Wrist Tightness and Pain in a Young Pianist

A 28-year-old right-handed man-who holds Bachelor of Arts and Masters degrees and is now working toward a Doctorate in Music at a large midwestern university school of music-complains of increasing episodes of "tension" over the palmar surfaces of his wrists while playing his principal instrument, the piano. Though the right hand is more affected, the sensation of "tightness" may occur in either wrist depending on the piece he is performing or practicing. He has learned through experience that if he attempts to "play through the sensation," it only increases to the point at which his wrists become painful and his fingers seem weak and far less dexterous than usual. On occasion, this has forced him to refrain from practice for several days at a time in order to recover.