Upper Back Pain in Musicians: Sylvia's Advance7 Story

Sylvia P · Basingstoke

Sylvia P never turned professional, but the piano took her a good deal further than she ever expected, including some beautiful parties in France and two trips to America. Forty years of leaning into the keys left her with upper back pain across the middle of her back that would not shift. She tells us how she stopped hunching, and what finally took the edge off the ache.

Sylvia, tell us a little about yourself.

I have played the piano since I was six years old and I have never really stopped. I am not a professional, and I want to be honest about that, because I know people hear you have played abroad and they assume you are somebody. I am not. I wanted it desperately when I was young. I wanted to be a concert pianist more than anything in the world, and it simply did not happen for me. What did happen was rather lovely in its own way. I signed up with an agency, and they sent me all over the place. I played some beautiful parties in France, one of them in a house with the doors open onto the garden and the music going out into the evening, and I went to America twice. That is not the career I dreamed of, but I would not swap it. I just love playing for people. That is the whole of it, really.

When did the upper back pain start?

It crept up on me. There was no moment where I did something and hurt myself. It was just an ache that arrived one year and never quite left, sitting across the middle of my back, a little higher than the middle if I am precise about it, and worse on the left. Some days it was a dull heaviness and some days it was a proper sore, tight band across the top of my back. I would finish a long practice and feel as though somebody had been standing on my shoulders.

Do a lot of pianists get this?

I always assumed it was just me being soft. Then I got talking to other players and found half of them were the same. I looked it up afterwards, and there was a study of five hundred pianists where more than four in ten said they had some sort of ache or pain they put down to playing, and the neck and shoulders came second only to the hands. So no, it is not just me. I found that oddly comforting.

Were you aware you were hunching?

Not in the slightest, and that is the whole problem. When I am playing, I am not thinking about my back. I am thinking about the music, or about the bar coming up that I always make a mess of. You lean in towards the keys without ever deciding to. Your shoulders come forward, your head goes forward, and you stay like that for two hours. My husband used to walk past the door and say something, and I would straighten up for about ninety seconds and then be right back into it. I would not say I have a hunched back, I have been lucky there, but I certainly had the tendency, and I did not know I was doing it.

What did you try first?

I bought one of those posture braces, the sort that pulls your shoulders back with straps. I had high hopes for it. It was uncomfortable from the first day and I never got used to it. It rubbed under the arms, it made me feel trussed up, and I could not play in it at all, which rather defeated the object. It went in a drawer, and it is still there. Beyond that it was the usual, hot water bottles, the odd painkiller, and a great deal of putting up with it.

What did your doctor say?

She had a good feel around and said it was muscular, the sort of thing you would expect from years of sitting in one position and leaning forward, with a bit of wear and tear on top because I am not twenty-five anymore. Thoracic back pain is what she called it, which is simply the medical name for pain in the middle and upper part of the back. Nothing sinister, thank goodness. She sent me to a physiotherapist, which was the best thing she could have done.

What do you do for it now?

I do my exercises, and I do them properly, which is not like me at all. The physiotherapist gave me a short set to open out the chest and strengthen everything across the top of the back, and I do them every morning before I sit down to play. I take a break every half hour, I get up and walk about, and I had the piano stool changed for one at the right height, which made more difference than I expected. I am eighty per cent better on posture than I was. People say I sit very straight now, and I take that as a compliment.

How did you come across Advance7?

A friend from the choir I accompany swore by it. She has bad knees and she goes on about it endlessly. I had tried creams before and thought very little of them, but I was sore and I was out of ideas, so I ordered some. There is a gel you massage in, a spray for the parts you cannot reach yourself, which for the middle of your own back is most of it, and capsules you take alongside.

How do you use it?

Of an evening, after I have finished playing, my husband works the gel into the middle and upper part of my back for me. He is not gentle, but he is thorough. The rubbing is half of it, I think, because it gets everything warm and loose. For the spot between my shoulder blades that neither of us can get at comfortably, I use the spray, and I take the capsules every day alongside the gel. It has become part of shutting the lid on the piano for the night.

What difference has it made?

An honest one. I will not tell you the ache has gone, because after forty years of leaning at that keyboard I would not expect it to. But the tight, sore band across the top of my back settles now instead of nagging at me all evening, and I sleep properly, which I had rather given up on. The exercises keep me straight and the Advance7 takes the edge off what is left. Between the two of them I can practise for as long as I want to, and at my age that is the only thing I really care about.

Are you still playing?

Every day, and I have no intention of stopping. I play for the choir, I play at friends’ houses, and I still get asked for the occasional party, though I do not travel the way I used to. I never made it as a professional and I made my peace with that a long time ago. Playing for people is the part I loved anyway, and nobody ever took that away from me.

What would you say to someone in the same boat?

If you sit at anything for hours, a piano, a desk, a sewing machine, watch how you are sitting, because you will not notice on your own and somebody must tell you. Get the pain looked at so you know what it is, do the exercises you are given rather than nodding at them and forgetting, and find something that helps you with the soreness that is left. For me that is Advance7 and my husband’s hands of an evening. Do not just put up with it for years the way I did. I lost a lot of comfortable evenings to that back.

Sylvia’s experience is her own and results vary from person to person. Advance7 is not a medical treatment for back pain. If you have ongoing back pain, or any numbness, weakness or unexplained symptoms, please see your own doctor.

The thoracic spine, the middle and upper back, is where Sylvia’s pain sits.

Frequently asked questions about upper back pain

These are the questions we are asked most often about pain in the upper and middle back. They are for general information only and are not a substitute for seeing your own doctor.

What causes upper back pain?

Upper back pain is most often muscular. Long periods sitting in one position, leaning forward over a keyboard, a desk or an instrument, and carrying or reaching all put the muscles across the top of the back under steady strain. Wear and tear in the spine can add to it as we get older. Persistent upper back pain, or upper back pain that comes with other symptoms, should always be checked.

What is thoracic back pain?

Thoracic back pain is the medical name for pain in the middle and upper part of the back, the stretch of spine between the neck and the lower back. It is less common than lower back pain and is usually related to posture or muscle strain, as Sylvia found after years at the piano.

What causes middle back pain?

Middle back pain, or mid back pain, is usually muscular, whether from strain, posture or the way you have been sitting. Pain in the middle of the back can occasionally be referred from elsewhere, so if it is persistent or severe it should be looked at. For most people it settles with gentle movement, stretching and time.

Can playing the piano cause back pain?

Playing related aches and pains are common among pianists. In one survey of pianists, more than four in ten reported a musculoskeletal problem they attributed to playing, with the neck and shoulders among the most affected areas after the hands and wrists. Leaning forward towards the keys, often without realising it, is a well recognised habit. Sitting at the right height, taking regular breaks and exercises for the upper back all help.

Do posture braces work for a hunched back?

Some people get on well with them and many do not. Sylvia found hers uncomfortable and stopped wearing it. Most physiotherapists put more weight on strengthening the muscles across the upper back and opening out the chest, along with setting your seat at the right height and taking breaks, than on wearing a brace. Ask your own physiotherapist what is right for you.

What causes pain on the left upper back side?

Pain on the left upper back side, or middle to upper back pain on one side, is commonly down to muscle tension around the spine and shoulder blade, the sort that builds up from posture and repetitive work. One side often takes more of the strain than the other. Persistent one sided pain is worth having checked.

Can Advance7 help with upper back pain?

The back is one of the most common things people tell us they use Advance7 for. As Sylvia describes, many people have the gel massaged into the sore area, use the Advance7 Spray for the part between the shoulder blades that is awkward to reach alone, and take the capsules alongside. It is well worth a try for ongoing soreness, alongside the advice of your own doctor and physiotherapist.

What is in Advance7?

Advance7 is made with ingredients of natural origin, including devil’s claw and peppermint, and it is designed to feel cooling and comforting as it is massaged in. Sylvia likes that it absorbs without leaving her back greasy, so it fits into her evening routine.