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  1. #51

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    That's great, Ol' Fret! I might even take that along to the doc. I think you might be right about the PIP and DIP connection, and it is indeed almost impossible to curve the finger to meet the palm crease. Actually, none of my RIGHT-hand fingers can do that either, but I don't seem to have a problem playing.

    So, what's the solution other than ibuprofen?

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  3. #52

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    Rob - best wishes for a resolution of your finger pain. My own case was no fun and in any case has been well controlled for many years now. Do take care!

  4. #53

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    Thanks, k. Appreciated. I'm glad yours is manageable now.

  5. #54

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    Quote Originally Posted by Rob MacKillop
    ... it is indeed almost impossible to curve the finger to meet the palm crease. Actually, none of my RIGHT-hand fingers can do that either, but I don't seem to have a problem playing.

    So, what's the solution other than ibuprofen?

    Don't worry! The range of joint / muscle motion is an individual thing - medicine tends to think in statistical numbers. Comparing individual qualities to the average is sometimes unrewarding, only leading to upset. Not everyone can play guitar that well as you do with your hands … or as Django Reinhardt did.
    Many different smaller and larger muscles are responsible for the power of finger joint motion: Motion of the Fingers - Hand - Orthobullets
    If the joints, tendons and tendon sheaths are allowing, simple active hand exercises can help: HB Hands: Tendon Glide Exercises


    It's good to see a doctor; only he/she will tell if a medical treatment is promptly inevitable. The big rest of disorders will heal by nature, or by a gentle corriger la nature; of course, the application of anti-inflammatory substances will be the first choice.

  6. #55

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    Thanks again, Ol' Fret. I'll see the GP armed with at least a little understanding.

  7. #56

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    If it's OA, Voltaren Gel works wonders for me. It's a NSAID, but very little is absorbed into the bloodstream given that it's topical and applied to very limited areas. I have been advised to rub a little on every four hours - if playing. Otherwise I don't need it at all.

    There may be a few over-the-counter alternatives, perhaps less strong (Blue Emu? I don't know). Also, Voltaren Gel is over the counter in some countries.

    You may also want to consider lighter, lower tension strings. And, you should ensure that your nut slots and action are not set too high.


    Good luck!

  8. #57

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    Well, the doc has organised an x-ray and a blood test - she wants to cover all bases. Thinks it's probably osteoarthritis.

  9. #58

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    Voltaren Gel is ok. If conventionally applied, most of the superficially applied gel is metabolized in the cutis and subcutis. To bring it effectively and deeper to soft tissues and joint structures, you can put it under an "occlusion" bandage, before going to bed: rub the gel gently into the skin over the painful structures for one or two minutes, put one more dose on the skin, cover the whole with a household foil, finally a gauze bandage around the limb. Remove the bandage the next morning.
    Don't do this if you're allergic to one of the ingredients of Voltaren gel or if you have a very sensitive skin, neurodermatitis, etc.!!

    Anti-inflammatory drugs should be taken in recommended dose. The body (liver, kidneys) tolerates it much better if it gets a pharmacologically effective dose for eight days, than ineffective reduced dose over several months. This applies the more if you have to take in cortisone: better to apply really strong initial dose (so scaring in popular belief - indeed it isn't ), then reduce gradually and as fast as the clinical and laboratory findings allow.

    Since the OP seems to have a concomitant cold temperature sensivity, which might be sort of a neurovascular reaction, before playing it could help to put the fingers into a warm substrate like sand or rice or whatever is available, and move the fingers around for a some minutes. The Scottish Highlands are lovely and certainly musically inspiring, but maybe would a move to Florida or, at least, South Italy, help also ...

  10. #59

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    Quote Originally Posted by Rob MacKillop
    Well, the doc has organised an x-ray and a blood test - she wants to cover all bases. Thinks it's probably osteoarthritis.
    Well, statistically, in most cases such discomforts are joint related; let's see what the x-ray shows.
    If this is also the case here, it proves once more that online medical communication is often vague and, um, a bit unproductive.

    Most of us older persons will show radiological and clinical signs of finger joint osteoarthitis (consider it a normal fact of life). Many will suffer from short periods of discomfort for this reason, though most people find a healthy way to get around minor ailments. So much musicians showed a very respectable performance even being in their eighties or nineties - just think of Mundell Lowe (RIP).

    Good luck!

  11. #60

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    Thanks again, Ol' Fret. We have no plans for moving to Florida, haha. I've taken to immersing my hands in very warm water for a minute or so before playing, and find it does help for a while.

    I'm imagining I will suffer from such ailments over the coming years, but as long as I can keep playing at least for myself, I'd be happy with that. I don't do concerts or recordings these days, just a few videos from home. That will continue, I'm sure.

  12. #61

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    Quote Originally Posted by Rob MacKillop
    I've taken to immersing my hands in very warm water for a minute or so before playing, and find it does help for a while.
    I believe Segovia used to do that before playing, I'm sure I read that somewhere.

  13. #62

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    Well, he WAS one of my students...ahem...

  14. #63

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    Well you did a good job...I understand he became quite successful.

  15. #64

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    As a person with pinched nerves that almost ended my playing days and a family history of arthritis, I can say that getting to the bottom of it with a doctor is the right thing to do. Along your path of exploring this I also suggest you look into all the self help methods to keep you body in playing condition. Heat pads, stretching, etc. are all little things that can extend your life on the instrument.

    Best of luck on this.

  16. #65

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    I fractured my LH pinky about seven years ago, and since it was the least of my problems at the time, never got it looked at.
    I just played right through it.
    It started bothering me last year, so this time I went to a doc, and he said it was traumatic arthritis, and all i could do for it was take an ibuprofen before I played.
    I played a duo concert the next day and the ibuprofen worked very well. Since then, I haven't taken anything for it, even though I'm in the middle of a month where I've got 26 gigs. The pain is so familiar, that I think of it as part of my playing.

    However, I've got to do some recording 7/9 and the week of 7/16, and the pain prevents me from doing five fret stretches, so I'll take some ibuprofen before playing.
    If you get used to the pain, you can tolerate it up to a point, but if it prevents me from being free to do anything on a jazz recording, that's the tipping point

  17. #66

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    Good luck with that. I asked my doctor about ibuprofen, but she said paracetamol was easier on the stomach.

  18. #67

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    Quote Originally Posted by Ol' Fret
    Don't worry! The range of joint / muscle motion is an individual thing - medicine tends to think in statistical numbers. Comparing individual qualities to the average is sometimes unrewarding, only leading to upset. Not everyone can play guitar that well as you do with your hands … or as Django Reinhardt did.
    Many different smaller and larger muscles are responsible for the power of finger joint motion: Motion of the Fingers - Hand - Orthobullets
    If the joints, tendons and tendon sheaths are allowing, simple active hand exercises can help: HB Hands: Tendon Glide Exercises


    It's good to see a doctor; only he/she will tell if a medical treatment is promptly inevitable. The big rest of disorders will heal by nature, or by a gentle corriger la nature; of course, the application of anti-inflammatory substances will be the first choice.
    I've had lots of hand, finger and wrist issues and pretty much cleared them up with many of the exercises mentioned above. Including the ones with the weights and theraband. This was all done with a Dr's supervision

  19. #68

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    Quote Originally Posted by Ol' Fret
    Voltaren Gel is ok. If conventionally applied, most of the superficially applied gel is metabolized in the cutis and subcutis. To bring it effectively and deeper to soft tissues and joint structures, you can put it under an "occlusion" bandage, before going to bed: rub the gel gently into the skin over the painful structures for one or two minutes, put one more dose on the skin, cover the whole with a household foil, finally a gauze bandage around the limb. Remove the bandage the next morning.
    Don't do this if you're allergic to one of the ingredients of Voltaren gel or if you have a very sensitive skin, neurodermatitis, etc.!!

    Anti-inflammatory drugs should be taken in recommended dose. The body (liver, kidneys) tolerates it much better if it gets a pharmacologically effective dose for eight days, than ineffective reduced dose over several months. This applies the more if you have to take in cortisone: better to apply really strong initial dose (so scaring in popular belief - indeed it isn't ), then reduce gradually and as fast as the clinical and laboratory findings allow.

    Since the OP seems to have a concomitant cold temperature sensivity, which might be sort of a neurovascular reaction, before playing it could help to put the fingers into a warm substrate like sand or rice or whatever is available, and move the fingers around for a some minutes. The Scottish Highlands are lovely and certainly musically inspiring, but maybe would a move to Florida or, at least, South Italy, help also ...
    It's more than "OK" for me. It keeps me playing, period.

    I don't have to do any of that bandage ritual that you mention either. And "before bed"? No, I don't play the guitar in my sleep. I apply it right before playing the guitar (well about 15 minutes prior, to let it dry and I rub off the side of my fingers with a wet washcloth to remove any stickiness, while leaving the gel over the top of the PIP or DIP joint). Good for 4 hours of playing, and can be repeated multiple times per day!

    This is precisely what my arthritis doctor advised. My family doctors were/are very good but ignorant about this topic. "Worthless" might be a good word to describe their "help" with this. So, I strongly advise seeing an arthritis doc if one has arthritis (Rheumatologist).

    In summary, if it's OA it's here to stay. We all know that one can't keep taking cortisone shots, and shouldn't rely on frequent and extended use of oral NSAIDS either. Those may be fine for an initial booster but then what? I love the warnings for continued use of oral NSAIDs - sudden death from your esophagus tearing itself in half, without warning. Nice.

    Some people say that Turmeric/Curcumin provides some minor relief as well. Can't say, might be worth a try.

    I have noticed that slinky stringed electric guitars are not much of a problem, but classicals with somewhat high action and archtops with 12s drive me to use the gel. Light strings and low action are something to keep in mind as you age....
    Last edited by Jazzstdnt; 07-05-2018 at 12:56 AM.

  20. #69

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    Hi Rob. I do hope you find a combination that works for you. Getting used to OA takes time in many cases, and it may have a somewhat ambulatory quality in the pain sector which is, in my case, difficult to understand, at least at times. I have used Ibuprofen, which I find does no better or worse compared to the other NSAID agents of comparative dose I have tried. I tried, several years ago, 5 or 6 of the most common brands in order to: 1. compare their effect, of which I found them all to be good, 2. to compare whether one was milder on the stomach in as I reacted with discomfort in a way that I imagine one has with an ulcer. As far as the second point is concerned, all of the med´s gave stomach discomfort of roughly comparative quality. I find that when forced to use ibuprofen now days, if I take a Omaprazol ( Losec) about an hour prior to the ibuprofen I no longer have discomfort. This may be a issue for you, and then it may not. An abrupt awakening to the effects of ageing, having to take a pill in order to take a pill.

  21. #70

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    Thanks, Ozoro. Yes, we have reached that age! Thanks for your top re Omaprazol, which I'll make a note of.

  22. #71

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    Rob, I have told this story here elsewhere but it is worth repeating.

    After 45 years of daily guitar playing without a lick of trouble, a little while back I found I was feeling a pain in the most distal joint of my left index finger. It only hurt when I made a particular motion where I held it to the finger board rather flat in order to move between notes on adjacent strings at the same fret, this only hurting when done above about the 15th fret...

    Since it came rather suddenly and was so specific to one finger joint, I looked for any changes in my routine that specifically involved this finger - basically I ran a little program in my mind's background to detect anytime I used that finger so I could stop and determine if I was doing something new.

    That little trap caught two new things; the first was that I had recently "repaired" my toilet so it would flush right, but the repair was incomplete and required me to hold down the flush lever for about 5 seconds to get the thing to work... good enough until I could revisit the problem someday and complete the fix... I was holding it down with my left index, not pushing very hard but slightly bending the joint backwards. I changed my flushing method to not stress anything and in a few days my finger was much better, but the joint still had a lingering ache.

    The little trap's second catch was noticing that I had switched coffee cups to a heavy porcelain one given to me by my niece as a birthday present - painted by her with my name, my guitar, etc. This cup was big and heavy but only had a small loop handle that I could only get one finger through - I drink left handed and that finger was my left index, bearing the weight and bending that joint. I switched back to lighter cups with bigger handles and in a few more days all was well.

    I guess the moral of this story is to check for any repetitive new things that might be stressing the fingers and eliminate the new stresses. I was lucky to find them and discover that once they were eliminated the issue disappeared altogether.

    Hope all is well for you and hope this helps anyone else that might find it.

  23. #72

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    Thanks for that, Paul. Appreciated. I'll have a good think. However, the problem dates back to January, with the initial pain on contact with cold water. And it does seem like I have osteoarthritis, though that's to be confirmed. We shall see.

  24. #73

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    I must admit to doubts about mentioning my problem online, but in doing so I've learned so much, and have heard quite a few similar stories from other players. So, any young player reading this far should learn a lesson: take care of your hands, keep vigilant, take preventative measures, and hopefully you will not have any of the problems mentioned here and elsewhere.

    The hands are very sensitive tools, so be sensitive to them.

  25. #74

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    Ibuprofen, naproxen, and others don't do much for my pain. What works best for me is what is sold as "migraine formula", which is a combination of aspirin, acetaminophen (paracetamol over there), and a touch of caffeine. Of course, YMMV, as different products work better with different people.

  26. #75

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    The best advice for younger or beginning players is to work on strengthening your hands before they start to go bad. It's good to do the exercises mentioned above as diligently as you practice playing. Take a tip from dancers. They all are constantly working on keeping in shape and all too often recovering from injuries. As guitar players our fingers are in effect dancing and the athletic aspects of being a musician can't be neglected. As an older player I am as concerned with maintaining my chops as much as I am the musical aspects. One thing I've learned is that as soon as I feel any real pain while playing I stop immediately. I'll rest for as long as necessary and do gentle exercises and stretches and won't resume playing until the pain is gone. Warming up with stretches and warm up exercises on the guitar before playing can help. And strengthening with the therabands and weights is important. If a joint has got problems strengthening the muscles around it can only help. All this should be done under the supervision of a health care professional. You don't want to ''do a
    Schumann''. He made a device with a string a weight and a pulley to increase the range of motion of the ring finger which naturally doesn't lift as high as the others. He over did it and seriously damaged his hands.