Wrist Pain

August 24, 2006 at 04:02 PM · I’m a teenage male who has been having wrist pain (both wrists, right hand dominant) for more than a year and a half. I get a dull pain in my wrist whenever I write. This pain usually radiates to my forearm, but does not get more than four or five inches. Typically a dull pain in my elbow corresponds to my wrist pain. This pain only happens when I am writing by hand, playing the violin, and sitting down on my back with my elbow bent and arms extended upwards (reading at night). If I extend my elbow in the reading position my pain goes away. It usually is not very bad until I write for more than five minutes. The pain gets so strong that I physically have to stop writing. I run a successful company from home and am typing almost all day. I type almost everything for school – as much as possible. I stopped playing the violin for about six months and at the same time I did not participate in physical education (doctor’s request). I have been to a pediatric orthopedist [many times] (at DePont in New Jersey), a rheumatologist (at DePont in Deleware), a geneticist (director of Marfan’s research at University of Pennsylvania), a neurologist twice, a wrist specialist at a wrist center (New Jersey), a chiropractor, and my local pediatrician. I have been tested for almost everything possible (MS, Marfan’s syndrome, Lyme disease, Fibromyalgia, etc.). I had a neck x-ray, spine x-ray, spine MRI, two EMGs and NCVs of arm. Everything came out normal. I have gone through five rounds of physical and occupational therapy at three different centers. Ibuprofen, acetaminophen, naproxen, heat, cold, wrist and elbow braces – nothing works. My former occupational therapist (I do not go anymore) believed it was an entrapped, stretched, or twisted nerve in my elbow (ulnar), my orthopedist thinks it is chronic pain, and my pediatrician believes it is growing pain that not can be explained. I believe that it is some type of ulnar nerve problem. I have a pretty good basic understanding of the medical field (especially after seeing all of these doctors!), but obviously I am not a doctor. Does anyone have any ideas as to what is causing this pain and/or how to treat it?

Replies (12)

August 24, 2006 at 10:05 PM · Hi, I just wrote you a very long message about your pain problem, but it was somehow lost near the end of the message. Since my typing is very slow and effortful, i haven't the energy to retype it. I am a violinist and teacher who specializes in pain problems, I have never failed in thirty five years of teaching been unable to help a student with pain problems. Doctors etc. have no idea how to fix this problem. The problem lies in tension and how it works. Find an Alexander teacher, or call me at 212-874-5350. Good luck, Larry

August 24, 2006 at 10:05 PM · Hi, I just wrote you a very long message about your pain problem, but it was somehow lost near the end of the message. Since my typing is very slow and effortful, i haven't the energy to retype it. I am a violinist and teacher who specializes in pain problems, I have never failed in thirty five years of teaching been unable to help a student with pain problems. Doctors etc. have no idea how to fix this problem. The problem lies in tension and how it works. Find an Alexander teacher, or call me at 212-874-5350. Good luck, Larry

August 24, 2006 at 11:57 PM · Well, just to throw out something from a playing injury I had a while back, I was having a ridiculous amount of pain doing practically nothing (though it did get worse if I played a lot, typed a lot, etc.) late into my freshman year. Took about 6 months to figure it out -- saw oodles of different types of doctors and specialists. I ended up going to see an osteopath in the area (kind of like a chiropractor, except a full medical doctor AND he focuses on full skeletal structure instead of just your spine and ribs -- several years of extra schooling and quite helpful, I must say) and after trying multiple options, took a MRI of my wrist. Turned out that the bones in my wrist had shifted -- stretching the tendons slightly (took a little time for things to tighten up again) and mostly causing ridiculous amounts of pain by having all 9 tiny little bones of my wrist sawing away at each other and my cartilage instead of creating the amazing little jigsaw joint they're supposed to. He began manipulating the bones into place and I probably had a 50% reduction in pain within 10 minutes, the rest of it fading within the next few months as I began to heal and strengthen up again.

Anyway, the pain was always IN my wrists instead of along them, though I could feel it other places. It also tightened up all the muscles, tendons, and nerves as they no longer had the nice little pathways to slide through. I knew from descriptions of CTS that I didn't have that, that I also didn't have tendonitis.

I wish you the best in licking this and sometimes a two-hour doctor's appointment is the cure! I hope it will turn out to be something relatively simple for you as well to get you back on the road to recovery. Hopefully this offered ideas or insight for your search.

August 25, 2006 at 12:59 AM · The problem is likely your workstation and not your violin.

Given that you spend far more time at the keyboard than at the music stand, that's likely where the problem originates. All the therapy and lessons in the world won't help one iota if the workplace is not improved.

It sounds to me, Paul Cohen, as if you might want to check your chair and your computer desk. Often chairs and computer desks aren't people friendly.

I find a flat simple table that isn't as high as the typical computer desk and a standard folding chair to be much easier on the body than the standard office workstation.

August 25, 2006 at 03:37 AM · Posture at the computer is very important. Try to keep your head straight, and your back. You can get some office chairs that have an adjustable seat - one that goes from dead straight, to slanting downwards. These are great, as it provides you with a much better posure than a dead-flat chair. Also, keep your feet flat on the ground, and your forearms parrallel with the floor (or as close to as possible. You don't want them pointing down). I'm sure that since you're typing most of the day, you know how to touch type. Try also to learn as many of the Windows keyboard shortcuts as possible, to try and avoid using the mouse as much as possible. And remember to take breaks - every 20-25 mins, stare away from the computer screen and try and focus on something far in the distance. Every 45-60 minutes, take a break from the computer - walk around the house, make yourself a drink, something to eat, etc.

August 25, 2006 at 01:14 PM · One of the services offered by the health & safety department at my job is the evaluation of our workstation by an ergonomic specialist. For anyone who spends a lot of time on the computer & experiences pain while playing, making sure your workstation is properly set up is vital. Perhaps you could have a consultation with a specialist like this.

August 30, 2006 at 03:54 AM · I decided to get a new ergonomic keyboard. Now my wrists are not bent upwards. Is there anything I can do with my violin to make it less painful? My main problems are with the G string and slightly less with the D string. A and E strings are usually fine. Any ideas?

August 30, 2006 at 05:25 AM · Your body needs to heal first, Paul Cohen.

Do keep your eye out for other signs of pain. Chances are that you have further environmental tweaking to do before we can really address the violin issue.

August 30, 2006 at 05:53 AM · I think saying this is simply about posture is really destructive; there is obvioulsy more going on here than just that! Especially when you consider that almost all of us have bad posture.

My advice is to do the same as some of the top studio players in L.A. are doing right now, who also happen to be hurt: try one logical path that has had empirical success after another till you find someone who can help you, and try to find the faith to believe that if you do not give up you will find that person who sees and help you heal this problem....look at this persons story about the osteopath! Keep the faith, and keep searching

Look at this way: if you were Perlman they would have found the solution to this problem, right? Then that means the solution is out there, and you will find it if you do not give up.

September 1, 2006 at 11:11 AM · Thanks for all of your suggestions. I am really going to work on this! I appreciate your help!

September 11, 2006 at 03:07 AM · Hi, Paul

I have an idea that may help with the wrist pain.

After over 40 years as an Electrician my wrists were sore every evening...I even had to wear wrist braces with velcro straps to ease the pain.

About 2 weeks ago I went to a Deep Tissue Massage Therapist in a nearby town. He really worked out a lot of bad places in my back, shoulders and arms.

Then he worked on my wrists and hands and the pain was as severe as in all the other places because he really presses down deeply. Soon he had limbered up my hands so much that he could fold my entire hand and roll it up like a McDonald's Breakfast Burrito wrapper!

Now it is 2 weeks later an I still have very little pain in these old wrists even after several hours of making skwaaking noises on the ole violin.

Maybe you should try Deep Tissue Massage on your arms and wrists.

Take care!

Dan Horon

September 11, 2006 at 04:43 AM · Either you have physical pain or nerve damage. Some people have disposition to nerve damage from doing things repetitively like bowing. Sad, but true. If it is physical pain, you have to start therapy to ease the pain or have surgery.

If it is nerve damage, you will have to stop playing violin completely. Nerve Damage can get worse easily, and is close to impossible to heal.

Vince

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