Piano World Home Page Forums Our Most Popular Forums Adult Beginners Forum Tendonitis and the Cortisone injection

Hello,

I've been suffering from recurring tendonitis, which seems to hover no pain and early stage pain. (I've been playing on and off, never really giving myself total rest.)

I purchased a home ultrasound machine and use it several times a week. It is supposed to break down scar tissue and reduce inflammation. I also use a menthol deep cold cooling gel. This almost completely relieves the pain in a lasting way (3 to 5 hours).

I have also resolved my technique problem of playing with tense fingers, wrists, and arms. I now focus all my efforts on loose, relaxing play. However I have not been able to recover fully, even since June.

I have heard of a steroid injection which really helps promote a full recovery from this. I've also heard that it can simply be a temporary fixed. I am seriously considering this option -- can anyone give any information on it, such as if you had one, did it work? for how long? did the tendonitis return? was it worse or milder?

Thanks for any advice. I'm really sick of this.

Hello,

I’ve actually been having tendinitis problems / hand pain problems, from before I recently went back to classical practice.

I’ve taken advice, much gleaned on this forum, about relaxed practice. And to some small extent it seems to help a little.


The best docs around haven’t really been able to do that much, so I also checked out acupuncture.

I didn’t want to pursue the seemingly fruitless paths my other docs and specialists were following.

Cortisone injections were never proposed, but I try to steer clear of anything that's remotely invasive..

So I started this treatment (the practitioner is a Doctor of Medicine) about week ago and have noticed marked improvement already..

However, today I just saw another MD, a rheumatologist, planned from some weeks ago, and he confirmed that, for my symptoms, acupuncture was probably about the best bet…

Hope you find a solution – it’s always a nagging worry when you start to get pain.

What was the treatment you started?

I've been doing laser and ultra sound (today will be the sixth sitting).... I have not noticed the slightest improvement.
I have a problem in my baby finger - at the metacarpal joint - it "clicks" - the tendon is not sliding smoothly through the joint.

Hello Cheryl

I was referring to the acupuncture

Maharishi, I will agree with your recommendation on using acupuncture. I believe it is the best approach for inflammation.

I had a cortizone shot in the arm for tennis elbow about 20 years ago. The pain vanished almost immediately and has never returned. About 2 years ago I had a cortizone shot in the foot for plantar fasciitis, again the symtoms were gone in a couple of days and haven't returned. Some people apparently have allergic reactions to cortizone but you won't know until you try it.

Thanks for your comment, joangolfing. Do you have any "hands on" experience?




Hi John, that's interesting, too..

In spite of my present path, it's always good I think, to keep an open mind..

But I'm keeping a close eye on my symptoms, and "working on relaxation" .. if that's not a contradiction in terms!

Hi John,

You say the pain never returned. Did you quit playing tennis? or did you resume playing tennis after the shot?

Personally, I'd give it more time before going with a cortisone shot. I've been dealing with a hand/thumb injury since March or so that is finally starting to clear up. I suspect that the original injury is related to tension while typing at work (plus a small incident while riding a scooter) which carried over to tension while playing piano. Since the onset of the problem I've been focusing on playing with relaxed hands. My teacher has been of great support in this by giving me hand and wrist relaxation exercises that have really helped. We also took a break from arpeggios which seemed in the beginning to exacerbate the problem. It's only in the last two months or so that I really feel I've gotten a good handle on the various motions that caused me problems and I've worked to use the best technique possible in whatever I'm doing. For me it was a matter of evaluating how my hand felt with all daily activities, not just piano, which helped me to adjust things and to see some improvement.

My experience is similar, foxyw, in that the original problems came up outside of my piano activities, but seem to have carried over..




I am really interested to what kind of exercises they are: do you know where I might get some info about them?

Someone posted a link a while ago to a simple set of exercises for carpal tunnel.. I think they're aimed at drummers, but I find they help when my hand feels strained for any reason.

Thanks, Carol,
I'll take a look

It wasn't caused by playing tennis. It was work related and I really had no choice about returning to work . Tennis elbow is used to refer to inflamation of a tendon in your forearm. In my case it had to do with rotation.

Cortisone injections can be effective at putting the brakes on a runaway inflammatory process. Once one of those gets going, it can create its own self-sustaining situation. My doc has usually coupled them with physio, to try to deal with the root cause of the problem. I have had to learn to modify the behavior that allowed the problem to develop, or to perform a balancing movement to offset the habit of posture or movement.

Injections are not appropriate for every situation. They are not a very risky procedure when given by a skilled practitioner, though. If your doc is recommending this and you have fears about it, ask questions and do some research (and then ask questions too). In the end, it's your decision.

Acupuncture does help some people; others, no. It is low-risk, though it takes more time and patience and requires a tolerance for the (not very great) pain of the needle insertion.

NSAIDS like ibuprofen, aspirin, naproxen sodium taken at a clinical dose (usually more than the OTC label instructions) can be very helpful with both pain and inflammation. There are risks (which it seems most people don't realize), especially if they're taken long-term or at very high doses.

Icing the injured area three or four times a day for about fifteen minutes can be very helpful at reducing inflammation. It is more inconvenient than painful (well, after the first five minutes). Some people find that heat works as well or better (a heating pad).

So, there are a lot of things you could try. But I'd suggest, first give yourself the advantage of knowing your doc's experience and work with him or her. It gives you the best shot at a good outcome.

It sounds like you're already taking positive action that will very much help you out. A good doc can really work with someone like you. I hope that you're able to turn this around, and that you will feel better soon.

I've had acupuncture, cortisone, & surgery at different times for different tendonitis situations. Acupuncture worked for one (that had come back after cortisone) but not for others. I had cortisone for 3 separate sites of tendonitis, & in 2 it proved to be temporary, but in the other one it worked. I've had surgery twice, both times for a "trigger" situation. My advice: start with acupuncture - it's the least invasive. Cortisone is like magic when it works (as long as it's injected by someone who's good enough with a needle to get it to the right place) & in my experience it's relatively painless, so if acupuncture didn't work that'd be my next choice. The times I needed surgery, it was pretty simple - took about 20 minutes, & about a week, I think, to heal.

Thanks again for the video, Carol. I had a look late last night and am going to try it. I think that for me, with the acupuncture, and now the exercises, I've already got something to expect progress from.

It's helpful for me to read other people's experience and helps form an overall view - keeps it in perspective..

Hope you find healing, schlittk,

Maharishi,
I have lots of experience with the Chinese acupuncture approach to all of my inflammation problems. There is a difference in acupuncture done by a chiropractor and done by someone from a Chinese Healing perspective. Acupuncture along with the Chinese healing art of qigong has been proven to influence inflammation in the body. The Mayo Clinic among other medical institutions are now proving with their research that these approaches work. I now practice Tai Chi (Yang form, Wu, and Chen styles) along with 3 methods of meditation--standing (Santi and Wuji), seated, and laying down. I also do barefoot walking with the 5
Fingers Vibram Trek shoes. The more time you spend grounded (with barefoot walking) the less inflammation you are likely to have, resulting in better overall health and increased longevity.

BBC News item reports that cortisone injections for tennis elbow do more harm than good. The original report refers to other tendinopathies.

That too is interesting, joangolfing.

My acupuncture specialist is an Asian MD. Is he Chinese? I’m not sure. He’s quite old, which may well mean he brought his knowledge from Asia here to Europe.

There’s a lot in you post to look at, and meditate on. I’ve begun looking at qigong..

The 5-fingers too. When you talk about walking barefoot (presumably with your "5-fingers", do you mean just around the house, or further afield?

So far the “parallel medicine” solutions seem to be outweighing the Western-style. Although I have no real quarrel with the latter, “scientific” line, I do admit I would tend to lean towards the older, oriental-based approaches.


So I’ll post again when I’ve put all these things together and found how to apply the right mix for myself.


So a thank you to you, too.

Maharishi,

That is wonderful that you are investigating these alternative approaches. What I meant in looking for an acupuncturist--one who practices the Chinese medicine approach. They can be any nationality.
I have been walking outdoors on sidewalks with my Vibram shoes and they work just fine on any surface. I also exercise at my Y using them.

Qigong is such an interesting study and I encourage you to keep looking for a teacher who specializes in it. Chunyi Lin, Dr. Yang Yang and Bruce Frantzis all have tremendous followings and resources. Try googling them.