Billy Joel has finally filled in one of the biggest missing pieces of the health crisis that took him off the road.
The 77-year-old singer revealed that he underwent brain surgery after being diagnosed with normal pressure hydrocephalus, or NPH. Speaking on SiriusXM’s The Billy Joel Channel, Joel said doctors implanted a shunt after persistent balance problems left him feeling as though he were rocking on a boat, according to Entertainment Weekly.
Joel initially wanted nothing to do with the procedure. He changed his mind after learning that a shunt could potentially help his balance and memory, and he now says both improved after surgery along with his general ability to function.
Joel says his doctors warned that the volume of his rock shows was giving him “something like a concussion” each time he performed and could put additional strain on his brain while he continued recovering.
Joel Initially Wanted Nothing to Do With Brain Surgery
The first problem Joel described was his balance. He said he felt a persistent rocking motion, as if he were standing on a boat, and eventually saw a neurologist because he could not understand why he had become so unsteady.
Doctors diagnosed him with normal pressure hydrocephalus. The National Institute of Neurological Disorders and Stroke describes NPH as a buildup of cerebrospinal fluid in the brain’s ventricles that can cause problems with walking, bladder control, thinking and reasoning. It is most common in older adults.
Joel said doctors then recommended inserting a shunt. His initial reaction was to reject the idea after hearing that the procedure involved drilling through his skull and placing a tube inside his brain. He reconsidered after researching the treatment and learning that it could improve symptoms involving balance and memory. “It’s hard to tell what’s age and what’s a condition,” he said while explaining why the memory issue particularly concerned him.
Joel ultimately agreed to the surgery. “They implanted a shunt in my brain,” he said, adding that the procedure “actually improved things.”
The Shunt Helped, but His Doctors Gave Him Another Warning
Joel said the changes after surgery were noticeable. His memory improved, his balance got somewhat better and his overall ability to function improved. Joel said doctors focused specifically on the volume associated with his job and warned that repeatedly performing very loud shows was creating concussion-like effects.
“The doctors told me this, because of my job, which is playing rock and roll music very loud, that it was giving me something like a concussion every time I did a show,” he said.
Joel went further in describing their warning, saying he was told the performances could damage brain nerves and lead to the loss of additional brain cells. He said he continues physical therapy and is following his doctors’ instructions to limit stress.
His Team Had Already Canceled Every Remaining Concert
The public first learned about Joel’s NPH diagnosis on May 23, 2025. His team said at the time that recent concert performances had exacerbated the condition and contributed to problems with hearing, vision and balance.
The announcement on Joel’s official website canceled every remaining scheduled performance. The canceled itinerary stretched through July 2026 and included stadium shows with Sting, Stevie Nicks and Rod Stewart.
There had been an earlier indication that something serious was happening. On March 11, 2025, Joel postponed eight dates for four months while recovering from what his team described only as “recent surgery” and undergoing physical therapy.
He Has Tested the Stage, but Not a Full Concert
Joel has not stayed completely away from live performance. On Jan. 2, 2026, he surprised a crowd in Wellington, Florida, during a concert by the Billy Joel tribute band Turnstiles.
Walking onto the stage with a cane, Joel sat at the piano and joined the band for “We Didn’t Start the Fire” and “Big Shot.” It was his first public performance since announcing the NPH diagnosis, but it lasted only two songs.
His last full concert remains the Feb. 22, 2025 show at Mohegan Sun Arena in Connecticut. During that performance, Joel fell backward while singing “It’s Still Rock and Roll to Me,” recovered and continued the show.