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  1. #26

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    Hi AndyTT
    IIRC, my cortisone shot was pure hell for 24-36 hours and then it was like a curtain lifted, birds sang, and all was good. for about six months. That was after my first surgery which at that time we didn’t know was royally effed up by the surgeon. It took two more surgeries by the top hand guy at Jefferson in Philly to correct what that =/;(&+ did.

    Probably recall from my comments earlier, Im not a doctor I’ve just gone through three surgeries to correct De
    Quervain's tenosynovitis. DeQ happens at the base of the thumb (sorta) whereas Trigger Finger presents in the finger(s). Check the Mayo Clinic site for excellent reference data.
    Certainly look it up, but DeQ in advanced state doesn’t just heal itself. As the tendons in the sheath inflame, rubbing on each other it just builds more scar tissue. At its worst for me, my thumbs (both were damaged) would stick straight out and be very painfully stuck.
    Anyone facing this has my empathy sympathy and prayers.
    There is a test for DeQ, you can do yourself, the Finklestein Test. Rather than describing it here’s a link with a good video to help:

    Finkelstein Test - Physiopedia

    Very much a gold standard to determine real DeQ vs other fleshy stuff.
    Best of luck there and feel free to PM.
    I will spout no voodoo. Just clinically verified data.
    jk




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  3. #27

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    Quote Originally Posted by rpjazzguitar
    This may not directly address the OP, but may be helpful to someone.

    I've had multiple injections in finger joints.
    At Kaiser, they just plunged in. Eye popping pain for a few seconds until the anesthetic (mixed with the steroid) kicks in.
    Outside of Kaiser, they prepped it with something that feels cold and makes the injection a little less painful.
    Iirc, I was told that injecting the anesthetic would hurt as much as injecting the steroid, so there was no point in it.
    I never had anything guided by ultrasound ... maybe that takes longer, so you need the anesthetic.
    I had one trigger finger resolve on its own.
    I've had one well known hand surgeon inject a steroid into a finger joint and another well known hand surgeon recommend against it. I've had two rheumatologists inject joints.
    I also tried the usual supplements, fish oil, and some other things. No improvement from any of them.

    One thing seems to help, but it should be done with blood work and ongoing medical supervision. It's Vitamin D3. One of the hand surgeons said that his musician patients do best with the D level in the bloodstream at 50 to 60 of whatever unit they use in the measurement. He recommended a level of D3 intake that my PCP didn't like.
    To explore this, first you have to have your blood level of D measured. If it's low, you supplement and have it checked again after a suitable time period. Reportedly, there are hazards in taking too much. There are well documented hazards to not having enough D.
    Even though I get some daily sun, the D3 supplement seems to help.

    Good luck.
    Thanks, interesting stuff. Yes it felt like there was a lot of poking around in different areas with the anesthetic needle (uncomfortable, but not painful) then by the time the steroid needle went in I couldn't feel a thing.

    A blood test last winter found I was slightly low on Vitamin D, my GP recommended a specific dose of D3 to take so I've been taking that ever since, even through the summer, as it's not a particularly high dose (but it's larger than you normally find in supermarket multivitamins). I've had various blood tests since and my vitamin D level has not been mentioned again ( I normally get my blood test results via a letter rather than a consultation, so not easy to ask) so presumably it is in the normal range. It would be good to know the specific level though. As you do I try to get some daily sun even when working.

  4. #28

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    Quote Originally Posted by jazzkritter
    Hi AndyTT
    IIRC, my cortisone shot was pure hell for 24-36 hours and then it was like a curtain lifted, birds sang, and all was good. for about six months. That was after my first surgery which at that time we didn’t know was royally effed up by the surgeon. It took two more surgeries by the top hand guy at Jefferson in Philly to correct what that =/;(&+ did.

    Probably recall from my comments earlier, Im not a doctor I’ve just gone through three surgeries to correct De
    Quervain's tenosynovitis. DeQ happens at the base of the thumb (sorta) whereas Trigger Finger presents in the finger(s). Check the Mayo Clinic site for excellent reference data.
    Certainly look it up, but DeQ in advanced state doesn’t just heal itself. As the tendons in the sheath inflame, rubbing on each other it just builds more scar tissue. At its worst for me, my thumbs (both were damaged) would stick straight out and be very painfully stuck.
    Anyone facing this has my empathy sympathy and prayers.
    There is a test for DeQ, you can do yourself, the Finklestein Test. Rather than describing it here’s a link with a good video to help:

    Finkelstein Test - Physiopedia

    Very much a gold standard to determine real DeQ vs other fleshy stuff.
    Best of luck there and feel free to PM.
    I will spout no voodoo. Just clinically verified data.
    jk
    Hi jk,

    Thanks, it's useful to know that your shot gave you problems for 36 hours. My swelling has come down somewhat, but I still have some anesthetic numbness in the end of my finger after 24hours.

    I have read about De Quervain's previously, it sounds awful so you have my sympathy. Have you now recovered, or still recovering? are you able to play guitar again?

    I have had some thumb pain and stiffness on and off, but it seems to be either deep in middle of the fleshy part of the thumb, or in the end joint, and seems to be aggravated by being in warm/hot situations where there is more blood flow to my hands.

    I will certainly have a go at the
    Finklestein Test though. When you say base of the thumb, do you mean near the wrist? I've not had any pain there.


  5. #29

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    I have a trigger finger in my right annular, fortunately with the trigger point in a position where it rarely affects my guitar playing.

    The origin is probably arthritic: the base joint of the finger in question is one of those where I'm hyperlax so it's easy to make that joint crack by just making a tight fist. I'm still thinking the TF syndrome was triggered by playing too roughly with my dog, esp. using a ball launcher with a shitty grip that presses into my tendon right where the nodule is now.

    It's been almost 1.5y now, with some ups and downs but never bad enough to go find someone trustworthy enough to get a cortisone injection. I do massage the spot regularly, and do daily exercises that involve "rolling" my fingers with hands and arms in different positions so all the mechanical parts involved get warmed up gently and the muscles stretched (these are actually part of anti tennis-elbow exercises). I've also become more mindful of my playing technique, avoiding to curl the 3rd and 4th fingers up too tightly when I don't need them while playing, and using the 3rd less when playing on the high E.
    The past few months I've noticed less and less triggering, and I'm convinced that the nodule has shrunk. Good to know about the vit. D; I have a running prescription for regular "shots" (15000-or-so unit vials) which is due for about now (according to my doctor there are also indications that vit. D boosts antiviral resistance).

    Shortly before last summer I read (on the AGF I think) about acupuncture which can apparently be very beneficial for this. I haven't yet tried (few in my region, expensive without a prescription, and my housedoctor only wanted to give me a prescription to get an opinion before prescribing the treatment). There's a specific name for the intervention (or rather the places where to put the needles), I've been meaning to relocate the exchange to write it down somewhere...

  6. #30

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    Hi, sorry to hear about your painful finger. awhile back I was doing a lot of repetitive work with hand tools and paint brushes. It was too much for an old guy. symptoms like yours crept in and effected my lousy guitar playing. finally went to a Plastic surgeon who was a hand surgeon. we did 4 or five steroid injections that eliminated problems in some of my fingers on the left hand. Pian and difficulty flexing the ring finger kept returning. So, after 3 times with steroids we talked about surgery. That took care of the pain and intermittent trigger finger in that ring finger. I never had problems with the steroid injections themselves, but everyone is different and reacts differently to meds. When all this is resolved, you might talk to a good surgeon and just get the surgery. Just get all the info and weigh it up.

  7. #31

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    I see several people who got the surgery, so I'd like to ask them a question.

    From what I understand, the surgery cuts the tendon sheath so that the nodule on the tendon can no longer catch. Now that sheath is there for a reason: to guide the tendon so it keeps flush to the joint when you flex your fingers. If you cut it open completely, you can/should get what I think is called "rubber banding", where the tendon lifts off the bones when you flex your finger, as far as your skin will let it go.

    Does anyone notice something like this?

    I just remember I had some similar nodule(s) on the thumb-side of my left index finger when I was in my early 20s; not hindering me but I could sometimes feel them when playing baroque violin. Talked about it with a teacher who told me it'd go away ... and it did.

  8. #32

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    Quote Originally Posted by RJVB
    I see several people who got the surgery, so I'd like to ask them a question.

    From what I understand, the surgery cuts the tendon sheath so that the nodule on the tendon can no longer catch. Now that sheath is there for a reason: to guide the tendon so it keeps flush to the joint when you flex your fingers. If you cut it open completely, you can/should get what I think is called "rubber banding", where the tendon lifts off the bones when you flex your finger, as far as your skin will let it go.

    Does anyone notice something like this?

    I just remember I had some similar nodule(s) on the thumb-side of my left index finger when I was in my early 20s; not hindering me but I could sometimes feel them when playing baroque violin. Talked about it with a teacher who told me it'd go away ... and it did.
    I had trigger finger in my right ring finger about ten years + ago.

    It was bad so had the surgery you referred to.

    The results were very good. I have not noticed any rubber banding.

    I now have mild trigger finger in my right hand middle finger but am hoping to resolve it with rest, stretching, etc. We'll see.

  9. #33

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    I had three releases, two left one right, about 15 years ago. The first “surgeon” did not entirely clean the scar tissue out of the sheath. Found that out several weeks later when my thumb froze out at 90 degrees. Needless to say got a referral to an occupational hand surgery specialist who fixed that and did the right hand.

    Mine were due to a bicycle accident. So although I’ve been pain free in all honesty the permanent damage from the accident stopped my public playing both guitar and classical organ. Again due to accident damage not the D’Querrvaines Release.
    Just don’t use that jackaxx I first did at Southern ocean County Hospital NJ.
    jk