Guitar related hand injuries: Prevention and Treatment

Along with pianists and violinists, guitarists are one of the most vulnerable musicians to hand injuries. Guitarists frequently develop repetitive strain injury and tendonitis (tendinitis/tendinitides) that may coexist with compression nerve syndromes because of non functional posture and positioning of the upper extremities during long-term practice and performance. Musicians aren’t generally known for their athletic prowess, but it is physical exertion all the same.

Repetitive Strain Injury (RSI) (also known as overuse injury) is an injury of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions. Here is the list of 5 most common guitar related hand injuries.

1. Nerve compression syndromes:

A. Carpal tunnel syndrome:
Carpal tunnel syndrome very often occurs in stringed guitarists and other stringed instrument musicians who use to play with their wrists in excessive flexion. The medical reason behind this injury is the compression of median nerve in carpal tunnel in the wrist leading to complaints like tingling, pain, numbness or discomfort in the lateral 3 and 1/2 fingers.
Further Reading: To understand more about carpal tunnel syndrome

B. Cubital tunnel syndrome:
This syndrome is caused due to ulanr nerve entrapment as the nerve passes through the anatomical structure called cubital tunnel in the elbow region and will usually only involve the fingers with ulnar nerve supply i.e. medial 1 and 1/2 fingers (ring and pinky). This is the same nerve that causes the tingling sensation when you hit in elbow. It frequently affects your fretting fingers (i.e, in left hand for right handed guitarists and vice versa). Since, both carpal tunnel syndrome and cubital tunnel syndrome are nerve compression syndromes, they involve common complaints along the region of nerve supply.

However, cubital tunnel syndrome is not as common as carpal tunnel syndrome.

2. Tendonitis:
Tendonitis/Tendinits refers to the inflammation of tendons and guitarists commonly get it in their wrists leading to tightness of muscle, connective tissue constriction and pain. This is called wrist tendonitis and it is caused due to friction and strain produced due to overuse of the wrist muscles. If you get it due to long hours and bad posture during guitar practice, you may call it guitar tendonitis.

3. Tennis elbow:
Tennis elbow, also known as lateral epicondylitis, is an inflammatory process located in the outside part of the elbow (the thumb side of the elbow). The main symptoms include pain on the outside edge of the elbow, pain when gripping especially while extending the hand at the wrist. In guitarists, the main cause leading to this injury is over-practicing and putting extra pressure on fret board than necessary.

4. Focal dystonia:
Focal or functional dystoniae are painless, stereotypic, localized movements encountered in some professional groups of patients that perform many times per minute the same tasks. Several fingers on a musician’s hand just curl up and stop responding. The management of patients with focal dystoniae is challenging.

5. Arthritis
Arthritis is the wear and tear of joints, for guitarists this could be frequently in the hand, wrist, elbow and shoulder. It usually occur at the carpometacarpal joint of the thumb and may lead to instability. The most common case is osteoarthritis where joints get worn down through overuse and begin grinding against each other.

How to prevent guitar related injuries?

Most of the times its already too late when you realize that playing guitar can cause injuries and it can be prevented easily.

  1. Warm and stretch your fingers for some time with easier stretches and motions before playing complicated and swift ones. During winters you can try warming up your arms and hands with a warm water soak or shower.
  2. Don’t hang your guitar too low so that you need to flex your wrist more. Metal guitarists may look and encourage you but this type of playing style encourages injuries.
  3. Avoid practicing and performing for lengthy period of time and take breaks in between.
  4. Always try and keep your wrist as straight as comfortably possible.
  5. Icing 20-30 minutes after prolonged effort will reduce inflammation and reduce potential damage.
  6. You can use ergonomic guitar and pick
  7. If you experience pain, swelling, or weakness then stop playing and seek advice from doctor.
  8. Taking plenty of fluids to prevent dehydration
  9. Getting ample sleep


Hand and upper extremity disorders of the musicians should not be treated surgically and guitarists are no exception. Surgery should always be considered a last resort. Treatment may involve:

  1. Physical therapy
  2. Psychological support
  3. Rest
  4. Use of braces
  5. Use of medicines, ice, vitamis, essential fatty acids, etc.
  6. Use of muscle gel or deep heat

  1. June 29, 2015
    • January 23, 2016
  2. November 29, 2016

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