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Carpal Tunnel Syndrome is caused by compression of the median nerve that passes through the carpal tunnel in the wrist. Along with the diagnosis of Carpal Tunnel Syndrome comes considerable pain and impairment along with numbness, paresthesia (pins and needles) and loss of hand strength, coordination, and pincer grasp. This impairment is problematic for almost any profession; however, it can be entirely disabling for musicians.

The most widely diagnosed nerve entrapment disorder, carpal tunnel syndrome, is characterized by pain, swelling, numbness, and tingling in the hand and wrist. The disorder stems from excessive stress and strain placed on the arm, wrist, and hand that result from repetitive and/or static (non-moving) flexion of the fingers and wrist. This unidirectional strain causes a muscle imbalance in the hand and forearm, resulting in the stronger, shorter flexor muscles that close the hand to compress the underlying median nerve within the carpal tunnel, which is central to hand, and wrist movement.

The median nerve actually begins in the neck and travels through the shoulder joint through the Brachial Plexus down to the elbow and eventually to the carpal tunnel joint in the wrist. With repetitive unidirectional motions / activities being performed on a regular basis, the imbalanced muscles in the hand and forearm can cause the carpal bones that form the carpal tunnel to become misaligned, creating pressure and pain in the wrist as the bones compress the median nerve within. Critically, it is not only carpal tunnel syndrome that can result from an existing muscle imbalance in the hand and arm, but also other repetitive strain injuries that involve the ulnar and radial nerves at the wrist or elbow junctions. Thus, effective treatment must address muscle length and strength imbalances that may be present in the entire upper extremity region.

For musicians, carpal tunnel syndrome can be akin to a death sentence. Incapacitated through the hand and forearm, musicians may have to modify practice and performance routines. It is impossible to play the piano, strum the guitar, or manipulate the bow of a cello without superb dexterity and responsiveness in the fingers and wrist. Rest is often the first-line recommendation for treating carpal tunnel syndrome, but it is an option that few professionals can afford to take.

Thankfully, there are effective treatments that can protect against the development of carpal tunnel syndrome in musicians and that can curb the impact of symptoms as soon as they emerge. Strategically designed exercises that target specific muscles and groups of muscles in the hand and forearm have been shown to reduce symptoms of carpal tunnel syndrome with ninety percent effectiveness.

If anyone recommends gripping, squeezing, pinching or finger-walking exercises, run the other direction, as these are the exercises / movements that musicians perform too much of in the first place and are the muscles that are already overused on a daily basis. Musicians need to strengthen the opposite muscles that they overuse. It is that simple. Keeping muscle groups with 25% strength of each other will reduce muscle and joint imbalance, reducing the possibility of musicians becoming afflicted with carpal tunnel syndrome or other finger, hand, wrist, elbow or shoulder injuries. Balance is the key.

It is important to consult with a physician or healthcare professional before beginning any type of exercises program for the treatment of injuries.