Carpal tunnel syndrome is a condition in which there is pressure on the median nerve—the nerve in the wrist that supplies feeling and movement to parts of the hand. If you play your instrument for many hours per day without adequate breaks and/or stretching, you may one day find yourself afflicted with carpal tunnel syndrome. In his book, The Bassist’s Guide to Injury Management, Prevention, and Better Health, Chicago-based chiropractor, Randall Kertz, D.C., discusses the condition in depth. Making Music asked Kertz to shed some light on the symptoms, treatments, and preventive measures. Though he’s a bass player himself, and his title suggests that it might be specific to that instrument, Kertz designed the guide to point out problems that any musician may encounter.
What are the Causes of Carpal Tunnel Syndrome?
Because of overuse, you get repetitive strain injuries. It makes that area swell from inflammation because of the extra work. The result is pain and numbness. There’s a ligament at the wrist crease called the transverse carpal ligament and when that gets tight, it presses down on the nerve and you get this issue. Carpal tunnel syndrome is also very over-diagnosed. Physicians and therapists tend to say that anything coming from the wrist is carpal tunnel and that’s not the case. True carpal tunnel syndrome will go to the thumb, the index finger, the middle finger, and sometimes half of the ring finger. You’ll feel numbness or tingling in those areas. It will also wake you up at night due to the swelling from the fluid that accumulates there when you’re resting. If it doesn’t wake you up at night, it doesn’t go to those areas, and it goes to the pinky, it’s something else entirely.
How Do You Treat Carpal Tunnel Syndrome?
There are few effective treatments. One of them is what I do as a chiropractor. There’s an adjustment called “the opponent’s role” utilizing a toggle board device. I take the wrist and stretch out the affected area by lifting the ligament up off the wrist and then, with a high velocity thrust, I am able to secure the adjustment. What that does is stretch the musculature out and it gets the bones moving properly again. The carpal bones in the wrist tighten up because the attached muscles are tightening from repetitive motion. Carpal tunnel syndrome makes those bones, which should articulate individually, not move independently. The adjustment helps restore the proper motion. That works most of the time. There’s also ultrasound, which is a physical therapy treatment. It penetrates down below the surface of the skin and reduces inflammation. Acupuncture is also very effective.
How Do You Prevent Carpal Tunnel Syndrome?
If you’re practicing your instrument eight hours a day without breaks, or just starting to play, you’re likely to get these problems. Keeping the wrist in a neutral position as much as possible will reduce the risk of contracting carpal tunnel. I’m a bass player and I play with my fingers, so if you look at it in the context of that instrument, my left hand is constantly in a flexed position so that I can grab the notes on the neck. My right hand is also in a state of flexion because I play with my fingers. What happens is players tend to get their hands on the instrument, crook them over into that flexion, and just let them sit there. By keeping it there, the force doesn’t let up; there’s no rest. So you have the flexion component causing a problem.
Being aware of this and resting your hand when possible will reduce the risk. You’re not going to be able to rest all the time, you have to play the instrument—I get that. You can also reduce the angle at which you’re playing, or maybe in between songs or takes, you can put the wrist into the neutral position. This is going to prevent you from getting carpal tunnel or a similar symptom. Taking a break once in a while, shaking the wrist out and stretching will help immeasurably. It’s really about awareness, which nobody talks about. When you go to music school, whether kindergarten or university, nobody tells you, “Do these stretches or keep your wrist in this motion.” In fact, it’s quite the opposite. There’s a mentality that, “I practice 10 hours a day, now you have to too.” That may be the case, but there’s a better way to do it.
For more on carpal tunnel syndrome and Dr. Kertz’s The Bassist’s Guide to Injury Management, Prevention and Better Health visit Dr. Kertz’s website.
I have a question. If you have carpal tunnel do you have to give up the guitar? I play death metal and as you can imagine there is a lot of tremolo picking. Please get back to me at your convenience. Thank you.
Just a note that Occupational Therapists are actually also trained to treat Carpal Tunnel. Certified hand therapists are trained to use ultrasound, and can be either PTs but are usually OTs.
I am an older working musician and guitar/bass teacher. My issues with CT syndrome were with my wrist and hand
tingling and waking me up at 5:00 am. Why early morning, I don’t know but I have found that wearing a flexible wrist wrap.
Stretchy with Velcro fastener works wonders. It hooks over your thumb and around your wrist. Make it snug and wear it to
bed each night. It immobilizes your wrist enough give it some healing rest and for me at least has completely solved my problem.
It’s a cheap fix that really has worked for me so, I recommend trying it before doctors and drugs.
Don’t believe a chiropractor, don’t follow their advice. Chiropractic is a dangerous pseudoscientific therapy
I’ve been playing cello for 30 years & recently started having a pain in my left wrist, on the side opposite the thumb. It mainly happens when I’m playing in thumb position, which is frequently used in advanced pieces. The wrist bone is very sensitive to the touch. I don’t get any numbness but I feel it most when I wake up in the morning. Yes, after shaking my wrist, the pain subsides.
I liked the article. I’m a guitarist and I wear braces when I’m typing and sleeping, so that I don’t have to try to wear them while playing. A few I can practice in, but it’s awkward.
Couldn’t find anything relating to ‘“the opponent’s role” utilizing a toggle board device’ on Google.