The carpal tunnel demon is back and I do not understand why, I have not been playing that much at all. I have had it in the past and have had two cortizone shots. The shots work great, it makes the numbness disappear but my doc told me "no more shots, next time it is surgery".
Has anyone ever had the surgery and does it work? any side effects? how long with no pickin?
I have been to two orthopedic hand specialists. One of them is a guitar/mando player and the other is one of the better doctors I have dealt with in any specialty. Both told me the same thing: Avoid surgery if you can. Hand surgery does not have a high "satisfaction rate" (my term, not thiers). I would try the "time without pickin'" up front to avoid surgery, rather than worry about the recovery afterwards. Some things I would try before surgery:
1) The stretches on musicianshealth.com. I would do them before picking and few times a day regardless.
2) Get my mando properly set up with really light strings. If that is not enough, go with single strings rather than courses. If that is not enough, get a ukulele and string it like a mando. This allows you to keep picking without the strain, until you recover.
3) Get with an instructor who can help you sort out your technique for less stress.
4) Find another doctor and possibly an associated physical therapist who really understand musician's issues. They are hard to find, but they are out there.
I had CTS surgery on my left (fretting) wrist, about 18 mos ago, endoscopically. I don't believe the endoscopic approach is associated with any difference in outcome, but is thought to reduce recovery time.
For moi, it was greatly worthwhile. I tried one cortisone injection, exercises, and nocturnal splinting, without relief, prior to the surgery. I was able to play gypsy jazz rhythm guitar on a 2 hr gig, about 3 wks after the surgery.
Charlie
One thing to consider.... Is it definately CTS? or is it Pronator Teres syndrome? (same nerve, different location) or is it both?
I would have to be absolutely sure that it was CTS before surgery.. I would get some second opinions.
That's just what I would do, first...
Good luck,
Eric
When not playing mandolin, I an an orthopaedic surgeon by trade and carpal tunnel syndrome is something I see often in the office. It has numerous causes from repetitive stress, benign cysts to fluid retention from recent weight gain/salt intake. The treatment varies as to the severity and duration of the symptoms but overall starting with conservative measures is essential. These may include weight reduction,frequent wrist stretches, nocturnal wrist splinting, activity modification and ergonomic evaluation. Later treatment may include cortisone injection, electrodiagnostic evaluation to confirm pressure in the canal at the wrist or surgical release (open or endoscopic).
This tends to be an occupational risk for those of us who use our hands/fingers consistantly; in fact I tend to have fluctuating episodes of CTS. For me it is from building stone walls, wearing tight surgical gloves, hammering, eating pretzels and then playing mandolin for hours and hours. So far I have been able to be conservative with mine but if the numbness becomes persistent, more aggressive care is warranted. It may take upwards of 8 to 12 weeks to regain full muscle memory and precision dexterity. Listen to heath care people you trust. I hope this helps, Doug
Years ago I injured my right hand playing volleyball and ended up with pain in the right thumb area that could put me down on my knees with pain. I saw a number of doctors that had many different opinions (guesses) as to what the problem was. I ended up seeing an orthopedic surgeon who specialized in hands. He diagnosed the problem as Dequinlin's Tendonitis (guess on spelling) and tried cortisone once. It helped, but I never have been happy taking any drugs and the doctor suggested I try ultra sound. I bought an ultra sound device from Sharper Image ($300) and used it for six months on a daily basis and have been pain free for the past 25 years.
Will this work for you....I'm certainly not a doctor, but it did work for me.
Before anyone cuts on me, I get at least 3 opinions to make sure it must be done. I worked in the optical business for many years and saw eye surgeries that produced less than desired results. Doctors do their very best and still are confounded by the differing reactions by our individual bodies due to the complexity designed in to it by God.
Good Luck,
John
I have been to two orthos in the past and they both agree it is CTS. I have been sleeping with the brace and it helps the sleepy hand in the morning although it is still not very comfortable. Doug, I think you may have nailed it. I recently lost about 15 lbs and within one week of vacation, gained 10 back. "Recent weight gain" could be the problem. I played for a couple hours last night and it absolutely killed me, at one point I could not even feel my hand.
Try actupunture. I had sesmoiditis (bone/muscle in ball of the foot). I could barely walk for 10 weeks. The oldies were passing me with their walkers. Greyfox was coming up in 4 days. Cortizone shot did nothing. As a last resort I went to a Korean actuputure. I pointed to where in my foot it hurt and he treated. Later that night I felt much better (which would happen time to time over the ten weeks). In the morning I felt great. At the fest. I had no problems what so-ever.
I am one not to believe until I experience, so I am waiting til next 40yr old ache.
Some years back I had surgery for CTS on my left hand, and have played pain free ever since, but I have never been able to snap my fingers since the surgery. Not that snapping fingers is a required ability, but it indicated that everything didn't heal back to "original condition." FYI, I was recently told that the "open surgery" was a safer option, simply because the surgeon not having to work within the confines of the endoscopic equipment made it less likely that something unwanted might happen, like nicking a nerve. This was passed on to me by an orthopedic surgery resident who was suffering from CTS, and had researched the options extensively. Mine was bad enough that the time for options had run out, but I have avoided surgery on the other hand by doing the types of things that have been mentioned by the other responders. I did have it done by a neurosurgeon who also played music, and had a thorough understanding of my needs. I should mention that it was not caused by my playing; if that is the primary time you are affected, you should have an evaluation of your playing techniques. It is possible that hand, body and instrument positioning could be causing the problems. If the hands are numb while driving, eating, keyboarding, etc., then playing techniques are not the issue, although they could be contributing. As mentioned, there are those medical practitioners who specialize in treating musicians, and it could be well worth your time to locate one. You have gotten some good input from cafe members, and I wish you the best of luck in dealing with this.
All of these things that everybody is mentioning is falling into place. I just returned from vacation which involved A LOT of driving, which did strain my left hand. On vacation, I let loose and gained some weight, I quit chewing tobacco and took up sunflower seeds (SALT). I am going to let it rest, and see what happens.
I had symptoms of CPS but delayed treatment for a couple years. I had the surgery but not before irreversible muscle loss had occured in my fretting hand. I've had physical therapy and have continued exercises for two years but will never have the strength I once had. Now it looks like I might have to have the same surgery again.
I was wondering if anybody ever suffered thumb problems. I bought a new mando on Saturday on the way to a 5 hour jam, and decided to play it at the jam. It has a thicker neck and must have hit a nervein my thumb because that night and for two days after the end of my thumb was numb.
I am now afraid to play that mando until I learn how to hold my thumb in a different spot. I have or have had 9 different mandos and a few guitars and this has not happened before.
In 1983 my right hand was operated on; it had developed a
ganglion at the wrist from playing a guitar with a very high bridge. My left hand has never caused me any trouble.
Great thread friends...I haven't had problems.. but am terrified of developing them.
Salt? Diet in General? Weight gain? great info...never considered them...Thanks for the info..
craig
Harrmob,
How long have you been playing fretted instruments?
Bill James
www.axinc.net
Kevin, Witch MD (Ha,Ha) are you seeing? Dr. Bob McGinley operated on my left wrist about seven years ago for Dequervane's (Sp.?) Disease. Call it what you will; it was a real pain! His description was that in or near the thumb joint, tendons or ligaments running through a hole in the bone become inflamed, therefore bind in the hole, causing pain. He reamed out the hole in the bone, allowing the tendons or ligaments more freedom. Now and then I feel some discomfort and apply an ice pack to provide relief. Also, I have been wearing a linked bracelet which has a small magnet imbedded in each of the appx. 20 links and I am convinced that this really helps keep down the pain. Someone mentioned accupuncture; I wouldn't object to trying that, myself. Let me hear from you!
"Look upward; He is coming back!"
I have been playing mandolin religiously, everyday, for 5 years. #I kicked around a piece of plywood guitar since I was in 10th grade (1985), but I would go months without playing "Stairway to Heaven" or "Sweet Home Alabama", so that does not count does it. #I'm a total addict to the mandolin, and not playing, letting it rest is tough. #The first time the CTS numbness happened was about a year and half after playing- and I got a C shot. #Then again about 2 years after that- I got another C shot. #Now it is back a year and half after my second shot. # I stopped wearing a big titanium watch that I was wearing on my left hand which I am sure helped. Ken- what is the deal with the magnets? #Is that supposed to help? Is that the "current" thing to do? #
Before I got my last shot, the Doc did the CTS test where he taps the underside of the wrist, and I just about knocked him on his butt. #I told him not to do the test b/c I knew how bad it was going to hurt and send that electical pulse up my arm. #He tricked me, made me look away and WHAM, tapped my wrist. #I cringe thinking about that and getting another one of those tests, so sticking a needle (acupuncture) in my wrist that is already sensative, is totally out of the question.
I have run every weekday this week (today is Tuesday) so I am working on my weight, I have my water bottle beside me, I quit wearing my watch and I warm up b/4 I play. I played the other night (FAST for 2 hours) with no problem, yet two nights before that, it went numb.
ken- Dr. Thomas and Dr. Ray have both looked at it. Dr. Thomas is a hand specialist.
Kevin, Supposedly (not positive-sounding, is it?), the magnets are capable of providing better blood circulation. I can't give you any biological explanation, but I know it works for lots of folks. There is some magnetic measurement stated on the packaged product, which denotes the particular strength of the magnets in the bracelet. You might shop around in order to obtain the highest strength you can buy; I can't recall, but it is something like 1,500. They are made of stainless steel and there are several styles ( with extra links and a tool). My wife and I both wear them, as they also help with arthritis pain. Hope you can find some fast relief!
"Look upward; He is coming back!"
Another possibility is osteoarthritis of the base of the thumb joint often secondary to an injury to the wrist/hand area.(like, falling flat on your face ski racing at 30 mph in a longgone foolish youth, and wrecking your left hand into a post ) ...current symptoms include -- when one bends the L hand in a certain way such as when fretting a tough chord or grabbing a guitar case, , a bolt of pain like lightning shoots up past your thumb and wrist.(also wrecking the chords...) Surgery to grind away the bony arthritic deposits is a guaranteed 6 months w/o mando, so it is kept in check by occasional doses of Naprosyn ( naproxen) , a powerful over the counter antiinflammatory that actually works fast and well if you take it 20 minutes before playing a gig. with these legal drugs i have had no problems playing 6 hours at a stretch. I also hear there is a performing musician's clinic of MDs out of Cleveland Clinic in-- you guessed it , Cleveland Ohio.
Harrmob,
I also started a few years ago and felt like I had to play every day. The problem is, you are asking your hands and related joints to do something that is very demanding of them. In addition, you are asking at a point in your life when your physical state is in decline. In other words, asking too much at the wrong time.
I had used my hands extensively my entire life and not had any real problems. Still, when I started playing the mandolin and guitar at age 44 I developed multiple issues almost immediately. Early stages of CTS, especially in the right wrist and hand.
You may be overdoing it. You mentioned playing for two hours. That's a lot for someone having serious problems. If you were lifting weights and training the same muscle and joint group every day, at some point you would start to develope problems and go backwards instead of making progress. There HAS to be some rest to let things recover.
Try resting one day and playing the next and sometimes maybe a couple of days in between. Believe it or not, you will play better. I've proved it. And don't fret,(sorry) you will get used to not playing when you realize that you are now getting faster and making progress again. You will actually progress and play better instead of sitting on a plateau.
Or, you can trash yourself.
Good luck to you.
Bill James
www.axinc.net
I had the endoscopically surgery, My CTS was so bad I could not make it through one song. this was about 10 years ago and for me it worked wonders
Don't argue with an idiot; people watching may not be able to tell the difference.
http://prancing-pony-agency.freeservers.com/
I have not played in 5 days, which for me is a record really. My left index finger usually has a problem closing all the way, and normally will not until my hand is warmed up. If you can imagine making a fist as tight as you can and your index finger still poking out- not good. The doc said it was b/c of the CTS that is happening. ANYWHO- after taking a break for a while, I can make a real fist this morning without my finger poking out. Surgery may be inevitable, but not until it is as bad as Grant's case, getting through one song, then it will have to be the knife.
I've had three operations for this - Dupuytren's Contracture
It's very painfull. I've included a web site for those who want to look at what it is.
http://orthopedics.about.com/cs/hand...dupuytrens.htm
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