Picking guitar triggers horrible headaches

Hello and congratulations for this amazing guitar forum
I need help , i cant find any answers by health specialists since they are not aware of musicians injuries where i live …
I am 50 years old playng and teaching for many years ,
Unfortunately i have many problems with my right arm … I am trying a lot to reduce stress when picking … and i even changed my techique from floating my wrist, to anchoring my little finger to reduce forearm temsion …
Nothing seems to work for me …I play for 5 minutes and then start to experience some tingling at my right shoulder / neck… which will likely trigger a bad headach …always present at right side of my head…
it appears i cant use any picking motion at all … i am not having any pain in shoulder or carpal syndrome …
Does anybody has any similar troubles ?
I am posting ,if allowed … a small clip to check if you want and tell my any advise you might observe …
thank you

Hi, I enjoyed your playing and I’m sorry to hear about your issues. I am in no way medically qualified to diagnose etc, but I am currently experiencing some of the sensations and pain you describe and have done in the past and what I’m suggesting below seems low risk of anything detrimental happening, but I do recommend getting pro help if possible.
I have tingling and numbness that affects my fretting hand, caused by pinched nerves due to tight muscles in my neck and back (I think this is might be known as Thorasic Outlet Syndrome - im not 100% sure). I have longstanding back issues because I have a bad posture and no core muscle. Having to work from home and school my kids because of covid, this has gotten far worse as I spend most of my time sitting down. I used to get physio once a month pre-covid which maintained me enough to exercise and build core muscle to support my back. Since covid wrecked that I have had to try and do something myself. I found a YT channel called DIY Joint Pain Relief. He has some guitar related videos, but I also looked at his neck, shoulder, arm, elbow, wrist videos. They are very similar in the methods used to target certain areas of tight muscle that cause pain in other areas and putting pressure on the nerves which cause the tingling.

The most surprising one for me was the neck one I think, where you start by focusing on the back of your skull. My muscles there were incredibly tender and tight - I had no idea there was a problem there. When I worked that area, I felt pain above my eye sockets - the same headache pain I had experienced a few days before - my neck and shoulder muscles were so tight that it caused the headache pain at the other end the muscle group. After working on it I haven’t had that head ache and my other symptoms are better on the whole, but I’m still working on my back and neck daily to stop them from going into spasm. I’m also taking cold showers to help with inflamation- I don’t know how much this is actually helping, but it sure does wake me up in the morning!

Like I say, I have no idea whether this will help, but its worth a shot. Also, make sure you are staying hydrated. I swear that being stuck at home in the winter with the heating on all the time dehydrates me more than usual…

Let me know how you get on and/or if you come across anything else.

Just looked at that YT channel, there is a migraine video too, might be good…

Hi there , I really appreciate your reply and help !!
I think i ve seen this channel before and it was very interesting indeed .
If i remember well it has some exersizes for guitarist forearm …i will check it again thoroughly thanks a lot .

i am doing also some exerizes from physio …but i ve seen some relief from applying heat and a tens machine i own .

but as soon as i start playing i feel it coming again …

i dont know if i must change something in my technique or
It looks like when the problem has reached to that point there must be a break from guitar …

Quick question, if you press directly under your right collar bone (kind of underneath it) is it really tender?
Also, what physio exercises do you do?


these are the 3 basic exersizes
and Yes i think the collar bone
at right side is more tender than left but not extreme



Thanks, yes that 1st one is quite a good one if you get it in the right place.

Yeah, I find mine gets tender too and is associated with Thoracic Outlet Syndrome - sometimes its caused when people have an extra rib under there (no joke). I got great relief when I worked to get rid of the tenderness there. I did this be applying pressure to the painful part and moving my shoulder backwards and forwards -working along the length of the collarbone.

I will try that too, Thank you !
Meanwhile I am thinking of extreme Solutions… like practicing for sometime legato without using right hand…
I also have the impression that if I use fingers only like a classical player don’t have so much tingling
Strange… I don’t understand how the tension is being transferred to the shoulder from wrist picking …

Well its all connected really, so if you have tight inflamed muscles in your shoulder, the wrist and forearm muscles might be pulling on those, referring pain to your neck and head.

When I get the numbness, I feel it in my hand and my back of the shoulder - nothing in between! It is all a strange feeling.

Definitely keep working on the legato, I really like your style and note choices.

that 's the best explanation so far , i wish the physio i am going could explain this …
thank you once again for your replys

So I must disqualify myself from any medical advice because I am not a physician. HOWEVER, there are some things that come to mind.

The first thing is that I think that you need to see a neurologist. Have you seen one yet? (Actually, I’ll ask my siblings what kind of physician you should see, they’re both physicians.)

My second question is this: How does your neck and shoulder “know” that you are playing guitar? In other words, your movements seem very moderate, and I am sure that your pain is real, so what is it that creates the tingling? The only thing that I could think of is that it somehow involves holding your arm out, e.g., lifting your elbow up? What happens, for example, if you put a pillow between your right arm and your ribs to bear some of the weight? Does this impact the pain? And what happens if you practice while seated, where your elbow might be resting on a pillow, etc.? Does your right scapula move to a troublesome position when you play, e.g., does your posture impact the pain?

Third, I was trying to determine how much of your arm weight do you rest on the edge of your guitar. I seem to put a lot of weight on the edge of my guitar, but I couldn’t really ascertain how much you put on yours… also, I don’t know if your guitar has a sharp edge with high pressure on your forearm, or a more gentle lower pressure (if the edge is rounded, or if you put some padding on it).

I really enjoyed your playing and hope that you find a great resolution ASAP!


Great question…

Very good questions dear friend , its the kind of posture mechanics i d like to talk with my doctors but they dont have that knowledge since they are not guitar players …
I have visited two neurologists ,the first one precribed me an antiepileptic medicine for neuropathetic pains …it helped me to play more time but after 6 months i had many side effects and when i quited it the problems returned in double …
the other doc wanted to precribe antidepresentants …i refused to take them …

you are right in second question , to be honest i have similar tinglings when i type a lot or using the mouse ( so i switched to left hand ) but playing guitar is the main problem since it is my main job and demands much more endurance.
I have tried playing lying in bed so the weight of arm is not hunging from shoulder , it looks like working but after half an hour or so i feel the forearn tensed .
in that point i must say that the biggest problem appears when i try to increase tempo … I guess i am loosing control of relaxation.
also experimenting playing seated (the pillow you mentioned seems to be a good idea) and also using a
a shoulder support belt ( hilarious look …)

As for the third question i have a semihollow gibson that i am not using because it forces my arm to be so faraway from my body making it worse and i turned to a musicman axis with "less " guitar body i think it helps more .

thank you so much for your time to read and reply to my problem !!

This is quite common as the antidepresents are a muscle relaxant. It would have been a really small dose, but I can understand you might not want to go down that route.

One thing I didn’t ask is that does the pain come from trying to picks slow, fast or everytime?

Hey dude! Nice playing. My girlfriend also complains of headaches caused by guitar playing … but I’m the one who’s playing it :sweat_smile:

I’m a Kinesiologist by profession and work in a physiotherapy clinic designing exercise programs for people to rehabilitate injury - and while I won’t attempt to diagnose you online, any time someone presents with symptoms like parasthesia (numbness, tingling, @PickingApprentice this probably applies to you as well) this likely indicates a nerve issue where the nerve is either being stretched excessively or compressed (pinched), causing the symptoms you’re experiencing. Nerves like to move but they don’t like to be squished or to experience more pressure than they’re accustomed to; irritated nerves will be more sensitive to this type of stimuli and certain motions will probably be painful. Nerve mobility drills such as “flosses” which involve moving the nerve back and forth (like flossing your teeth) can help improve nerve mobility and increase their tolerance to being stretched.

Here’s a great and relatively short video explaining neurodynamics and the concepts behind the efficacy of nerve flossing:

The most typical presentation of Thoracic Outlet Syndrome is caused by a compression of the brachial plexus, which is the area @PickingApprentice described underneath the collarbone - it’s a passageway for multiple nerves but the most relevant ones in your case are probably the ulnar, median and radial nerves. Look up some nerve flossing or sliding/tensioning exercises for them on YouTube (there’s hundreds of them) and see if they give you any relief. Addressing the symptoms by using these exercises, in combination with seeing a professional and addressing any postural/muscular issues that can be contributing to the symptoms should hopefully give you some kind of improvement!

Chronic pain is very frustrating and I would see patients experiencing it every day at work so I know how much it sucks - I hope you can find a solution and get back to playing pain free!


I was thinking about this yesterday, and I wonder: “Is there a way where you can play guitar with your picking elbow relaxed and close to your ribs?” This would, in short, mean that the headstock of the guitar would move further in front of you (to some degree), and your fingering arm’s elbow would have less bend, in order to reach the more distant neck. This might work seated, I’m not sure how well it would work standing. I also suspect that edge-related pressure of the forearm on the guitar is bad, and at least some padding might help (?).

I don’t know if you have an Alexander Technique practitioner near you, but they’re really good at noticing asymmetries, tension, etc., and they often work with musicians.

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Hey man! Thanks for posting, and great playing.

It sounds like you’ve pursued a number of medical options for this already, which is great. And you’ve got some great responses here, one from a medical professional.

The only thing I’ll add, because I always have a healthy paranoia about these kinds of things, is that you want to make sure this isn’t possibly the result of some health condition that could get worse and cause other problems. For example, you’d want to rule out a degenerative condition like arthritis. Have your doctors recommended seeing any other specialists for more workups, like a rheumatologist? Could be worth a shot. This way, at least you know you’re dealing with something that’s “just” mechanical, and not actually dangerous.


dear friends i am already feeling better thanks to your positive energy …
thank you all for your replies… you gave me new ideas to work with …this is a great forum with so nice members !
to resume some some ideas up to now ,

i will check again the intrument / body -elbow geometry
right now i am using an ergoplay pillow that brings the guitar upwards like classical posture

find a specialist to search for pinched nerves
( when i asked my physiotherapist for a pinched nerve he was negative because he claimed it produces a constant pain … )
also check for thoracic outlet syndrome and median ulnar and radial nerves
a lot of homework with the youtube exersizes Philausopher uploaded

I ve also talked with an Alexander Technique teacher but we have a hard lokdown in my country since November… i am reading some DIY books for it though …

Also as Troy proposed i will check the arthritis part to make sure i am not having any issues .

Until then i will take it easy with practicing

and only admire the picking masters and the amazing videos in here !!

i hope you are safe and enjoy playing !

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