Taking care of hand and finger pain.

So what actually was the fix? Fusion?

 

Good luck with it. Let us know how it works out playing wise.

 

I think many of us are discovering some of the beauties of older age recently. I'll share some of my experiences here, really to try to help encourage people about re-learning when things stop working exactly right...

For the first time, since onset of last winter last year, I've developed severe pain and stiffness in my hands, including a trigger left thumb and a trigger right ring finger. I've been diagnosed with RA, and in talking with siblings and tracing back family history I have found out that it runs in my family. Fortunately the joint swelling from RA tends to lighten up in the hands after the movement in hot water from washing dishes in the morning, but unless I opt for surgery, my trigger fingers appear to be staying around.

I've seen multiple doctors and PT/OT people about the trigger fingers and other than surgery, which is not a 100% guarantee of recovery, all they can offer is boutique immune-compromising RA meds, braces, salves, heat therapies and pain meds. Since I'm already immune system compromised, I'm staying away from the boutique meds. But really, the braces and washing dishes in hot water have provided the most help.

Regarding my instruments, the trigger fingers have been especially challenging, but I'm re-learning a few 50-year old playing practices. I'm wearing braces overnight on these two fingers to teach them how to stay relatively straight, very willingly giving up some range of motion for the continued ability to play music, and also to have realtively normal posture and appearance of my hands.

Regarding re-learning, I expected the left trigger thumb would be the biggest problem, but really the right ring trigger finger has been the biggest challenge. Since I'm primarily playing 5-string banjo, mandolin and double bass, the variety of re-learning for each instrument has been really interesting:

Regarding my left hand...

On each of the smaller instruments I've always held my left thumb near the back of the neck to extend reach of my fingers over the fingerboard. With bracing to teach it to stay straight, that trigger thumb is using a little more of the side of the thumb on side of the back of the neck which leaves playing those instruments pretty much unaffected.

For the double bass the straight thumb and stiffness in the lowest thumb joint is pretty much forcing more of a baseball bat grip, which for my playing in various roots genre is working out very nicely; if I were training for formal orchestral or modern jazz work where I would need the thumb on the back of the neck to extend finger reach over the fingerboard, this would be a problem, but really those have never been my goals in playing double bass.

Then there is the right hand...

For 5-string banjo, I had to re-learn how to anchor my fingerpicking hand -- for 50 years I had been bending the right ring finger under my hand and anchoring with my little finger only (Doug Dillard posture), which has the advantage of making a more agressive angle of attack with the picking fingers and thumb, but requires a severely bent ring finger. This is actually a pretty popular alternative posture, but bending that ring finger under the hand is possibly what has encouraged trigger finger in that finger over the years. I've learned to anchor with both my brace-straightened ring finger and my little finger (Earl Scruggs posture), and have adjusted my fingerpicks for a more agressive attack, and this is turning out to be a much more relaxed and comfortable posture for that finger and my whole right hand.

On the mandolin, in early winter as the RA was setting in, I suddenly found myself catching the first string under my bent right index finger's fingernail as I was holding the flatpick, causing bleeding and a lot of pain. This wasn't directly releated to the right trigger ring finger, but was a resullt of RA, the joints being swollen. So I've re-learned how to hold my flatpick with a straight index finger so the string cannot catch under the fingernail. This again provides a more relaxed posture for that index finger and the whole hand, plus it provides a lot of new flatpick angles that I can use more effectively for various techniques.

For the double bass, in pizz I typically use a thumb anchor on the fingerboard with my index and middle fingers stroking the strings together, so the trigger ring finger hasn't been a problem. With slap, that trigger ring finger is actively used for both my note-stroke and the slap stroke, but the fact that it is brace-straightened yet still allowing a little curve, does allow me to continue using it for slap. For arco, there is also enough curve in that finger that I can continue to hold the French bow comfortably.

Having braces to teach the trigger fingers to stay straight has been essential. Normally the trigger effect would be forcing the joints into a flexed posture which would make playing impossible.

The most valuable realization for me has been that even with RA and trigger fingers, re-learning is possible and actually pretty stimulating for the advantages of the newly learned techniques. And also, it has been very interesting to realize that the double bass is not the only instrument that can possibly contribute to finger, hand, arm and shoulder problems, especially when combined with RA.

Guessing at the future, I do imagine that RA may eventually spell the end of my instrument playing. Realizing that, I'm working on extending and making the best of the time I have left. I'm very happy to be able to continue for now, and looking back, I'm really thankful that I've had a long 50 years of musical fun.

 

Glad you’re getting it done, Trey! I was just diagnosed with an arthritic right wrist yesterday. Been going on about a month. Prescription strength Aleve for now. Re-address in two weeks.

 

I can't take Aleve because it causes a bit of bleeding in everyone and I'm on a blood thinner. Don't want to take Tylenol because of possible liver damage. I've discovered an herbal substitute that works great and if it has negative side effects they're apparently yet to be discovered. Devil's Claw. It's been a game changer for me.

 

Didn't intend to add more ills to the list but since it's been mentioned, ditto on the trigger finger. I'm classical but after last (hopefully not forever) concert of a Shostakovich concerto with a relentless driving plucked bass line and me having way too much fun with my new low B string...middle finger right hand locks mid extension at second joint from tip.

Haven't seen a doc but read up on Mayo website. Classic case: worse in morning, eases up in evening. Wake up with bent finger, sometimes have to use other hand to pull it straight. Major "crack!" noise, much pain. They suggested much as dhergert does: wear a splint at night. Wake up with stiff finger but at least it's not locked.

Long been aware of the therapeutic value of ironing to ease the mind. Have to add hot water dish washing in there too.

 

You really have my sympathies, I hope your middle finger recovers naturally with time, otherwise I hope you find alternative ways to play the way you need to.

Yea, the braces and washing dishes have saved my playing this time around. I'll only consider surgery if I absolutely cannot find a workaround.

 

Thanks. Mayo was actually pretty optimistic. They said steroid injections into the joint can last up to a year.

Plus, I mostly bow and mostly play at night so..... Fortunately or unfortunately, just heard earliest resumption of concerts for us is February, possibly April. Lots of time to recover.

 

I won't go into my issues having already done so on here a few times, and most of yall are familiar, but I have constant pain in my left arm and especially hand.

The other day I didn't feel like lugging my bass, and played my bl's bass, which has steel strings set wayyyyyyy high up. Mine are guts laid way down. Whoooooo-eeeeee, after am hour my hand was a claw, lol, and it took two days for the pain to chill out. Never again! Sticking to my setup!

And I feel you on the alleve, but my poison is advil. Advil and daily ice packs everywhere keep me going baby! And I'm only 44!

 

It's amazing just how quickly a messed up setup can mess with your body.

 

How long do you have to wait before you're allowed to try playing?