Nerve problems
Nerve compression injuries are common in high level musicians, and also occur in those that play less often at a lower level but who have poor technique. String players are at risk as they hold their instruments in abnormal positions for long periods, and percussionists are often affected.
- i) Carpal tunnel syndrome.
This is common in string players and is caused by repetitive movements of the fingers and the wrist, and by the position in which the instrument is played. Rest is required and physiotherapy and splints may help. Nerve conduction studies may indicate that referral to an upper limb specialist is required.
- ii) Cubital tunnel syndrome.
This is common in string players and guitarists who often develop problems on the side that they fret the instrument. The ulnar nerve is compressed by inflamed muscles making up the cubital fossa at the elbow, and flexion of the elbow brings on symptoms or worsens them.
Pain or an abnormal sensation goes from the elbow, along the inner side of the forearm and to the 5th finger and the ulnar side of the 4th finger. Tingling and numbness is often felt, and the forearm muscles can be achy and sore. Musicians notice that they can’t control the 4th and 5th fingers as well as normal, with loss of dexterity, speed and control of these fingers.
Computer work, leaning on the elbows, neck problems, bad posture and forward head tilt can all contribute to the condition.