Billy Joel is finally opening up about how a diagnosis of Normal Pressure Hydrocephalus last year revealed the unexpected damage his concerts were causing to his brain. In an interview on his SiriusXM channel on Wednesday (Sept. 9), 77-year-old “Piano Man” singer described going to see a doctor after suffering from balance problems that made it feel like he was “on a boat.”

After giving him the diagnosis, his neurologists recommended implanting a shunt in his brain to reliever some of the pressure. “So I agreed to do the shunt,” Joel said, noting that he initially said he’d “pass” on the suggestion of the surgery that entailed drilling a hole through his skull to implant the shunt, in order to stop the progressive condition from getting worse.

“But then I read up on it and I realized it can help improve your balance and can help your memory. You know, I don’t want to lose my marbles,” Joel said. “It’s hard to tell what’s age and what’s a condition, so I agreed to do the shunt and I had a surgery, and they implanted a shunt in my brain and it actually improved things.”

And while he said his memory, balance and ability to function all improved after the procedure, the bad news was that his doctors also advised him to stop performing live because they said the physical effects of playing loud rock shows might cause further damage. “I realized, and the doctors told me this, because of my job, which is playing rock ‘n’ roll music very loud, that it was giving me something like a concussion every time I did a show,” the singer said. “It was causing damage to my brain nerves and I could be losing more brain cells the more shows I did and I realized that means I shouldn’t be doing this right now.”

And so, Joel canceled his planned 2025 tour dates due to the diagnosis and recovery from the condition that occurs when cerebrospinal fluid builds up inside the skull, pressing on the brain and affecting a number of abilities, including “thinking and concentration, memory, movement and more,” according to the Cleveland Clinic.

Taking his doctor’s orders to let his brain rest, Joel decided he needed to take a break from the road. “I gotta improve. They don’t want me to stress too much,” he said. So now he’s doing physical therapy and “whatever it is they tell me to do because I don’t want to lose it.” In addition, he described constantly “testing myself,” while assuring fans who’ve heard about his condition that he’s doing just fine. “I just want people to know, don’t worry about me,” he said. “I’m not going anywhere. I’m here. I’m still here.”

Joel’s last full show before the break was on Feb. 22, 2025 at the Mohegan Sun Arena in Uncasville, Conn., where, near the end of his set, he did a microphone spin and then fell down during “It’s Still Rock and Roll to Me,” which led to the diagnosis. The singer revealed the condition to fans three months later after canceling the rest of his planned gigs.

Since the diagnosis and surgery, Joel has only performed in public once, on Jan. 2, when he hopped on stage with a Billy Joel tribute band called Turnstiles at a show in Wellington. Fla., where he performed “We Didn’t Start the Fire” and “Big Shot” with the group. He was also in the audience at a March tribute fundraiser at Carnegie Hall featuring Rufus Wainwright, Matchbox Twenty’s Rob Thomas, Matt Nathanson, Train’s Pat Monahan, Wyclef Jean and Mary Chapin Carpenter that raised more than $225,000 to support music education.

Listen to Joel discuss the surgery and recovery below.