Music is undeniably powerful. Artists across the globe regularly move thousands of fans in packed stadiums to tears with their powerful ballads. Playing an instrument can even benefit your mental and physical health by reducing blood pressure and heart rates.

Unfortunately, avid musicians may experience hand injuries and nerve issues as a result of practicing their instruments. Depending on the instrument you play, you might develop carpal tunnel syndrome, wrist sprains or tendonitis.

On average, the prevalence of playing-related musculoskeletal disorders ranges from 37% to 47% of active musicians, which increases to 89% throughout their lifetimes. Pain from overuse is common and might be part of almost every musician’s life at some point. However, you can still embrace your love of music while protecting your hands and nerves. Learn more about common hand disorders in musicians and how to treat and prevent them.

What are the different types of hand disorders that musicians can experience?

Your hands are a remarkably complex part of your body. A combination of bones, muscles, nerves and joints work together to move your fingers and wrists, which allows you to play your instruments. Unfortunately, this also means that there are several disorders that can occur. Potential sources of hand pain include:

• Overuse syndromes: Repetitive movements like strumming a guitar can wear out your hands. Some of these syndromes include sprains and tendonitis.  
• Entrapment neuropathies: Nerves can be pinched or compressed, which can send pain signals to the brain. Carpal tunnel syndrome is a form of nerve entrapment.  
• Focal dystonias: This condition causes your nerves to spasm or stiffen unexpectedly. 
• Joint hypermobility: While joint hypermobility provides musicians with a large range of motion, it can also lead to fatigue and a higher risk of injuries. 
• Thoracic outlet syndrome: This syndrome causes pain, numbness and tingling in your hand.

It’s clear how the joints, nerves and muscles have their own hand disorders that can make playing uncomfortable — if not impossible.

What entrapment neuropathies impact musicians?

Your body communicates with the brain through a series of nerves that run down the spinal cord and out to your extremities. Entrapment neuropathies occur when these nerves become compressed, which can either cause them to send constant pain signals to your brain or prevent them from sending signals at all — leading to a feeling of numbness.

Here are a few common conditions related to entrapment neuropathies.

What is carpal tunnel syndrome?

Carpal tunnel is when the nerve that runs from your forearm to your palm becomes entrapped at your wrist. Musicians often develop carpal tunnel from repetitive motions of the wrist or practicing incorrectly with poor technique. Playing while injured can also worsen this condition.

Carpal tunnel symptoms include feelings of numbness or swollen hands and fingers. While this is an environmental condition, research shows some musicians might be more genetically prone to developing carpal tunnel over time.

What is cubital tunnel syndrome?

Cubital tunnel syndrome has the same causes as carpal tunnel, except the main nerve that is affected is located in the elbow. The pain feels similar to when you hit your ulnar nerve, commonly known as your funny bone. This condition occurs in people who regularly pull and lift their elbows a lot like drummers and cello or bass players.

Symptoms include hand pain, pain in the elbow or a weak grip. Even though this is an elbow-based injury, symptoms can affect the hands.

What is thoracic outlet syndrome?

This occurs when the nerves around your collarbone are compressed and can lead to numbness or tingling in your fingers or pain in your hand. This is because the nerves struggle to communicate effectively between the brain and the arm.

Thoracic outlet syndrome (TOS) could be caused by trauma like a car accident or through repetitive motions. TOS can cause a weakened grip, which can prevent musicians from playing their instruments or even holding them effectively. The pain caused by this nerve compression can also prevent musicians from comfortably playing, to the point where some people can’t rehearse at all.

How do focal dystonias impact musicians?

Pianists, guitarists and violinists are more frequently affected by focal dystonia. However, this condition can make playing almost any instrument difficult. Involuntary contractions or spasms can cause musicians to make mistakes while rehearsing and could potentially ruin a performance.

What overuse syndromes impact musicians?

Overuse can create sore hands and make musicians more prone to additional disorders. You might get worn out when rehearsing faster because your hands can’t handle the repetitive motions.

What is tendonitis?

Tendonitis is a great example of a condition that forms because of overuse. You might feel pain at the location of the tendon, notice swelling in your hands or experience a grating feeling when you move them.

Oftentimes, rest is one of the best forms of treatment for overuse.

How does osteoarthritis impact musicians?

Osteoarthritis is the most common form of arthritis. Patients often report pain, swelling or stiffness in their hands, which makes moving them difficult. When a musician is having an arthritis flare-up, they might not be able to practice at all because handling the instrument is too painful.

Researchers are exploring the connection between arthritis and mental health. It has been demonstrated that arthritis may make it difficult to enjoy your favorite activities like playing an instrument and can lead to depression, hopelessness and even higher levels of anxiety.

How does joint hypermobility affect musicians?

At first glance, hypermobility might seem like a good thing for musicians because of the added range and flexibility. However, this condition also has several unwanted side effects. Musicians might experience muscle stiffness, fatigue and increased sprains. People with this condition are also more likely to sustain other hand-related injuries.

How can musicians prevent hand injuries?

You don’t have to give up your passions to have healthy hands. You can continue playing regularly and without pain by taking on a few healthy habits. Here are a few steps to implement into your daily routine.

• Warm up: Loosen your hands and stretch your muscles before diving into rehearsal. There are often instrument-specific warm-ups you can apply to your routine.
• Take breaks: Rest your hands by taking a break from your instrument. These include small breaks during rehearsal.
• Healthy diet: Make sure your diet is high in protein, iron, fruits and vegetables. Also, bring water with you to drink while you practice.
• Build strength: Consider building up your hand muscles to protect your bones and joints.
• Practice body awareness: Consider your posture and how you hold your instrument. Poor form can lead to injuries.
• Consult with a certified hand therapist: These professionals can help you improve your hand care so you can continue playing.

Several small steps, like adding warm-ups to your routine and drinking more water, can add up and allow you to keep your hands healthy.

How are hand injuries diagnosed?

Diagnosis always starts with a discussion. Tell your doctor about your symptoms, when they occur and how you treat them — the more details the better. Based on this information, your doctor will either provide a diagnosis or request a series of tests to confirm their theories. Here are a few tests you can expect.

• Physical exam: Your doctor will feel your hand, move your fingers and confirm where your pain is and what causes it. 
• X-Ray: An X-ray is a pain-free way to take a picture of your bones and joints. 
• MRI: Magnetic resonance imaging (MRI) provides a clear picture of every organ. This test is used to look at soft tissue. 
• Nerve tests: Your doctor might also recommend various nerve tests like an electromyography (EMG) exam. This evaluates the condition of your muscles and nerve cells.

Your doctor might only request one test or they might want you to have multiple in order to rule out various conditions. You might not have just one hand disorder, but rather multiple problems at once.

Treatment for musicians’ injuries

If you think you are developing one of the conditions discussed in this guide or another music-related hand disorder, meet with a doctor to discuss your injuries. Early intervention is always ideal to prevent a condition from becoming severe. With the help of a medical professional, you can learn how to reduce your symptoms and prevent further damage to your hands.

Who treats hand injuries?

The first person to turn to, if you experience hand or wrist pain, is your primary care doctor. They should be able to diagnose the issue and recommend a treatment plan. Additionally, they might recommend visiting a sports medicine physician, which is someone who specializes in helping athletes and other professionals perform at their best.

You might not immediately associate sports medicine specialists with music, but these medical experts can help you train your body in a healthy way to withstand regular instrument playing.

Finally, your medical team might recommend visiting a physical therapist to develop a series of stretches and exercises to support your hand muscles. Your physical therapy appointment will include a mixture of on-site exercises to strengthen your hands and tutorials for exercises you should complete on your own at home. The right therapist can give you the tools to help your hands heal now and to protect them in the future.

Medications

Along with stretches and exercises, your medical team might recommend medications to treat your hand conditions. They will either recommend painkillers or anti-inflammatory prescriptions to reduce the swelling around your joints. In most cases, your doctor might start with a basic over-the-counter medication but could write a prescription if the first course of action isn’t effective.

Another option is a corticosteroid injection, which contains a numbing medicine to reduce your discomfort. These injections are often used to treat tendonitis, carpal tunnel syndrome and arthritis. Results will vary by patient. Some people only need one injection while other patients might need multiple.

Conservative treatments

Your doctor will likely recommend a series of treatments that address your hand disorder. Painkillers alone won’t necessarily solve the problem in the long term. Along with a mixture of medication and physical therapy exercises, here are a few additional treatments your doctor will suggest.

• Ice: Cold therapy like the use of an ice pack can reduce inflammation. 
• Heat: Heat therapy can help relax your muscles. Some doctors recommend a combination of hot and cold therapy to treat sore hands. 
• Splints: These devices hold your hands in place so they can heal. 
• Rest: This is often the hardest treatment for musicians to follow — especially if they are passionate about their craft. You might have to limit how often you play in the short run.

The effectiveness of these conservative treatments is almost entirely in your control. You can decide how closely you follow your doctor’s orders.

Surgical treatments

If your hand disorder becomes severe, your doctor might recommend surgical intervention. This is usually after you try a course of medication and various conservative treatments. Here are a few options they might consider.

• Hand surgery for arthritis: Your doctor might recommend an arthroscopy, where the doctor smoothes rough spots and removes cysts and bone fragments, or an arthroplasty where they replace the joint with an artificial model.  
• Hand surgery for carpal tunnel syndrome: In a carpal tunnel release, the surgeon cuts the ligament that puts pressure on the carpal tunnel, which creates more room for it. 
• Hand surgery for ganglion cysts: Your doctor can either drain the cyst or surgically remove it. 
• Hand surgery for tendon problems: You might be a candidate for tendon repair, which can be done under regional or general anesthetic.

There are multiple surgical procedures for almost any hand disorder. Your surgeon should go over your options, share their recommendations, and allow you to make the best decision for your needs.

Recovering from hand disorders

Regardless of whether your treatment involves basic cold therapy or intensive surgery, your doctor will likely take a long-term view of your hand health. They want you to recover fully but also want you to avoid future injuries and flare-ups because of poor practice habits.

Make sure you follow their care instructions carefully and continue to practice any physical therapy exercises or stretches your surgeon recommends. Also, talk to your doctor as soon as the pain returns. This could be a sign that the initial treatment or operation was ineffective.

Additional medical resources for musicians

You can also follow additional resources for staying healthy as a musician. Here, you can find medicines that may alleviate common musician injuries, treatments, and ways to prevent the development of certain conditions.

• Performing Arts Medicine Association: PAMA is a great community to follow for the education, research, and networking of musicians. 
• British Association for Performing Arts Medicine: BAPAM provides a great resource of warm-up exercises for the whole body.
• Entertainment Community Fund: Their Artist Health Insurance Resource Center is a comprehensive collection of informational assets for Medicare, Medicaid, and insurance for musicians.
• The Jeremy Wilson Foundation: JWF supports anyone in the music industry who struggles with financing their healthcare needs.

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