-injury.

Things like avoiding doing the same thing the same way with the exact same movements. This meant putting the keyboard in a different postion and the chair in a different position every time. It didn’t take much change to make a difference. It meant taking breaks and doing other things.

It meant some exercises, some heat treatments, in my case very hot baths have promoted circulation, improved my healing, reducing muscle and tendon pains. These pains are not the original injuries but refer to my tendance to do things out of the ordinary from time to time. These are the kind-of the normal every day type injurys, bumping, pulling, straining, type stuff. Some folks seem to get over these buy just tuffing it out. I don’t. Things like heat, Ibupropen, and mild exercise are needed to keep injuries from snowballing from simple into systemic.

All of the above is what I’ve learned from my experience and what has worked for me and my wife, Peg. A good doctor, will help your learn about your physiology. Seeing someone now about the injury may prevent damage in the long run. Like I mentioned, and Jim indicated, it starts with you and your responsibility. Don’t look for your doctors and other professionals to rescue you or cure you. Look for them to help you get healthy.

Just my 2 cents born of Peg and my experiences. I hope this helps and that was seems comprehensible to me at 1:30 am is practical for you.

Hope this works out so you can concentrate on how you …

I am grateful to all of you for your responses. I planned to call my family doctor this am but now in a blizzard I may have to put it off till tomorrow. BUT I will make the appointment and look forward to a referral to the proper specialist. In the meantime I am holding off on playing the flute and will play the whistles - no help for the embouchure but good for the finger sequence.

Thanx again, BillG (typing with one and a half hands)