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Thread: Finger joint fusion?

  1. #1
    Registered User John Rosett's Avatar
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    Default Finger joint fusion?

    I've been dealing with arthritis in my fingers for about 15 years now, and while it's cut down on my speed and accuracy some, I've still been able to hold my own with the Gypsy jazz group I play with.
    Over the past couple of months, I've been having increasing difficulty with the distal joint in my right index finger, caused by the impact of the pick striking the strings. I take a prescription anti-inflammatory, turmeric, and fish oil, as well as a CBD cream, but that doesn't seem to help much. I went to the hand doctor, and had X-rays that showed a couple of serious bone spurs, as well as an almost complete lack of cartilage left in the joint. I got a steroid shot, which seemed to help for a short time, but last weekend I played two 2 hour gigs, and then jammed with a friend for another two hours. After that, I could barely hold the pick, much less play. I have tried holding the pick with my middle finger instead, but that one is almost as shot as the index finger.
    My doctor has told me that if the steroid injections don't work, my choices are: deal with the pain, or consider joint fusion surgery. He told me that They could set the joint to the position I use when I hold the pick, but the idea of a surgery like this scares the crap out of me, especially after reading a couple of horror stories about joint fusions that failed.
    So, I'm looking for some advice from anybody going through this kind of finger trouble, and/or anybody that's had a finger joint fusion surgery. Thanks!
    "it's not in bad taste, if it's funny" - john waters

  2. #2
    Registered User John Rosett's Avatar
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    Default Re: Finger joint fusion?

    Okay, I guess I'm all alone on this...
    "it's not in bad taste, if it's funny" - john waters

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    harvester of clams Bill McCall's Avatar
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    Default Re: Finger joint fusion?

    Second opinion perhaps? Have you checked the availability of hand surgeons specializing in musician injuries? May not be in Missoula.

    Tough road in any case. Good luck.
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    Registered User sblock's Avatar
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    Default Re: Finger joint fusion?

    Well, speaking in general, bones spurs (if these are the problem) can sometimes be trimmed with surgery, but if the loss of cartilage is the real underlying problem, then there exists no practical way to get that cartilage back. The resulting bone-on-bone contact within the joint, stemming from the cartilage loss, often causes pain. This is osteoarthritis. You can read all about osteoarthritis on the web, if you haven't already. It's usually age-related, and there is a genetic component. That said, no one except a qualified physician should give you any medical medical advice about what you should do for your condition.

    As you've already learned, a common treatment for osteoarthritis is with steroids, which serve to reduce the inflammation temporarily -- when they work. If steroids stop working (and they often do), then the pain returns. You can try to manage it with painkillers and the like, but the joint will usually continue to deteriorate with heavy use. As Bette Davis famously said, "Old age ain't no place for sissies!" Amen.

    To the best of my knowledge, there's no cure for osteoarthritis. It's flat-out tough, and you have all our sympathy. But rest assured, you are not alone.

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    Default Re: Finger joint fusion?

    I know of no one who has had a finger joint fusion. Sorry, I am no help. But I have sympathy for the joint pain, the older I get, the more my joints hurt, especially when the weather changes.

  7. #6

    Default Re: Finger joint fusion?

    Not alone, indeed. I can't speak to the specific issue at hand ( ) but I can certainly empathize with the struggle. I had to give up my instrument (classical/flamenco gtr) 10 years ago due to arthritis (they say the thumbs are the first to go) and instead have to play others.

    Still, I'm thankful that I can still play music. Or rather, the music play me.

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    Registered User Ranald's Avatar
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    Default Re: Finger joint fusion?

    I've found using thumbpicks, i.e., flat picks that fit on the thumb, quite helpful for my arthritic thumb, though perhaps not for yours. My favourites are Black Mountains, with a spring that holds them in place, and next are Hercos. I haven't run across any miracle creams, but I use over-the-counter arnica gel and Voltaren, which I understand is a prescription drug in the USA. They provide relief, but the fact that I use both tells you that they're not fabulous, just something else to try. As someone said, you have plenty of company among the olds timers here. I hope you find something that works for you. Good luck.

    https://blackmountainpicks.com/
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    Default Re: Finger joint fusion?

    I had torn ligaments in my right thumb about 16 years ago. I went to a local “orthopedic hand specialist” who recommended a fusion. I then went for a 2nd opinion. I saw Dr Ray Wittstadt at the Curtis Hand Clinic in Baltimore. He’s a surgeon who specializes in musicians hands. He, and one other surgeon examined me. They recommend surgery - cut open the joint and tie the torn ligaments back together, a common surgery at Curtis. They also said a fusion would take away the pain...BUT it would shorten my thumb by 3 mm, and leave me with no joint permanently. They told me that a fusion is a last resort, and only used to avoid amputation after a trauma, such as a car accident.
    Wittstadt did the surgery and I played a show 5 months later. I’m still good.
    I’m only passing on my own experience. I’m no medical expert.
    Bob

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    Default Re: Finger joint fusion?

    Here’s an article about the Curtis hand center. Scroll down just a little and click on the video. Dr Wittstadt speaks about musicians hands at about the 24 minute mark. The whole video is good information....even if you can’t go there.
    https://www.medstarunionortho.org/sp...l-hand-center/

    Bob

  11. #10
    Registered User GrooverMcTube's Avatar
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    Default Re: Finger joint fusion?

    Thumbpick might be the answer?

    I picked up a couple (actually 3) a couple of weeks ago from Black Mountain Picks (NFI).



    Everyone needs a gimmick and theirs is that the part that goes around your thumb is spring-loaded (with a fairly gentle spring). My problem with finger picks is they are hard on the cuticles and painful after a bit. This pick seems pretty painless so far. They'll probably end up in the pick jar, but if it's a choice of surgery or spending $7 on a pick...

  12. #11
    Registered User John Rosett's Avatar
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    Default Re: Finger joint fusion?

    Thanks for the info, etc, everybody. I use a thumb pick when I play steel, and I've experimented with on the mandolin without good results. Maybe a different one would work better, like suggested above.
    "it's not in bad taste, if it's funny" - john waters

  13. #12

    Default Re: Finger joint fusion?

    Good luck John. I have the same issue with pick/plectrum and why I also cant play much mndln either. It's a bummer.

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    Default Re: Finger joint fusion?

    If you are playing acoustic putting a pickup on the mandolin and playing softer will help. Playing less hours at a time will also help. I have different problems, but how hard I play makes a real difference for me. There are times when I have to play acoustic, and I focus on not playing so hard.
    THE WORLD IS A BETTER PLACE JUST FOR YOUR SMILE!

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    Default Re: Finger joint fusion?

    Stem cell injections could be worth looking into. Experimental and costly, so it would be a gamble. I live in the world of uber athletes who perform well into their 80s (I'm not one of them, mind you, I just live here in Colorado) and a lot of people say its the only thing that has worked for them (knees, shoulders, etc). I know nothing about its effectiveness for fingers.

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    Default Re: Finger joint fusion?

    In the late 40s, Les Paul was involved in a serious auto accident in Oklahoma. His right arm was shattered and the doctors told him his guitar-playing days were over. He wasn't ready for that so he had doctors in Los Angeles form his arm at a particular angle at the elbow to allow him to continue playing. It was set at slightly less than 90º to allow him to both hold and pick the guitar. I'm not a doctor but I'd say the operation was a success.
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  18. #16
    Registered User John Rosett's Avatar
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    Default Re: Finger joint fusion?

    Like most people, I've had all my gigs cancelled for at least the next six weeks or so, and it's giving me some time to rest the offending digits. I've also discovered that if I kinda squeeze my index finger with my middle finger against my thumb and pick, it doesn't hurt as much.
    "it's not in bad taste, if it's funny" - john waters

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    Default Re: Finger joint fusion?

    My next suggestion was to play in a fist supporting the 1st finger with the middle. I usually play with my fingers open, but have gotten where I can do either and playing with a close fist helps support that first finger a lot.
    THE WORLD IS A BETTER PLACE JUST FOR YOUR SMILE!

  20. #18

    Default Re: Finger joint fusion?

    Don’t do the surgery until you try liquid Magnesium for six weeks.

    I had problems tucking my little fingerS because I broke them multiple times catching football passes as a kid. I went to an Orthopedic clinic to be evaluated for fusing it out of the way on my right hand. The clinic specialized in musician hands, and they recommended surgery. I told a friend about it and he suggested Remag (available on Amazon) liquid magnesium. Before starting the supplement I could not bend my little fingers more than 20 degrees. Now I can tuck my finger and touch my palm easily. I still can’t get over the results, and it has been three years. I could see definite results in two weeks.

    One note of caution, the stuff tastes really bad. I put about 1/8 of an eye dropper in my tea at breakfast and lunch. Any more and you can’t drink it. Also, a full eye dropper will have you sitting on the John a lot🙈.

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  22. #19
    Registered User BeanJean's Avatar
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    Default Re: Finger joint fusion?

    Or you could see a certified hand therapist. (I was one before I retired.). This is an advanced specialty for physical and occupational therapists. Some of them specialize further in the hand problems of musicians. Depending on your particular condition a CHT could make you a tiny joint splint or teach you how to reduce or manage inflammation in your joint. There is a “find a therapist” link at this website.

    https://www.htcc.org/
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