Hand Injury not improving

[neil argonaut]

Before this year, I had never been bothered by hand injuries, but just in case was always cautious, warming up well and stretching fingers before playing, plus trying to be careful about technique, grip, etc.
However, late this summer, I started to get pains in my hand and wrist, and had to massively cut down the amount I played (which previously varied between 5-10 hours a day). I was quite sure this would solve things, but it didn't seem to help, so I've more or less stopped playing completely now for about 6 weeks, hard as that has been. I was given various pieces of advice, ranging from "just play through it" to "gradually start playing again a bit more each day" to "rest completely till symptoms are totally gone, then wait another 2 weeks". As I rely on music as my only source of income, and I've got enough money to get me through a few more months, I thought it wise to rest completely, quite sure this would solve things.
However:
It seems like with every week without playing, things get worse rather than better, and my hands are in a lot more pain than when I gave up playing. I'm willing to give it as long as needed (up to 3 or 4 months after which I'll run out of money) but if they're going to get worse anyway for a while, I wonder if I'm as well playing. I tried reading through many threads on tendonitis etc, but can't find any cases where it doesn't improve with rest - anyone else had this experience, or got advice?

[verbs4us]

Sounds like you might need a professional diagnostic work-up to rule out nasty things. One cheap thing to try if you haven't: ice. 20 minutes, three times/day. Ice calms inflammation and sets up conditions for the body to heal itself. I have used it for strains, sprains, tendonitis and other soft-tissue injury. If the cause of the problem is indeed just soft tissue, ice may be both pallative and curative over time. Try it for 10 days and see what happens. Tendons take a ridiculously long time to heal and the older you are, the longer the healing time. I'm 56 and a minor Achilles strain took almost three months to clear.

[neil argonaut]

I'm 33 so hopefully young enough for it not to take too long :)
Unfortunately ice isn't an option as I don't have a freezer (though give it a few more weeks and I could probably find some outside!). Thanks for the advice anyway, though.
Well I've been to a doctor already (luckily I live in a country where medical care and medicine is entirely free), and he said he thinks it's tendovinitus, and referred me to a physiotherapist, but that might not be for another month or two.
Another thing I've heard about is Rolfing and similar techniques, but not sure how much this works or whether it's just a bit of a new age con.
I've also got a powerball, but not sure whether using that or resting totally is better.

[nickster60]

Neil I am not sure how old you are but if you approaching middle age this is just a preview of things to come. I have had hand issues for along time. I had severe carpal tunnel for along time. I went to the doctor and they found I had a thyroid condition(carpal tunnel is side effect). I just lived with it for along time, I wish I had went to the doctor sooner. If you work with your hands and play instruments it is just a matter of time before the hands give you trouble.Make a visit to the doctor and see what they come up with. For my other aches and pains I use Advil.

[UsuallyPickin]

Man I know what you are talking about. I take Naproxen Sodium ( Aleve ). Which has a long list of side effects so tread carefully. It helps relieve the symptoms of pain and inflammation but it won't make it go away. Tendonitis is a condition not a disease. Weather effects it ... nobody knows why. I don't know if it can be taken with Ibuprophen ( Advil ) but it can be taken with Acetymenephin ( Tylenol ). Plants from the Nightshade family ( tomatos , potatos ) are said by some to effect tendomitis and arthritis patients. I play as much as I am able. I warm up by running my hands under hot water and stretching. I try not to over grip the mandolin or whatever I am playing. And when my left hand starts hurting I stop playing for awhile. Stopping altogether does tend to leave me with more pain and less range of motion..... Luck.. R/

[neil argonaut]

nickster, i'm 33 so hopefully middle age is a good wee bit away yet; yeah I've been to the doctor, he referred me to physio, still waiting for that.
Usuallypicking - well it has got much colder over past week or two, so maybe I am getting better but it's been balanced out by that. Do tomatoes and potatoes make it worse or better? I tend to avoid drugs whenever possible, and am not as bothered about the symptoms, i e putting up with a bit of pain, but more scared by them being a sign of underlying stuff; so I try to avoid anything that kills the pain as then I'll be unaware when my body is warning me not to play. did try ibuprofen for inflammation but didn't seem to make much difference.
Edited to add: So Usuallypicking, you suggest not resting completely, but keep playing a bit?

Obviously I maybe want to hear that kind of advice as I'm dying to get playing again even 30 mins a day, but I wouldn't want to if it sets back full recovery.

[JeffD]

but more scared by them being a sign of underlying stuff; so I try to avoid anything that kills the pain as then I'll be unaware when my body is warning me not to play..

I had hand and wrist pain after playing for about 30 minutes. Turned out to be undiagnosed diabetes. Once my blood sugar was corrected the pain was gone. Not abated, or less - totally gone, like a light switch. Do get it checked out. You are right to be thinking of the underlying stuff.

[Timmando]

I would stop with the powerball, rolfiing is a deep tissue massage, I had it done, once, and it causes pain, so I stopped. I would also cut out all diet sodas as the fake sugars are questionable in relation to fibromyalgia, pain in tendons and joints. While you are at it, cut out sugar period, as it is related to diabetes which can lead to joint issues. You are pretty young to be having health issues, but then I know a 15 year old who has and gets just about everything. I would think your problem is specific to overworking that part of your body. Let it rest completely, except for normal usage (ie, don't put your arm in a sling). Do the physio that is upcoming and for heavens sake...get a freezer!

Also, ibuprofen and other anti-inflammatories work better after you take them for awhile. In other words, once the inflammation is under control, the pills will help keep it under control, they will not solve the problem. If inflammation is beyond the bodies ability to control it normally, a cortisone injection can help bring it down to the point where the body can take over. You might try a cortisone injection into the area of pain. A doctor will mix the steroid with painkiller, and if the pain goes away immediately after the shot, he knows he hit the right spot with the steroid. Cortisone injections worked with tennis elbow that I had, from playing guitar.

[neil argonaut]

Well I only started with the powerball because it bills itsself as being good for rsi, tennis elbow, tendonitis rehab etc. I can't imagine it being something like diabetes as aside from music-related injuries (to voice, ears and hands in varying degrees) I'm quite ridiculously healthy. And don't worry, I never drink any kind of soda, but especially avoid diet stuff. and don't really eat stuff with sugar either.
I'm not even totally convinced it is inflammation, could just be pulled muscles, wear and tear, or something else, don't know.
And the freezer isn't really an option, there really is no room in my kitchen, unless I got rid of my tape player, and that ain't gonna happen!
Thanks for all the advice, folks.

[Folkmusician.com]

I started having issues with my hands in my 20's. Between playing, riding motorcycles and bicycles, computer usage, and then some hard labor thrown in, it was just too much. The single biggest cause was actually sleeping and posture. I found that my sleeping positions was irritating it, then any usage at all was too much. The same with posture, How I have my hands and sit throughout the day make a big difference. Lastly, lifting and gripping heavy things. If I pickup something heavy enough to stress my hands, I can feel it for the rest of the day. At that point it will be minor, but if I then go and play for a couple of hours and go for a bike ride, I have set it off. In my case, I did have to give up most of my playing time. That is my trade off for getting to work on instruments for a living. :)

I can't over emphasize the damage done sleeping. It took years for me to be conscious of this at night and adjust my hand positions. When sitting, driving, etc... I move my hands around until I find a very relaxed position. This may or may not work for you, but at least be aware.

[Timbofood]

Sounds pretty miserable, what has the physio had to say or did I miss that?
I was a pall bearer for a buddies mom and the casket was unimaginably heavy, tore the blazes out of the tendons on my left hand, pain for months, finally eased up but, it was a long time. I still have trouble with from time to time.
Pay attention to your doctor on how to handle it, share info if you so desire.
Best wishes for better musical health.

[Timmando]

"Well I only started with the powerball because it bills itsself as being good for rsi, tennis elbow, tendonitis rehab etc."

Don't believe everything they say in advertisements...doesn't sound like you are at the rehab stage yet, you still have to find and fix the problem, then rehab afterwards.

[neil argonaut]

Timbofood - thanks for the wishes; I'm still waiting to see the physio, but might be another month or so till I'm top of the queue.
Robert - hadn't thought of that; don't think I'm sleeping with it in a bad position but will look into it. Also, hadn't really thought of cycling, I travel everywhere by bicycle, and probably average about an hour or two each day on it, though wasn't using it at all when the injury happened as I was traveling, and amn't using it much at the moment as I'm not going to practices, sessions, busking etc.

[jaycat]

I've gotta think repetitive use of any body part for up to 10 hrs. a day is gonna crash and burn sooner or later.

I've had great luck with cortisone shots too. After you feel better, take it easier with the playing, or alternate with some other instrument that puts demands on different muscles.

"Dr. J."

[Polecat]

I too wish you a speedy and hopefully complete recovery. For the past ten or so years, I've had recurring problems due to arthritis (I'm 50), and have had to accept that some things I used to be able to play are now no longer possible - I hope for your sake, that it won't come to that. No doubt, you're aware of it, but the inflammation of your tendons is not a syndrome but a symptom, in order to tackle the problem, you need to find the cause (if this is possible). Jaycat may be right, your problems may be some form of "repetitive strain syndrome" and you need to change your practice regime, but if possible, it's worth pursuing every avenue available (x-rays, blood tests...) to try to get to the root of the problem.
As regards treating the symptoms, I've had luck with low-dose radiation therapy to reduce the pain.
For the record, I'm not a doctor so this is an unqualified opinion. Once again I wish you all the best.

[neil argonaut]

yeah, thanks, I am trying to solve syndrome and not symptoms; annoying as it is, I would quite willingly put up with any pain i've got just now for ever if I could keep playing like before, and not get any worse. It's not the pain that annoys me, but what it means, so I'll pass on the radiation therapy.

[Mike Arakelian]

Robert raises a very good point about the position of your hands and arms while sleeping. Several months ago I was diagnosed with a mild case of Carpal Tunnel, and one of the important things the doctor recommended was wearing a wrist brace when I go to bed at night. The brace prevents you from sleeping with your wrist in a position that could put tension on it. I also wear it whenever I feel any pain or discomfort, and it always helps. In addition, the doctor told me never to put my elbows on a desk or table and then lean on them. Again, it puts tension in the wrong places. I doubt that doing these two things will solve your problem, but they certainly won't hurt any and may help some. I'm happy to say that I'm almost 100% again! and hope you get that way too. Good luck!

[mandroid]

so, no power tools involved? that's a relief ..

[bratsche]

Robert raises a very good point about the position of your hands and arms while sleeping. Several months ago I was diagnosed with a mild case of Carpal Tunnel, and one of the important things the doctor recommended was wearing a wrist brace when I go to bed at night. The brace prevents you from sleeping with your wrist in a position that could put tension on it.

Unfortunately I toss around a lot in my sleep, and I know (from impressions they sometimes leave on other parts of my body) that I roll over onto my hands a lot, which explains why I often wake up with either numbness or stiffness in them. But also, unfortunately, any type of brace or wrap would prevent me from getting a good night's sleep... I know, I've tried it. Fortunately, though, my hands always return to normal once I get up. So far, anyway.

bratsche

[Pete Martin]

Read all you can about RSI http://rsi.unl.edu/music.html

[Tom Wright]

My worst case of tendonitis was when I was 30, after intensive practice for auditions. It was cured by a steady regimen of ibuprofen ( I saw an orthopedic guy---he prescribed the new drug, Motrin).

It can easily keep happening even without playing mandolin. If the tendons are inflamed enough they keep rubbing, and keep themselves irritated. All inflammation-reducing strategies are helpful including ice. But regarding the anti-inflammatories, I was old by the pharmacist back then that one should take it with food for better absorption (and stomach protection), and that it took a couple of weeks to build up the blood levels and the effective inflammation reduction. Then you stay on it for a few weeks. Problem solved, never came back. But it takes time and deliberate attention to reducing the inflammation.

[Stephen Perry]

Rolfing. I had 11 sessions, then 10 of Core Structural (lower angle version of the same), and a good deal of other work. Made a tremendous difference. For hands, the work on my forearms did wonders.

Ergonomics. For everything. Retraining my movement habits was difficult and works great.

Ice water. Dipping my hands in ice water helps a great deal.

Diet. Gianna changed her diet and mine with it. Much less, few preservatives, very little gluten, very little salt, very little sugar. Ginger. I think this might be the main thing. She lost 70 lbs, I lost 20. And no pain in my hands.

All that helped. I can even play the piano again, after over a decade off.

[neil argonaut]

Thanks again to everyone for so many suggestions and resources. Stephen, so the Rolfing definitely helped for playing injuries? I might have to try and seek out a practitioner. As far as ergonomics, I've been thinking of checking out the Alexander technique after reading more through following links from the website Pete suggested (which I'd recommend anyone checking who hasn't already); and tomorrow I'll look for a wrist support and try sleeping in it.

[verbs4us]

Meil--All non-steroidal anti-inflammatories (Motrin, Advil, generic ibuprofen, Naproxen) have gastric side-effects. There is a gel form, available in the States as Voltaren, that side-steps these side effects because it goes from the skin to the inflammation, bypassing the gut and the rest of the circulatory system. Might ask a doc about it.

[neil argonaut]

yeah I've got some of the gel stuff.

[re simmers]

Find an occupational therapist.....they work more with hand problems, even if you have to come to the U.S. Playing music is the least of your problems. If you keep trying to fix this yourself, you are going to screw up your hands to where you struggle to do daily living routines!

Bob

[Stephen Perry]

Thanks again to everyone for so many suggestions and resources. Stephen, so the Rolfing definitely helped for playing injuries? I might have to try and seek out a practitioner. As far as ergonomics, I've been thinking of checking out the Alexander technique after reading more through following links from the website Pete suggested (which I'd recommend anyone checking who hasn't already); and tomorrow I'll look for a wrist support and try sleeping in it.

My hands were stiff. Probably from cycling and auto mechanic work, not to mention rock climbing, caving, white water, and general mayhem. I thought it was my hands. Then a Rolfer gave a quick demo (I think think beer was involved) and I got instant improvement.

I taught myself how to walk and play piano with Alexander. I also had sessions with a trained Alexander practitioner that were totally revolutionary.

I never thought about hand issues from sleeping habits.

[Folkmusician.com]

I hadn't heard of the Alexander Technique or the term Rolfer, but after Googling it, I would serious consider this as it is pretty much exactly what I have been doing on my own. I have no doubt that overuse comes into play. My wife (and business partner), is going through the exact same thing. She has played guitar since grade school, spends way to much time in front of the computer, packs a good portion of our orders and we do a lot of cycling together. She has an ongoing battle with hand issues as well and again, we have traced a lot of it to sleeping and posture.

The reality is that you need to get it under control regardless of what it takes. Meaning, stop whatever is causing it. If playing is the main cause, you need to quit until it subsides and then change your technique. Do look at other aspects of your lifestyle. Cycling can be stressful on your hands. I am predominately a mountain biker, which doesn't irritate it that much, but when I commute back and forth to work with drop bars, I notice it.

This is not about manning up to the pain and playing on. You will do permanent damage.

[Pasha Alden]

Hi Neil

So sorry to hear about the hand. I hope there is an answer soon.

What does the physiotherapist or your GP say?

Also wondered, what kind of pain and where? Is it in the wrist?Assuming the lefthand?

Asking as I thought maybe one can try and favour the hand in some way during playing? However, Iwould imagine that would interfere with technique?

Really hope your hand pain is sorted soon and you can start playing.

[Beanzy]

yeah I've got some of the gel stuff.

I had an issue from using power tools, log-splitters and felling axe about a year ago with my osteo-arthritis which flares up form impacts, vibration and over use. It didn't happen or get aggravated from my playing so I didn't stop that and with treatment it went. I had been using the off the shelf ibuprofen gel but the doctor prescribed me a 10% one which hit the mark. He also said to rub it in until it dried then lightly damp the hands again and rub it in again etc until the gel was mostly gone. This had the advantage of making me massage the whole hands and wrists while also making sure the gel went in properly. The sides and join between fingers has thinner skin and it really helped to rub it well in there. I started the day with a 10min session of that then do another in the evening. and I do this now if the osteo-arthritis flares up. I also bought a new brush-cutter with a transverse handle as this reduces the vibrations greatly, the chain-sawing gets done by someone else now.

You could look at making sure the bike position doesn't have your wrists bent when on the bars. Cow-horn bar-extensions on a straight-handlebar bike or riding on the forward reach/lever hoods on a drop bar can really help there. Also make sure you're not leaning too much weight on the arms and keep a slightly bent elbow so you absorb vibration better.

Keeping my fingers crossed for you, because that may hurt if you do it. :grin:

[Ivan Kelsall]

Hi Neil - I just picked up on this thread. You have my deepest sympathy mate !. I suffer from all sorts of pains scattered around my 69 (soon to be 70 year old carcass). I have mild tendonitis in both hands & trigger finger in one hand (Middle finger - right hand).I use 'Piroxicam' Anti-inflamatory gel on my hands & it seems to work pretty well. Rather than refering you directly to a Physio.,i'd think that your Doc.should have sent you to an Orthopedic specialist to define 'exactly' what your trouble is. I'd definitely re-vist your Doc.& ask to see a specialist,he can't refuse your request ".. he thinks it's tendovinitus..." isn't good enough. If a specialist agrees with your Doc,then ok,but Physio.is good 'when appropriate',but not in all cases,
Best wishes - Ivan

[Stephen Perry]

Swimming is probably also good. Some here will no doubt remember Ms. Gianna's tribulations with transport devices, including horse (broken neck), car (cracked skull), bicycle (torn up hand and facial fracture), and motorcycle (plates in leg). She was getting stiff and arthritic. She changed diet and started regular swimming because she couldn't really walk well any more. Now she walks like a dancer and is swimming 3000 m at a go. I have done a little. It's great!

[le_wren]

Long-time lurker, first time poster:

I just wanted to throw my support in your direction, OP. I have gone through a similar experience over the last six months and I just wanted to encourage you to do everything in your power to get 100% before you go back to your instrument. I developed trigger-finger (or tenosynovitus) in my left index finger over the summer from adjusting to a new mandolin (i.e. very different neck), cranking up the action, driving thousands of miles (i.e. gripping even when "resting"), and playing without regard to proper rest and stretching techniques for 6-10 hours every day. It got to the point where I couldn't bend my index finger halfway down without warm water, massage, and prayers. I had also never experienced any playing-related injuries from any instrument over my 18-year musical life. I was in disbelief and denial for a long time before I realized this was an issue that needed to be dealt with in a serious manner.

Definitely go see an occupational therapist, and if necessary, and orthopedic surgeon. Though they may not have much to tell you in the way of good news about this issue, the right medical professional will convince you that this is indeed a real problem and that you need to change your mindset about the "injury." The single-most helpful thing that was told to me by an ortho during my mentally-excruciating months of not playing (at all!) was that I don't have an "injury" in the true sense of the word. Once my doctor started getting me to think about this as a "condition" as opposed to an "injury" I started to realize that it was more about management and prevention that recovery and healing. Tendons do take a long time to heal, and the best thing is to see a medical professional and follow their advice. Preferably a doctor or OT/PT who is used to dealing with musicians, who can be stubborn and downright depressed when told to stay away from their craft.

I am no medical professional, just someone who has experienced a similar problem. It took me months to realize that I really needed to not pick up the instrument for at least six weeks to begin the reset process. So stick with it and understand that playing through the pain is only going to make it worse. You have many years of playing ahead of you! Focus on that fact and get well soon.

I wish you a speedy and easy "recovery," my friend.

le_wren

[notneils]

Neil, if you do spend a lot of time on your bicycle, that can be a concern. When i was doing a long commute (2 hrs/day) i was having a lot of numbness and tingling in my hands. The fix was as simple as getting different shaped grips on my handlebars, which cost me all of $30. Any decent bike shop should be able to help you (and while we're at it, these days i'm on different shaped handlebars on account of my back, lol).

I do have a friend, a guitar player, struggling with arthritis. He had a luthier change the setup on his guitar to make it easier on him (easier action, etc). So if your problem turns out to be chronic, you may want to see about that (or a different style mandolin that gives you a different playing position, or a strap or sitting down, etc).

Best of luck!

[TonyP]

I wish you the best of luck Neil and that you find the right practitioner that can effect a cure. Being without music sux.

There have been some things said that I found on my own that I would like to repeat. Having lived off working with my hands all my life being a mechanic ,fabricator, and partime musician, I started to have problems with stiffness and numbness. Like Robert and Steven, I put two and two together and realized when I slept on my hands and made them go to sleep, even though it would go away when I got up, if I played or did certain things it would come back. It would seem as though the numbness would come out of nowhere. but when I thought about it, it was when I would hold my hands a certain way when I slept on my side. My cure was to basically hug my pillow and that would keep my hands from getting under me. I also tried getting back on my mountain bike, and even with special gloves and special grips I had to give it up. Too much pressure on my hands causing numbness. So I've gone to a recumbent tadpole trike. If they would have had this when I was younger, I don't think I ever would have messed with a regular bike. It's always been a fight between which was more uncomfortable, my hands or my rear. Now neither and I have no more numbness, ever.

I also suffered one of the most excruciating pains in my life when I was working long hard days and ended up pinching a nerve in my neck. What came out of that was that 40yrs of working on things where I looked down at everything, repairing cars, welding/fabricating etc. had taken the natural bow out of my neck. Nothing a doc could give me, no amount of pain pills, massage or chiropractic would dent it. I didn't sleep for 4days. And every time I lay down it got worse. Finally someone told me of an acupuncturist who was new in town and was directly from China. Now for me, there is no worse thought that having somebody put needles in me. But I was desperate. So I went. I had to sit up, next to the table because I couldn't lay down. After 20min I had almost all of my movement in my neck back(I was almost frozen, could not turn my head, could barely look level, and could only look down) and the pain was greatly diminished. Enough that I could lay down and sleep. Went back two more times that same week and have been ok for almost 10yrs since. I was extremely lucky to find her as there are a lot of folks who shouldn't be doing this kind of work. And even luckier that after I moved my wife found a local woman who is close to the equal of the Chinese woman. So I'm much more vigilant now and when I start having a bout I go see her. Usually once every year or two if I'm working too much and not keeping up with my stretches etc.

I don't know if any of these things are relevant to your situation, but one thing is. Observing what caused the problem. And I think that's what all of us are trying to relate. There's nothing worse than seeing another musician who taken out of the action.

Another thought was, you play sessions right? My take on a mandolin at a session is like taking a knife to a gun fight. And your pic looks like you play a pancake oval hole mandolin. I would think you would really have to thrash any mandolin to be heard and that makes me play too hard and if I don't watch it, I come away hurting from those kinds of jams.

best of luck.

[Beanzy]

Another thought was, you play sessions right? My take on a mandolin at a session is like taking a knife to a gun fight. And your pic looks like you play a pancake oval hole mandolin. I would think you would really have to thrash any mandolin to be heard and that makes me play too hard and if I don't watch it, I come away hurting from those kinds of jams.

Oh I see where this is going!.
Now we're getting down to some really proper good old fashioned Mandolin Cafe advice........... 'you really need to buy another mandolin lad. That'll get you sorted out in no time'

See the MAS is always lurking under the skin waiting to flare up :))

[Phil Goodson]

Would you ask your doctor about how to adjust your mandolin? No?? Then why ask mandolin players how to fix your orthopedic problem. Get to a specialist and get diagnosed and treated.

[neil argonaut]

Thanks again for all the advice and sorry for the late reply due to being in a massively different timezone.
I had to use my bike yesterday and was careful to observe the effect, and I've decided to give it a miss for the time being and stick to public transport / walking.
Swimming I'll look into, could be a good way to fill some of the excessive time I have now.
No, I don't need to update my mandolin, merely my profile. I long ago moved from that mandolin to a "the loar" and then to a national resonator rm-1, and if anything my main problem in a session is being too loud! On both I've had the action made low and spent time trying to get height/strap length/angle of neck etc right, so don't think my problem lies there.
Phil, I can see what you are saying, but don't see this as an alternative to other advice but an addition. I've already got so much advice here, from people experiencing the same problem with the same instrument, whereas it's unlikely I'll see any doctor / therapist who's dealt with problems from mandolin playing before.

[nickster60]

Neil it isn't just mandolin players, I also play the violin. My condition is much worse playing the violin. Supporting the neck and having your hand facing upwards can be very challenging. If I play for any period of time my hand is completely numb. Viola players are especially effected, they have the same hand position but it is a stretch between notes. If is a problem that is pretty common with musicians.

[Randi Gormley]

Another addendum, if you drive a car. The hand position on the steering wheel also needs to be noticed. I had to change the way I held onto the steering wheel (I commute to work so I spend a lot of time sitting in traffic) because it was making my hands numb. I got lucky and my carpal tunnel eventually calmed down enough to let me play regularly -- but I have been mostly playing my Eastman, which has a narrower neck than the strad (my used-to-be gigging mando).

[DGW1945]

Just read this post..Please do not take NSAIDs (Non Steroidal AntiInflammatory Drugs), together! In a simple explanation, they "cancel each other's effect" as well as causing other problems. You can take acetaminophen (generic Tylenol) with any of them as it is not a NSAID. Talk to your Pharmacist or Physician about any OverTheCounter medications you take, especially if you take prescription pain relief medication.

[stevedenver]

neil-they've said it all-a good doctor to evaluate-and REST. I can only relate my experience, and will do so.

I am suffering trigger finger for the second time. First incident (mid spring 2013) was my left pinky. I rested seven months from using the pinky at all while playing mandolin. I now am dealing with my left ring finger, which must have done double duty for the resting pinky. All due to my mando enthusiasm. Never had this in forty years of guitar.

I too found, mistakenly, that I could play, and, after say forty minutes, I would have 'no symptoms' and full mobility, ie it loosened up a lot. This worked for awhile, as I tried to 'work through it". It doesn't help, and this wont help one heal. I also tried massaging the sore area, and it didn't help, but im not a pro.

I decided to stop playing, as my finger/hand, was slowly getting a bit more tender every morning, and a bit less flexible upon rising.

So, I am in the second full week of not touching my instruments, not gripping heavy things, not lifting weights, and, riding my bike with caution and on fairly flat and predictable routes (to avoid needing to grip strongly or suddenly). I have decided not to touch anything, until mid june, at the earliest (7 weeks to start) , provided I have had no stiffness for some time. I may take much longer.

I made my wife shift the palette of garden mulch (as I did this once two weeks back to unload the delivery and could feel it the following day-bags aren't that heavy, but too heavy for my condition right now. I was able to do it easily, but felt it later, uncharacteristically so. Iit was the decisive factor im making me deal with needing to completely rest).

I take about 4 ibuprofen, twice daily, after lunch and breakfast. This has helped, but I will nto continue this too much longer.

I am seeing/feeling results. I have no pain, and much greater mobility, and now can close, fully, without it 'seizing'. Still a touch sensitive upon rapid full closure. I can shampoo my hair without it feeling 'touchy'.

As stupid males, you being more stupid than I due to your age and I presume, impatience and likely higher testosterone.... (as I was and still am extremely impatient with illness or injury) you have to rest, fully, and as wisely mentioned above return to 100% for a few weeks before you start again. The risk is that if you don't rest, it can become chronic and a larger problem, as I understand tendon things.

fwiw, I consulted with a surgeon for the pinky, became informed, but, his only solution was surgery. I proved him wrong, (obviously I could always have surgery if it didn't heal) as I have zero issues with the pinky (which was the first offending digit). Lawyers think in terms of lawsuits. Surgeons, well you get the picture....

I am no doctor, but I can tell you this: I am fit, I am over fifty, I play 2-3 hours daily and also with a performing band twice weekly on top of being a lawyer. My playing has all come to a halt. I quit the band without a specified return date. I didn't want to feel any pressure to start before I was ready.

This arose from over-doing my playing at a long loud jam, playing way too aggressively for over three hours. My point in the story is that I could feel my hand begin to fatigue and then ache slightly after that jam, something that has never happened in over forty years of playing. I knew I had strained my pinky, and I believed , as with any other muscular injury, it would heal with time. It did, it takes absolute rest, imho. The ring finger, is simply from playing too much, too long at ffCp exercises and Aonso exercises, trying to compete with a banjo and guitarist that don't understand dynamics. You have to rest.

This means not gripping even modestly heavy stuff, leaving your instruments completely alone.

(I de-tuned all of mine to avoid temptation for a 'quicky'-"hey I like that tune. wonder what the chords are?" "ill just use two finger chords", "ill just use an open tuning" etc).

It is mentally tough to break a love and habit. I am suffering mentally from this break, but healing.
Resting will do no harm. I began to feel a slight improvement this second week, but it is unmistakable.
I wish you well. These things take much longer than post hike, post weekend warrior soreness.

[neil argonaut]

Cheers steve for that in depth reply; I've been meaning to jump back on this thread anyway to update my progress. I went the whole of november and december, hard as it was, without playing music, and saw some degree of improvement. However, after that I joined a band, and am gigging between 1-4 times per week, and am gradually seeing my hands get worse. I've been trying to rest as much outside that, and warm up properly, stretch plenty, and have spent a lot of time trying to work on hand position / playing lighter etc. Steve, yeah, I know what I really need is a rest, of maybe 6 months or so, but unfortunately that isn't an option at the moment. It's not just me being hard headed and stubborn, I would quite willingly give up for 6 months if it would benefit my playing / wrist health in the long run, but unfortunately at the moment all rent, bills and food are being paid for by gigging, so I'm going to have to struggle on with it.

[stevedenver]

well neil, I understand.

in attempting to help with more viable solution, first, do whatever you can to reduce effort.
Consider lighter strings, maybe even tomastiks-i find they have lower tension and are easier on the hands.

Second, while I don't know what genre(s) music or other instruments you play, but assuming mando, if you are playing for 'color' and backup or melodic leads, consider too, slide. I found that slide worked well for me, as it does not require a grip, but a light touch and more or less straight fingers. It is , however, its own and somewhat limited or at least unique sound. I play slide on mando, and its ok, but tougher due to quick decay of the notes.

Obviously if youre playing irish music or classical, etc, its hard, if not impossible, to 'fake it'.

I read that joni Mitchell, who had polio as a child, had weak hands, and as a result, she used and invented many open tunings to compensate for not being able to reach/chord as she might have otherwise.

While I obviously don't know exactly what or where you are suffering, hands and/or fingers
I might suggest to you, if you are able, to try using open chords /tunings, and modify you playing to use perhaps two fingers? also consider fancier right hand technique such as cross picking, etc to add interest without fancy fingers. I would use a capo shamelessly too. Many many of the finest players used open tuning, besides Joni, Lonnie Johnson, Robert Johnson, pierre bensusan, Michael hedges, etc., etc

here is a gift to you, a favorite site of mine and inspirational-

http://warrenallencom.ipage.com/waguitartunings/tunings.htm

these may seem daunting initially, but, I have found that trying some of the more mainstream tunings , and taking a week or so to really work them can result in some superb sounds, and often with minimal fingering.

as for mando, I have only used maybe 4-5 open tunings, and they work well. do a search here for that thread for a variety of tunings. it is harder on mando imho, to use open tunings , but they can work. whats nice is that often they work with one finger strategically placed (on the mando!!!LOL) either droning a melody or barre, etc

I wish you well and a speedy recovery.

I hope others may try to think outside the box for you too.

[Al Bergstein]

Neil, have you seen a Doctor and what did they think? Given that you have had this for over six months, it's not likely to improve from ice at this stage. The question in my mind is does a doc think this is early onset arthritis, or some other kind of ongoing joint inflammation, or is it muscular (perhaps indicative of something deeper at work), or is there a bone spur that might be affecting things, which could be operable.

It might really be worth spending the money on an MD or an Ortho MD to find out what they think is the root cause. I have some issues, not in my hands, and it's really inoperable so I just rest more and take Ibuprophin, which does the job temporarily.

Another thing you might try, curcumin supplement (Phenocine) which is a natural inflamatory. It's available in coops and supplement stores. It actually worked pretty well for me when I had tennis elbow and also a gig. I took a pretty high dose, and my elbow pain went away for about two days. It's not a panacea, but it might work for you temporarily.

Good luck.

[neil argonaut]

Steve, thanks for the suggestions; i will continue to think about using alternative methods of playing things, but using slide or open tunings isn't really an option for me; i'm playing a combination of traditional irish stuff, and bluegrass (chop chords, improvised breaks, fiddle tunes), and even for the chords, if anything open tuning would make things tougher, as I find a bluegrass G shape more comfortable than barre chords; and for fiddle tunes, they're fast enough that no matter what tuning is used, fingers will be flying on and off the fretboard fast. As for cross picking etc, i'll have to look into that, but if it requires holding down chords while playing fast with rh it might actually be tougher and require more lh finger strength, though would mean retaining contact more instead of hammering onto frets so might be less damaging.

[neil argonaut]

Neil, have you seen a Doctor and what did they think? Given that you have had this for over six months, it's not likely to improve from ice at this stage. The question in my mind is does a doc think this is early onset arthritis, or some other kind of ongoing joint inflammation, or is it muscular (perhaps indicative of something deeper at work), or is there a bone spur that might be affecting things, which could be operable.

It might really be worth spending the money on an MD or an Ortho MD to find out what they think is the root cause. I have some issues, not in my hands, and it's really inoperable so I just rest more and take Ibuprophin, which does the job temporarily.

Another thing you might try, curcumin supplement (Phenocine) which is a natural inflamatory. It's available in coops and supplement stores. It actually worked pretty well for me when I had tennis elbow and also a gig. I took a pretty high dose, and my elbow pain went away for about two days. It's not a panacea, but it might work for you temporarily.

Good luck.
Well I'm fortunate enough to live in a country where seeing a doctor is totally free, so have seen a doctor, a physio and an ortho; the doctor seemed to know little about it but said it couldn't be early onset arthritis as i'm in my early 30's, the ortho took an x-ray and said there was no problem with the bones and the physion gave me stretching exercises to do, which I've been doing regularly, and said I could keep playing, just try not to overdo it, and it should get better with time, which it doesn't seem to.
From all that I've read on the subject, it seems that inflammation is probably not the major issue if it's continuing for months and months, and that would tie in with the fact that iboprophen doesn't seem to make a difference.

[Pete Martin]

You should get to a hand doc if you haven't already. Get a diagnosis from a professional. If you can find a performing arts doc, even better.

Sometimes you just have to rest a good long time. I used to practice 10-14 hours a day. Eventually I required almost 3 years off before I could play again.

[TonyP]

I wish you continued good luck Neil. The first part of this whole thing is know your own body and be conscious of your actions, circumstances along with the reactions and consequences.

I'm really glad you have an open mind. As you can see all of us have had to struggle to keep playing and most times had to figure it out on our own because the professionals were stumped. Personally I'll do anything not to get medicalized because I've had such bad experiences with it. But it's a good place to start and it sounds like you've pretty much gone that route. Don't let it get you down. We all figured out what was getting to us, I'm sure you can figure our what's going to fix you.

I did notice a lot of my friends seemed to be going through the same things I was going through at the same time of our lives. I often wonder if it's hormone changes or what. But we all worked it out.

There were two supplements I took that really helped with my joint pain and stiffness. MSM and glucosemine/chondrotin. I find it interesting it was used in animal husbandry(especially horses) before showing up on the shelves of pharmacies. MSM is mostly for inflammation and g/c helps with fluid in the joints. I took both for several years and my symptoms went away. I've not had to take either for several years but every once in a while my middle finger on both hands will start having a hitch in them, and I'll start back and it goes away. All my friends who went with cortisone shots when I went to my stuff are still needing shots. YMMV.

[dang]

...but unfortunately at the moment all rent, bills and food are being paid for by gigging, so I'm going to have to struggle on with it.

Nothing quite like living the dream!

[Don Grieser]

Other anti-inflammatory supplements you might look into are turmeric (concentrated capsules at a health food store), fish oil, and flax seed (grind it fresh daily). I've had the cortisone shot, and it hurts like hell and takes a couple weeks to really work. The combination of the shot and the supplements seem to have fixed my problem to some degree. A recent long jam (6 hours or more) led to pain the following day though, but the trigger stuff didn't come back. Hand was fine in a day or two. I play a lot on my days off work and never have any issues. Still have to do the country stuff like unloading bales of hay and chopping wood--I'm just very careful when I have to do those things.

[9lbShellhamer]

After one year of very solid practice averaging 10-12 hours weekly, my picking hand developed DeQuervains Tenosynovitis. A 10 hour jam locally was the straw that broke the camels back so to speak.

I played through the pain for a week and it just got worse. I finally took off several weeks, COMPLETELY. I wore a thumb-spica brace as the injury is from thumb extension. I feel your pain...taking off 6 weeks. Wow. Bummer...gosh. I'm a cyclist too and same age...lots of similarities.

I healed shortly thereafter but don't know how long it would have dragged on without wearing the brace and taking those weeks off completely.

I thought it was a much bigger deal at the time. In actuality, it made me free up some tension I was carrying and I'm better from it.

I wish you the best in your recovery. I hope you find yourself making some type of music or working on vocals in the meantime. Best...

I might mention...I'm DEFINITELY not advocating playing before you're better, but one thing I did which made me feel better, was WITH the brace on, I strummed the guitar with my fingers. It got me playing and singing and I didn't have to use my thumb at all. It was my saving grace. It wasn't mandolin, but at least it was something, and working on my vocals were Looong overdue.