Case Study Jazz Pianist presented with Carpal Tunnel
50 year-old male, overall good general health, no other history of problems. Onset of symptoms was 1980. Diagnosed with tendonitis of the right wrist. Only bothers him when
playing the piano. No other problems outside of playing piano.
Symptoms became apparent in 1980. Practices piano 8-10 hours daily. Has had part-time position as delivery driver for 9 years.
Past therapy: 2 months of Alexander technique with minimal effect. Acupuncture provided minimal relief – had two treatments one year apart. Also had standard physical therapy of strengthening and
modalities with no improvement. He said all previous therapies were only done to hand and wrist, even when he reported stabbing pain in his arm, they never looked past his wrist.
Symptoms in right wrist are rated at 3 during rest. When playing it increases to a 9 or 10. Initially he had shooting pains up the arm and was diagnosed with carpal dystonia and it was recommended that he
stop playing. He stopped playing professionally for 14 years. When he began playing again he again experienced pain and tingling. The physicians wanted to do steroid injections, but he never had
them. He was told that he would need surgery or he would have to quit playing the piano entirely. Since he is a professional jazz pianist and this is his life's ambition, he did not consider giving up
the piano.
Found us via our website. Read about what we do and wanted to try our techniques because "he felt fascia was the problem despite what he had been told or what had been diagnosed as carpal tunnel or carpal
dystonia"
Patient came to our office for an evaluation. We found his basic grip strength and range of motion to be within functional limits. However, he had several other postural abnormalities. He has
tightness in the carpal bones of both wrists, right greater than left and tightness in both arms, right greater than left. Specifically, we noted that he had a significant forward head and shoulder position
posture. He slumps causing decreased scapular glide bilaterally, more so on the left. Tightness across his chest and pecs was evident. He also had a pelvic imbalance.
At his first treatment, after the evaluation, we mobilized the carpal bones in both wrists. I released the fascial restrictions throughout the right extremity, because that was his symptomatic side in order to
give him relief of the tingling in his hand and pain in right wrist.
After the first treatment, he came in one week later. He stated he had about a 50% improvement in the symptoms of the right extremity. The second treatment we did basically the same steps as the first
treatment. However, we began to balance the pelvis and allow more freedom for normal movement. He was instructed in postural awareness.
When he came for the third visit, prior to treatment, he said he can play "normally" what he had been playing totally asymptomatic, however, when he tried more of the advanced jazz techniques, he experienced pain
after about three hours of playing. His pain level was now at about a 2 – 3 level.
Post third treatment, he reported the pain between his shoulder blades, neck and back pain that he had previously failed to mention, was completely gone. He felt he had a significant improvement in his whole
neck and shoulder girdle area than he had had in at least 10 years. He said he had a practice scheduled for that evening where he would be challenging the work we had done. He said this type of work
would normally raise his pain levels up to the 9 – 10 range after approx. 3 hours.
He contacted our office the morning after the piano practice and said he had a minimal amount of soreness from the mobilization done around his shoulder blades. He had not had increased pain during or after
practice. He had experienced no pain. He has not had to take any pain medications and he felt wonderful. He did not have any fatigue in his hand, wrist, back or neck that he would normally
experience after a practice session. He said he felt he had increased flexibility and mobility overall.
He is scheduled for future appointments.
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