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Thread: CMC joint arthritis (no mandolin content)

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    Default CMC joint arthritis (no mandolin content)

    I have worsening arthritis in the CMC joints at the base if both thumbs. At this point I'm considering surgery as a possible remedy. I'm wondering if anyone here has had this surgery & could help me understand what to expect. I'v already had steroid injections in both joints, but the relief was temporary. As long as I don't do much intensive hand work all is pretty good, but if I do much of anything in the shop, the pain returns. I would sincerely appreciate hearing about anyone's experience in dealing with this kind of problem.

    Thanks - Earl Tyler

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    Mediocre but OK with that Paul Busman's Avatar
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    Default Re: CMC joint arthritis (no mandolin content)

    My wife had CMC surgery. The most common procedure involves reconstructing the joint using one of the nearby tendons. You'll need patience as recovery is slow, but pain relief is excellent. There are other procedures involving artificial joints or implants which actually heal faster but I have no first hand (no pun intended) knowledge of those.
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    Default Re: CMC joint arthritis (no mandolin content)

    Thanks, Bill, for your response. From what I've learned from online research, the procedure you described seems to be the most common. I understand that recovery time is about 3 months, for each hand. The implants, it seems, don't have a good track record to date. I'm wondering whether post-surgery I'll have the strength to continue with shop work & all the other chores I need to do, even if the pain is relieved. I figured that it might be helpful to ask my questions here since I engage in some of the same activities as other members.

    Thanks - Earl

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    Default Re: CMC joint arthritis (no mandolin content)

    I had the same problem. I got some glucosamine gel, added 5% by weight allantoin and rubbed that on the joints. It worked wonders. Sometimes they get painful from overuse - then I use the gel mixture 3 times a day and rest them for a couple of days. Then I can carry on.

    The ingredients are inexpensive and easy to get (on eBay or in your local drugstore). Worth trying before you commit yourself to surgery.

    I have no experience of the surgery but was told that it gets rid of the pain, but leaves you with a weak grip. (That's in UK - procedures in US may be different.)
    Mandolins: Bandolim by Antonio Pereira Cabral
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    Default Re: CMC joint arthritis (no mandolin content)

    Thanks, Tony; I appreciate any help I can find. I'll search for the ingredients online & see what I can find. I'm not at all excited about the surgery route. My biggest worry is that it might be just as you suggested: pain relieved but not able to do what I need & want to do.

    Thanks again - Earl

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    Default Re: CMC joint arthritis (no mandolin content)

    You might like to take a look at this thread too https://www.mandolincafe.com/forum/s...thritic-joints
    Mandolins: Bandolim by Antonio Pereira Cabral
    German flatback by unknown maker converted from a descant Waldzither

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    Default Re: CMC joint arthritis (no mandolin content)

    I’ve averted surgery by using DMSO. It actually unlocked my left pointer finger.

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    Default Re: CMC joint arthritis (no mandolin content)

    Same problem just hit me after I started intensively practicing my 4-finger chop rhythm chords.

    I think it's because I was rhythmically squeezing the neck between my left thumb pad and fingers to dampen the strings, which put my thumb at a bad angle and put stress on that CMC joint and tendon.

    Now I realize that there's no need to do that. Just moving my fingers down to dampen the strings is a much simpler and more efficient motion that uses different muscles (the ones running down the back of my L hand and forearm) and has less chance of aggravating my CMC joint.

    I only hope I haven't done any permanent damage to my joint. I rested today, I've been icing it a lot, and I sent away for a thumb splint and some Penetrex pain relief cream (glucosamine, chondroitin, etc.). I'm going to see what it's like playing with my splint on, to keep my thumb in a neutral position but (I hope) still let it glide up and down the back of the neck as it's supposed to.

    And no more chopping for me for a while! (Sorry, Mr. Monroe...)

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    Default Re: CMC joint arthritis (no mandolin content)

    Call me Gina, the other action of DMSO, besides its anti-inflammatory analgesic properties, is that it carries along other medications when it penetrates the skin into the joint. Kind of a carrier. Might ant to add this to your local ointments to make them penetrate a bit better.

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    Default Re: CMC joint arthritis (no mandolin content)

    Hi Earl, my husband had this surgery last October. The surgery and recovery went well and as of this writing he said he feels he's regained about 90% of normal. By early summer he was able to row his raft and do all the other things that were causing pain/weakness prior to surgery.

    (I'm quizzing him as I'm typing...) He says his strength is back, pain is gone and he's happy he did it. Just make sure the Dr. you select is skilled/experienced in the procedure. We ended up going to a larger city about 5 hours away for the procedure.

    PM me and I'll put you in touch with him.
    Last edited by bigskygirl; Oct-02-2018 at 4:39pm. Reason: add'l info for OP
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    Default Re: CMC joint arthritis (no mandolin content)

    Thanks to all for helpful replies. I went to see hand surgeon yesterday, Dr. Douglas Calhoun in Knoxville TN. After a lengthy discussion we decided to go with injections in both hands again & wait until after the first of the year to consider surgery. Today my hands are much improved; I'll have to see how they do over time, esp when I get back to the shop. Also I ordered some glucosamine gel to try out. I'm still hoping to avoid surgery altogether!

    Bigskygirl - I'm glad your husband did well with the surgery & is satisfied with the result. Did he have the LRTI procedure in which the trapeziun is removed & the space filled by a tendon from the forearm? What concerns me most is not the surgery itself, but the long recovery time.

    - Earl

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    Default Re: CMC joint arthritis (no mandolin content)

    Quote Originally Posted by bigskygirl View Post
    Hi Earl, my husband had this surgery last October. The surgery and recovery went well and as of this writing he said he feels he's regained about 90% of normal. By early summer he was able to row his raft and do all the other things that were causing pain/weakness prior to surgery.
    How is his recovery with respect to fine hand skills? Grip strength? Finger and thumb meeting correctly? Rowing a raft is one thing, recovering the ability to do luthier skills like Earl is another.
    Earl-- the injections are a good start. They may keep you in shape for quite a while. Once they don't, get the surgery and deal with the recovery. CMC arthritis doesn't get better. In the long run it just gets worse.
    For wooden musical fun that doesn't involve strumming, check out:
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    Default Re: CMC joint arthritis (no mandolin content)

    Hi Earl, he did have the procedure where they take the 2 bones out and replace with tendon. As for recovery he said yeah while it’s about a year for full recovery after the initial 3 months of casting/splinting and very limited activity the PT gets going and he got his strength and dexterity back very quickly (he avoided shoveling snow all winter...ha). He said according to the gripometer thingie they have at the PT he’s back to 96% strength. By early summer he was able to do all ADL but strength was still an issue. Now, he says he mostly can’t tell the difference and at some point will probably have it on his other hand.

    Hi to you too Paul, he said his fine motor skills are good but he doesn’t do things like put a truss rod cover screw in, his thumb finger closure is good and he says he doesn’t really have any issues with dexterity, he does a lot of fly tying without issue.

    He’d be happy to talk to either of you or anyone else who’d like some firsthand (ha, pun intended) knowledge.
    Northfield F5M #268, AT02 #7

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    Default Re: CMC joint arthritis (no mandolin content)

    I just had CMC thumb arthoplasty surgery this week. My left hand was becoming more and more painful the more I played my mandolin (especially chords). All went well--I am typing this now with both hands. In two days I will get a new cast which will stay on for 3 weeks and then physical therapy. The pain was bad the first 48 hours, but is steadily improving and I'll be going back to work soon. I felt I had to have the surgery because playing--my great passion--would have become too difficult. I have a wonderful hand surgeon who has also done my carpal tunnel surgery. I'd recommend it, but it may not be for everyone.

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    Default Re: CMC joint arthritis (no mandolin content)

    Thanks, Leslie, for the report on your surgery. It sounds like you are doing quite well! I have been afraid that the surgery would be debilitating for a long while, but your experience thus far seems to negate that notion. I hope your recovery will be swift & complete! Please keep us posted on your progress.

    I have decided, for now at least, to put the notion of surgery on the back burner. My wife has developed health issues that make it necessary foe me to be able to care for her at least in the near future. I had injections in both CMC joints last week, but I'm not entirely convinced that they really help much.

    -Earl

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    Default Re: CMC joint arthritis (no mandolin content)

    Quote Originally Posted by Earl View Post
    Thanks, Leslie, for the report on your surgery. It sounds like you are doing quite well! I have been afraid that the surgery would be debilitating for a long while, but your experience thus far seems to negate that notion. I hope your recovery will be swift & complete! Please keep us posted on your progress.

    I have decided, for now at least, to put the notion of surgery on the back burner. My wife has developed health issues that make it necessary foe me to be able to care for her at least in the near future. I had injections in both CMC joints last week, but I'm not entirely convinced that they really help much.

    -Earl
    Earl
    I see you are in east Tn. There is Dr Green in Bristol Va that does acupuncture/chiropractic:
    Wiley A. Greene, DC
    1914 Euclid Ave, Bristol, VA 24201
    (276) 642-0107

    I used him around 10 years ago for this. I only have the left thumb issues. I did 3 visits for the 1st week, 2 visits for following 2 weeks, then 1 visit per month for 3 months, then i would only come back when i felt the least bit of pain coming back. usually every 6 months. Its actually been 3 years since i've had a visit. no pain, good movement(before getting the acupuncture, the left thumb would lock into a position, the base was always sore, always, limited grip due to the pain). i'm careful not to stress that thumb and it works fine. I never feel an issue. I never did any type of injection. His cost was $40 per visit if memory serves(that included i very extensive chiropractic adjustment-and it was excellent).

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    Default Re: CMC joint arthritis (no mandolin content)

    Thanks, Daryl; that's a potentially interesting approach that I had not even considered. I'm on the edge of the Plateau in Cumberland County so it's a bit of a drive to Bristol, but the distance is not totally prohibitive. Unfortunately, though, I cannot leave my wife for any extended periods right now. Perhaps that will be a possibility when she has recovered in a few months. Thanks again for the tip.

    - Earl

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    Default Re: CMC joint arthritis (no mandolin content)

    Thanks Earl for your kind words. I went for my post op visit today and a new cast was put on which I will wear for three weeks. The cast gives me more dexterity and less pain. I haven't tried playing mandolin yet; not sure how that might work but if it doesn't I plan to work on some right hand techniques. As I said the surgery isn't for everyone, but the pain I was experiencing was too debilitating. From what I have read it takes a good 3 months to get back to normal. I will let you know if this is accurate! I hope your wife does well--sounds like she is lucky to have you. Leslie

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    Default Re: CMC joint arthritis (no mandolin content)

    Quote Originally Posted by Earl View Post
    Thanks, Daryl; that's a potentially interesting approach that I had not even considered. I'm on the edge of the Plateau in Cumberland County so it's a bit of a drive to Bristol, but the distance is not totally prohibitive. Unfortunately, though, I cannot leave my wife for any extended periods right now. Perhaps that will be a possibility when she has recovered in a few months. Thanks again for the tip.

    - Earl
    ah, I was assuming you meant east tn as in Kingsport/Johnson city. check around your area for an acupuncture practitioner. be warned that all who hang a shingle are not of the same ilk. reach out for recommendations. if there are any naturalpathic doctors in your region they might know someone.
    Dr Greene told me from the start that if it was going to help/work, I should notice some benefit within 3 treatments. thankfully that left thumb base reacted immediately, it felt great soon as I left his office, and continued to improve with each treatment. of course the osteo is still there(along with a knot area), but the movement returned, and there was no pain associated with that area unless I overused it or bumped the knot into something. years later, it has not progressed and maintains the good movement and no pain-but, I'm careful how I use it and I keep very low actions on all my instruments. that's one huge reason I learned to set up my own mandolins, so I could achieve the lowest easiest action possible. I also avoid using my left thumb much at all with fretting, its more just a glide behind the neck.
    best of health to you and I hope you find something that works great for you-I know your pain, literally
    d

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    Default Re: CMC joint arthritis (no mandolin content)

    I am developing the same thumb problems- did any of you try switching from medium gauge strings to light, and did it ease any pressure on the thumb?

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    Default Re: CMC joint arthritis (no mandolin content)

    Quote Originally Posted by Curt Palm View Post
    I am developing the same thumb problems- did any of you try switching from medium gauge strings to light, and did it ease any pressure on the thumb?
    Curt, I had this issue before I started playing the mandolin last year (it could have been aggravated by years of the guitar when I was in my teens and 20s. I use light gauge strings normally, so I don't really have a good answer for you. I know that before the surgery my hand would throb after practicing. Chords are especially difficult.

    Good news, I practiced mandolin yesterday WITH my cast on! It was a little awkward, but I had to try. There was no pain at all. I hope that is a harbinger of what lies ahead.

    If you want to avoid surgery, I would try to find a good hand doctor who will prescribe hand therapy. It helps quite a bit. The therapist can tailor exercises for your specific issues (aka playing your mandolin). Good Luck! Leslie

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    Default Re: CMC joint arthritis (no mandolin content)

    Curt, I can't address your question directly either. My hands have bothered me most working in the shop building instruments, or any other kind of hand-intensive work, for that matter. I do get some pain while playing, but so far that has not been my primary concern. I haven't been able to spend much time in the shop lately so my hands have not caused as much trouble. I still get occasional "shooting pains" that make me wince & make my wife ask "what's wrong?" But right now I'm not inclined toward surgery. Daryl has recommended acupuncture & chiropractic, & that is interesting, maybe when my wife is on the mend.

    - Earl

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    Default Re: CMC joint arthritis (no mandolin content)

    Thanks for your replies. I think I’ll experiment with light gauge strings and check into chiropractic & acupuncture too. The dr in Bristol VA is about 4 hours from me, so I might try him if I can’t find someone in NC. I appreciate everyone’s help and I hope your wife’s health improves, and Leslie, it sounds like a promising recovery.

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