Do you have
questions for Dr. Jameson about your health-related problem?
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This page is
dedicated to people who have questions regarding their health
and would like to have a chiropractic viewpoint on their
condition. If you have a question that you would like answered
by a Doctor of Chiropractic, then visit our referral page
for the Chiropractic Performing Arts
Assn. and find a doctor in your area.
Q: I'm so glad that there
is such a thing as "Musician's Doctor" because
I have been trying to play some old songs by Metallica and
they require massive speed picking. Whenever I try to speed
pick, my hand sort of stalls on me. While I'm mentally speed
picking, I'm physically not moving. Is there a secret I'm
missing? After some time of attempting this, my hand begins
A: There's a few reasons
why your hand is not keeping up with your brain's messages.
First, maybe you need to perform some speed drill exercises
to develop the muscle fibers in your hand and forearms.
I would suggest doing this on one or two strings (not trying
to play anything - just pick the open strings. Start off
relatively slowly and then build your speed. You'll get
to a point when you begin to have trouble keeping the speed.
This is the "trouble zone" and this is where you'll
have to concentrate at developing the skill. Perform this
exercise twice a day for at least one month. Do it for about
10 to 15 minutes only each session. We're not trying to
fatigue the muscles - we're trying to build speed. You should
start to see your speed increasing. The purpose of this
exercise is to enhance the firing of the muscles fibers.
The next reason why you may not be able
to keep up the speed is because of a pinched nerve going
from the brain to your hand. Your brain is simply unable
to send the complete signal down to the hand and your hand
is screwing up. This problem would have to be determined
by a chiropractor who can then release the pressure on the
nerve via a chiropractic spinal adjustment - usually in
the neck area - and your speed will then increase naturally.
(a painless procedure - feels great!)
Finally, the last issue I would look at
is your nutritional status. Muscle contraction is highly
controlled by minerals like calcium, magnesium, and sodium.
Nerve conduction is the same way, and requires a great deal
of B vitamins. You may want to begin taking a multivitamin/mineral
complex as an insurance policy that your body has the right
nutrition to perform the work.
Good luck in your playing ability.
Q: I'm a musician from
Bolivia. I play the electric guitar. I'm 23 years old. I
work on computers too. I'm actually having problems with
my wrist. It`s very sensitive now. When I play I feel a
little pain in my wrist, when I move it sounds like a little
Please Help me!!!
A: This is something that
needs to be looked at right away by a health practitioner
to prevent further injury. I'm not sure what's available
in Bolivia, but you should seek someone who is familiar
with the muscles of the forearm and can perform massage
techniques and spinal joint and wrist joint manipulation.
The manipulation is important to restore nerve flow to the
arms and hands. The wrist pain can be coming from tightened,
contracted muscles in your arms. Feel your muscles by the
elbow. Are they sore to the touch? How about the area just
before the wrist in the forearm? Is this area sore also?
I would suspect you have a great deal of muscle tension
in the arm putting strain upon the wrist joints. The computer
use can also strain the wrist. Make sure you are keeping
your wrist in a neutral position while typing or mousing.
There's some good books available on computing and repetitive
injuries. Visit my web site www.musicianshealth.com and
visit the "recommended books" section. It will
be very important for you to become more educated about
what's happening in your body. Take care of this problem
now before it worsens.
Q: The pad in my left
hand suffers from barre work. I'm playing some difficult
pieces from the L.Mus list and often struggle with the demands
of holding on the neck for the many minutes each piece is.
Is there an exercise that will strengthen my grip??
A: There are a lot of
good exercises to strengthen your grip. Your hand is simply
fatiguing from the prolonged tension. The first thing I
would recommend is to seriously look at the amount of tension
held in your hand while playing the barre chord. Is there
any way of reducing the tension while at the same time producing
the tone? Some other factors to check in to are these:
- A thinner gauge string will allow less pressure to
produce the tone. Consider changing your strings to allow
your hand to reduce its work load.
- Check into the diameter of the guitar neck. If you're
struggling to get your hand to cover the barre chord,
then the neck might be too big or bulky.
- Take more frequent breaks while playing. For example,
practice for about 20 to 30 minutes, then take a 10 minute
break and stretch your hand. Some warm wet towels on the
hand can increase blood flow and relax the muscles.
To get your hand stronger, get a tennis
ball, or the putty-like material you can find in any drug
store or sporting goods store, to help begin developing
the palm muscles and forearm flexors. Don't forget the finger
extensors though - they are working just as hard. Use a
rubber band around your fingertips and extend them outward
against the rubber band.
Begin using these tips above and let me
know if it helps you.
Q: My question is this...is
it at all likely that a minor operation can fix this? I
know that for some people suffering from carpal tunnel that
a minor "cut" can alleviate the problems...please
let it be a possibility :)
Oh, and my technique/positioning now is
perfect, I warmup very slowly and for at least 20 minutes,
and I take 6-800 mg of Ibuprofen before I play.
A: First, there's no such
thing as a "minor" operation, especially the one
for cubital tunnel syndrome. Personally, I don't think getting
an operation at this point without seeking alternative healing
methods is a good move on your part. I've talked to too
many people who have had the nerve transposition surgery
(typically that is what's done with cubital tunnel surgery)
and have had little results, and some have actual worsening
of their condition. I'm sure your surgeon will downplay
these side-effects, but it is something that must be considered.
The fact that the problem came right back
with your renewed interest in guitar playing tells me that
it is the playing itself that is triggering the nerve deficits
- even though you're trying to use good technique. Unless
you correct the underlying problem with your playing the
problem will not go away - even with surgery. I perform
videotape analysis on my guitar-playing patients to help
determine the underlying biomechanical cause of their CTS.
Another thing to understand is that your
ulnar nerve may be getting pinched in your neck as well
(called a "double crush" phenomena). This weakens
the nerve and by the time is makes it through the cubital
tunnel, there's simply no transmission of energy from the
brain to the fingers. I like to use the analogy of a garden
hose. Imagine if you put a kink in your garden hose - what
happens to the flow of water. It trickles out at the end
instead of working at full force. The same thing happens
if there's a pinched nerve in your neck. The flow of energy
only trickles out down to the arm. Then if there's another
"kink" at the elbow, no flow of energy can reach
the hand - thus the tingling and numbing sensations. Of
course, you would have to be examined by a doctor of chiropractic
to determine if these pinched nerves are present.
I would definitely recommend a chiropractic
evaluation before you ever consider surgery. If you're walking
around with a pinched nerve in your neck and elbow, the
cubital tunnel surgery will be worthless, and most likely
will make your condition worse.
Another thing - taking ibuprofen can be
the worst thing you can do. Not only does it inhibit the
body's inflammatory response (that's why you are taking
it), but it also inhibits the body's healing response via
small substances called prostoglandins. Recent studys have
shown that the use of ibuprofen in low back pain prolonged
recovery by four to six weeks. Taking ibuprofen is simply
masking the problem, and you can actually worsen your problem
by playing with the injured elbow (and/or neck). Instead
of ibuprofen, begin taking essential fatty acids such as
borage oil and flaxseed oil. These slow down the inflammatory
response naturally, and are needed for cellular and brain
Q: 1) I know you are not
in a position to make a personal recommendation to a stranger
over the Internet, but in your opinion, should I refrain
from playing until I see the hand specialist?
A: 1)I would recommend
a Doctor of Chiropractic. A chiropractor is better suited
to determine the actual location of the pinched nerves -
which can be occuring in the neck, elbow, or wrist, or a
combination of all three. A hand surgeon will want to perform
surgery - that's the way they make money. (Think about that
for a minute). A chiropractor will help your body heal naturally
via hands on spinal "adjustments" and extremity
I would recommend holding off playing until
you find out the underlying cause of your symptom. You see,
it may be the way you are playing that's flaring up this
whole condition. I always videotape musicians playing to
determine structural and biomechanical causes of their illness.
Q: I've heard that Vitamin
B6 therapy over the course of a few months has shown success
in alleviating the symptoms of carpal tunnel syndrome for
some sufferers, have you heard of vitamin or other therapies
that offer similar relief for ulnar nerve inflammation?
A: B6 is not always the
answer. Again, it is determined upon what the cause is.
A good B-complex vitamin is a great idea though, just as
an insurance policy that you're getting the vitamins you
Q: 3) If I'm seeking a
physician who has experience treating guitarists, do you
know of any referral network that might complement my own
attempts of trying MDs out through trial and error?
A: Again, I wouldn't recommend
an MD for your condition. The typical MD approach is steroid
injections, splinting, physical therapy, and when that doesn't
work surgery. Medicine is reactive to the complaints - not
proactive at determining the underlying cause of the complaints
and then allowing the body to heal naturally by removing
the interferences to health.
Q: I have been living
and working in Cyprus, as a violin teacher for the last
15 years. I have a very good violin student aged about 11.
He was doing very good progress as a violinist until last
June, whne he begun to complain of a pain in his right forearm.
the pain then went away during the summer although he continued
violin lessons with me. But in September his problem worsened.
He was also playing tennis, which he started last spring,
so I persuaded his parents to stop that for a while. However,
he still complains of that pain, even when he writes at
school, although the pain is not constant. He went to a
doctor, who is not a specialist, but managed to locate the
pain in the inside of his right elbow joint. They run all
kinds of tests on him but everything turned out to be ok,
except the pain kept, and still is, reappearing. May I add
that from the beggining he had the tendency to use a lot
of bow when playing, something which gave him a good strong
sound, although at times he exaggerated. I don`t know if
that`s the reason, in fact, I don`t know what else to suggest.
May I add that there are chiropractics in Cyprus, but I
wouldn`t know if in his situation he eould be able to get
any help. Problem is he`s got exams on the 17/11 and although
he`s learned all his pieces etc. very well, lack of practice
is starting to take its toll.
A: Are your school systems
based on a September through June schedule like here in
the States? If so, I would seriously look what is happening
in this child's schooling - there may be some serious stressors
(physical or emotional) there that are causing him to respond
by being more prone to inflammation - a common reaction
to emotional stress. I noticed you said he was better during
the summer (not is school, I assume).
I'm working in my clinic with a cello player
that goes through the same pattern. During this past summer,
she felt great and was back to her regular practice schedule.
But as soon as she went back to college, the arms became
inflammed again and she could only practice 15 to 20 minutes
at a time. We began addressing this issue and started her
on mental relaxation exercises and stress reduction - it
seems she was overextending herself and trying to do too
much. Her body and mind simply couldn't handle it.
I really don't know if there are chiropractors
in your area. You'll have to do a little searching on that
one. I would recommend it though. You need to rule out nerve
irritation as the cause of the pain - this is chiropractic's
Q: I'm 27 and in relatively
good health. I work on a PC for 8 hrs a day and play guitar
5-10 hours a week. My symptoms are different from most other
diagnoses I've seen thus far. My forearms get "tight",
wrists are painful, and fingers often ache. Am I a candidate
for RSI? Also any practical suggestions would be greatly
A: You are definitely
showing early signs of tissue stress. I wouldn't say you
are a "candidate" for RSI (I don't like the term
candidate, since it implies that it is something useful
to work towards.) Your body is giving you signals. At this
point in time, you have to make a decision. Are you going
to ignore it and hope it goes away? Or are you going to
take these signals seriously and find our why they are happening?
I hope that you follow the latter question. From a chiropractic
viewpoint, the tissues weaken because of dis-ease or lack
of ease in the tissues. This results from an inability for
the body's intellegence to correct the imbalances. The body's
intellegence flows through the nervous system. Therefore,
I would take a very close look at your nervous system function
to determine the underlying physical cause of your symptoms.
The computer work is a physical stress upon your body, and
may be part of the stresses on your tissues. You may want
to pick up one of the many books on ergonomics at the computer
so you can reduce the stress on your body.
A chiropractor is the only doctor who can
detect stresses upon the nervous system due to what is called
"subluxation" of the spine - a misalignment of
the spinal bones that weakens the impulses from the brain
to the tissues and visa versa. I would recommend you visit
one in your area to determine if subluxation is the cause
of your tissue injuries. It may be the most important step
you make in taking control of your health.
Your body is giving you symptoms to tell
you that something is wrong. Don't ignore them.
Q: First up, the website
is inspired - a godsend in an area that seems, still, to
be massively under-represented. You are evidently a very
generous man. I only hope that time will see it flourish,
expand, and become ever more comprehensive.
I am a pianist, living in the UK, that
has been experiencing acute tendonitis for the past 2 months.
Specialist help is very hard to get here (if one isn't London-based)
- which is why I am writing for your advice. Any help would
be recieved with utmost gratitude!
I apologise in advance for the length of
this message. It is only through trying to be as thorough
as possible - I am very conscious of the demands I am making
on your time.
The case history goes as follows: In June
of this year I began intensive piano practise. 4-5 hours
a day, very few breaks, emphasis on muscle strengthening,
Hanon, and so forth. Although I felt unusual pains around
the elbows, I decided to press on. By September/October,
the tensions seemed to be receding, and I felt my technique
had massively benefitted from the experience.
In October, I began heavy full-time kitchen
work, involving repetitive till work, minor lifting, washing
up, cold temperatures, and very few rest periods. I was
still trying to practice 3-4 hours a day! However, I must
stress that my playing seemed relatively pain-free, and
there was no problem until after 1-2 weeks into my new job.
From then on, the pain increased, eventually to a crippling
level. I worked in this pain for 3 weeks before quitting
on November 4th. Total period in work was 5 weeks.
For the last month & 1 week my lifestyle
has been very sedentary indeed. I have been on Ibuprofen
for 3 weeks. I have had two sessions with a physiotherapist,
and have been regularly massaging and stretching the elbow
area. I have been bathing my elbows in the hottest possible
water at least once a day. I should also mention that the
weather here in the UK has been rather cold. However, the
pain on resuming shop work has been extreme in both arms.
When piano playing it is only my left arm that is painful:
it is a general ache, stemming from fingers 3 4 & 5,
and lasting up until 1-3 hours after playing.
Tender flesh around the bony protrusions
on both sides of both elbows Without Ibuprofen - a constant
dull ache in both arms With Ibuprofen: sharp pain (one can
trace the lines) during till/shop work duller (but not ache)
pain when playing, mostly in left hand, mostly in weaker
fingers, lasting up to 3 hours after playing No pins &
needles/pain when pressing the Carpal Tunnel Pain reduced
in warmer conditions Pain reduced when exercising An apparent
'switching' of the pain between arms. I mean - when playing,
it is either the left or right arm that will hurt. Rarely
These are the questions I strongly need
answers to. I have been through all regular sources of help
(NHS, sports injury...) with little success.
- How serious is my tendonitis? How much time would it
take to recover?
- I have three options available to me: Cortisone injection
through NHS (FREE) 2/3 week therapy at sports injury clinic,
involving massage, ultrasound, ice/heat, stretch therapy
Chiropractor/alternative healing centre. What treatment
do I take? I can only afford one of the last two: which
would be of most use? (I understand from your website
that you are strongly in favour of chiropractice, but
I trust your impartiality)
- Can I still practice through the treatment period?
4) Can I still work through the treatment period? Both
important - I am a university student.
Once I again I thank you for the time you
have taken to read this. It is a revelation to find a medical
authority that can offer informed, and PRECISE (!!) advice
on such a complex issue.
A: As a Doctor of Chiropractic,
I'm always looking for the root cause of a condition, not
just investigating the symptoms. There's three main reasons
why the body will begin to malfunction (any organ system
can be involved by the way) : Physical, Chemical, and Emotional
Quickly ramping up practicing time is an
example of a physical stressor. It's like weightlifting
a 10 pound dumbbell every day for a year, then immediately
switching to a 40 pound dumbbell without any attempt to
allow the body to adapt. This can lead to irritated tissues,
strained and torn muscles, and pain. But the body does have
an amazing coping mechanism, that if you continue with the
long practice times, the body, if working perfectly, can
recover and adapt.
Other things to consider are these: When
you began your kitchen job, what was going on in your mind?
Did you not like the job? Were their situations in the job
that stressed you mentally? Were their chemicals you were
around more? The reason I'm asking these questions is that
I don't think it is a coincidence that you pain level worsened
with this last job. There's definitely a connection there,
again either physically, chemically, or emotionally. The
physical is the easy on to figure out - chemical and emotional
can be tougher. We know now through research that people
who do not like their jobs, or the job environment, have
a much higher incidence of pain syndromes.
Chemical stressors can be things like the
cleaning solutions you were using, any consumption of diet
or regular sodas, smoking, drugs, overconsumption of alcohol,
etc. And let's not forget an inadequate diet.
So the question is now, what are you going
to do about this. First off, the traditional medical route
will invariably get you nowhere. Medicine treats symptoms,
not cause. For example, you will most likely be given physical
therapy just for the elbow. In my experience, these conditions
involve not just the elbow, but also the entire arm, the
spine, and nervous system. If you work only on the elbow,
but leave out the rest, you've missed 80% of the problem.
That's the inherent weakness of chasing symptoms. Drugs
make your body sicker - so it couldn't heal this problem
even it tried. Ibuprofen leads to kidney and liver malfunction.
It also blocks healing because it inhibits secretion of
substances in the body called prostaglandins. They are definitely
NOT the answer.
You have to choose a health provider who
will integrate a total-body knowledge that your arm pain
is simply an expression of your overall health. This is
what we call the "holistic" or "vitalistic"
model of healing. When someone comes into my office with
arm pain, that means there whole body is sick, not just
the arm. The arm pain is just an extension of their dis-ease.
So how do we address this? By allowing the body to regain
health! Sounds pretty simple doesn't it? In essence, it
truly is. When you overall health improves, your circulation
improves, your immune function improves, your tissue healing
capability improves, your nervous system is optimized, your
innate healing mechanisms are powered up. The end result
- no more pain, and feeling better than you have in years.
So where do you go for this type of healing?
Here's a few helpful hints:
- A principled Doctor of Chiropractic is essential for
overall healing of your body. I'm not saying this because
I am a chiropractor, but only due to the years of understanding
physical healing, and the incredible power of enabling
your nervous system to overcome dis-ease by taking restrictions
away from nerve stresses.
- Begin getting some nutritional support. I'm not an
expert in nutrition, but here's something you may want
to investigate more. Essential fatty acids, found in such
things as Borage Oil, Flaxseed Oil, and Fish Oils are
essential in healing and blocking inflammation. Of course
vitamins and minerals, especially trace minerals are essential
- Begin an exercise program, if you have not already.
Increased blood flow is essential for healing. Just walking
20 to 30 minutes a day is helpful.
- Here's the most difficult one- begin looking for emotional
and/or chemical stressors that are stressing your body.
These are short circuiting your nervous system and creating
And just to let you know, chiropractors
come in different flavors. Some are pseudo-MDs, who will
take the same approach- chasing the symptoms. There are
others, of which I am a member of what we call "principled,
subluxation-based" chiropractors who focus on total
body healing by removing nerve interference. We do not solely
focus on the symptoms, but focus on the cause. I would recommend
this type of chiropractor. Always talk with a chiro before
consenting to a treatment program. Find out his/her philosophy
of healing. Go with one that you feel right with.
One final word- you must give your body
time to heal. Don't expect the pain to be gone in two chiropractic
visits. I often find that it takes the body two to three
months minimum, after a repetitive injury, to show signs
of healing. Hopefully yours will be faster if you're including
nutritional support, exercise, and stress relief. A good
chiropractor will place you on a program of care of at least
three times weekly for six to eight weeks. It sounds like
a lot, but there's a great deal of work to do to allow your
body to overcome these maladies.
Regarding the practicing and working through
the healing time - this has to be taken case by case. I
often recommend a musician to continue practicing, even
if it is only 10 minutes at a time. You don't want to loose
your touch. Just practice wisely and listen to your body.
Pain is a sign that it is time to stop and rest. DO NOT
PLAY THROUGH PAIN!
Working is the same. You have to listen
to your innate wisdom. If you believe this working is making
your body worse, then there's lots of other jobs out there
that will stress your body less during this healing time.
Treat your body like a king right now, and you'll make it
I hope this helps you make a decision.
If you don't mind, I would like to place this Q&A on
my web site. Your name will be omitted of course. This may
help others in your situation begin to realize that their
bodies can overcome these maladies.
I am 57 with osteo in the spine and osteopaenia
in the hip. It's likely that my bone density
was poor even before menopause as I could not
"do" dairy growing up and wasn't on a very
healthy diet. The spine is now gradually getting
worse according to DEXA scans, although I feel
no symptoms. I am taking calcium and doing
weight bearing exercise and using Miacalcin.
The doc has prescribed Fosamax and I am very
hesitant to take it, as long term problems can
begin immediately. The stuff is toxic in my
opinion. I feel trapped and fear for my spine,
its eventual collapse and the prospect of having
to stop playing and being disabled. This
disease is in my family...I watched my mother
crumble. Do you have suggestions?
I'm not surprised that you want to avoid
Fosamax. Here are the side effects that I picked up off
a web site:
severe esophagitis (ulceration of the esophagus)
key with osteoporosis is understanding the
underlying imbalances that are leading to it.
It's not all about Calcium either. I would
recommend you research Vitamin D a bit, because
it is Vitamin D that transfers Calcium into the
bone. You can have calcium throughout your
bloodstream, but without Vit. D, it can't get
into the cells of your bones. There are lots of
great osteoporosis formulas out there. I
recommend companies such as Metagenics or
Nutriwest. You can find them on the web. The
best source of vitamin D is through regular sun
exposure - at least 15 to 30 minutes per day.
When sunlight reaches the skin, it creates a
chemical reaction that activates Vitamin D.
(for more info on Vit. D and sunlight, go to
Eat lots of green leafy
vegetables to get the calcium from foods.
Another important concept to consider is that
after menopause, the adrenal glands take up the
production estrogen. This hormone is also
essential for deposition of calcium into bone.
There are adrenal support formulas by the same
companies mentioned above.
Chiropractic care also allows normal function of
the organs and glands of the body by restoring
and enhancing neurological control from the
brain to the body. There are very gentle
techniques in chiropractic for women with bones
that are becoming osteoporotic. It also
enhances structure and reduces strain upon the
Exercise is the final way to enhance bone
strength. Weight bearing exercise is very
important - at least 20 to 30 minutes four to
five times weekly.
in summary, these are the steps I recommend to
my patients: 1) nutritional enhancement via
supplementation with Vit. D and Calcium and
green leafy vegetables, 2) sun exposure every
day, 3) adrenal support, 4) regular chiropractic
care, 5) exercise.
hope this helps you out.