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I am a high school student in a magnet school for music. My main instrument is the piano. In the last few months I've been having more and more problems with hand and wrist pain. It started out just hurting when I played. Now it hurts while I'm playing and for several hours later. What can I do about this?

Pianists are at risk for overuse syndromes most often affecting the forearms, wrists, and hands. Some pianists also suffer with neck, shoulder, and upper arm problems. Many different conditions have been diagnosed and described in association with piano playing. It seems that music requiring fast and forceful finger movements puts musicians at the greatest risk.

Studies using computer and video systems to track hand motion have helped identify some of the problems pianists experience. Researchers have found that music with trills or arpeggios played with speed or endurance can cause many problems.

Rest is always the best treatment but most serious pianists don't feel they have the ability to take time off from practice or performance. Choosing less difficult music for awhile may be one way to rest the soft tissues.

Without special equipment to analyze your arm and hand movements, you can still do several things on your own. Set up a video camera to record yourself playing. Ask your piano instructor to watch a short amount of the video with you. Look for anything that might help you reduce the muscular stress in the upper extremity.

A physical therapist or hand therapist (sometimes a physical therapist, sometimes an occupational therapist) may be able to help you identify a motor control problem. The muscles may be firing too soon, too late, or too long for the motion required. the therapist may be able to show you ways to change how you play without negatively affecting your playing.

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