Arthritis of finger knuckles

I have arthritis in my hands, in the middle knuckles of the four fingers (but not in the thumbs). This causes me some pain when I play the piano, although I try not to focus on it. I have tried a number of remedies, none of which are a panacea, but some do offer a little relief. In order of greatest benefit, these are:

Dipping hands in a bowl of warm water for at least a minute, Voltarol cream rubbed into hands several times a day, rechargeable hand warmer, hand massager and heater (e.g. iReliev), Glucosamine Sulphate (difficult to know whether it has an effect).

 

I note that arthritis has been the subject of several posts, which I have read with interest. I wonder if anyone has arthritis of the finger knuckles and if they have found something else that offers good relief.

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  • From my mum I got:

     

    Good looks

    Equanimity

    Osteoarthritis

     

    The OA showed up in my hands first, mostly first phalange knuckle (where old peoples' hands get all gnarly). I'm 64 now, and this started in my early 40s.

     

    Potential Placebo Alert:

     

    A pal suggested I try capsules of Turmeric which is apparently something that helps with inflammation (also fixes bad posture, belly fat, and the tendency to rush through difficult piano passages). I thought "sure, that'll work" but… since starting the daily regime I've had greatly reduced issues with those puffy knuckles. Probably a placebo? But who cares; it's better.

     

    I do have a slight injury to my 3rd knuckle, right hand index finger that has not improved from the tasty Turmeric capsules. This is a more intractable problem. I experience restricted stretch capability between 2 and 3 in the right hand, and this was causing some discomfort and lack of function in particular for arpeggio passages and certain broken chord passages. In Prokofiev's 8th Sonata, last two pages of the first movement, a real problem there.

     

    Also, that finger gets "hung up" and, if I flex it, a nice cracking sound comes from the joint. I'd love to say it relieves the pain; it is actually not a comfortable sensation. But the mobility comes back. I was getting kind of worried that repeatedly cracking that knuckle (just by flexing it when it was barking at me) would make it worse.

     

    I did get some improvement by taking my teacher's advice (often given, not so often followed. Turmeric doesn't do much for stubbornness?), and being really careful to optimize fingerings, hand and arm position, all that Taubman stuff. I was not enthused about the prospects for improvement, but I have to say at this point I was wrong, and it has gotten a lot better. I still can't span the little stretches I used to be able to, but we are getting there via other means and I have less pain as a result. I'm not experiencing the hanging up and cracking near as much.

     

    What helped? Listen to my teacher and practice more carefully? Seriously? (and some spice)

    Hope that helps and, for sure, I feel ya, bro!

     

    PS I might be flattering myself a little on the looks

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    • John Whynot Love your sense of humor. You are spot on with careful alternate fingerings. I also have a great teacher willing to work on helping me play with arthritis. I had to get over my purist tendencies (that's "purist" not "puritanical") and be willing to grace note a few large spans and also to just leave out a few notes. I'm admitting to myself that I'm not building a concert career (the world's loss) and my friends and family have no idea when a note or two have gone astray. I play for enjoyment,  not torture. Save the fingers above all!

      Like 1
    • John Whynot Thank you, John and Victoria, for your ideas and suggestions, as well as your sense of humour - very welcome! I too play for fun, which is just as well given that the concert world seems to have passed me by - can’t understand why.

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    • Tim
    • Tim_Wong
    • 8 mths ago
    • Reported - view

    Heat has worked for me as well. I have some gloves that I can microwave for 1 minute. I use it when I take a 5 minute break during practice sessions to boost blood flow for the rest of the session. 
     

    Watching blood sugar seems to help (takes a couple weeks to see effect)

     

    i also take fish oil but not sure if that actually helps. 

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    • Tim Thank you, Tim. Useful suggestions.

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    • Tim sugar definitely induces inflammation so it makes sense that it would offer some relief. Plus chronic inflammation has long term deleterious effects so reducing sugar in your diet would likely have many benefits beyond your knuckles. Probably the easiest way to do this is to simply eliminate all “added” sugars. Food labels typically distinguish added sugars from natural ones so it’s easy to identify what to exclude, and you don’t have to eliminate things like pastas and fruits. 

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    • Randy Wight Thank you, Randy. I shall watch the video with interest.

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  • My pleasure, Michael! I'm in a similar way and have found Barbara's recommendations to be miraculous! Happy playing :-)

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  • I have arthritis in my fingers and especially my thumbs (bone on bone). I am currently undergoing chemo for cancer (curable!), but my oncologist is big on nutrition, and his rule is “No cakes, pies or cookies.” Sugar drives cancer cells. I am strictly adhering to his advice and have found that cutting out refined sugar is the very best remedy so far for reducing the pain in my hands when I practice. I wish you the best, and keep playing!

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    • Donna Diggons Donna Diggons Thank you, Donna. I’d not heard that before about sugar. Luckily I avoid processed food, which often has a lot of sugar.

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      • Tim
      • Tim_Wong
      • 8 mths ago
      • Reported - view

      Donna Diggons I wish you all the best during your treatment! Glad you are following doctors advice (I heard the same about sugar and cancer), and hope you’re still able to enjoy the piano during this time. ❤️

      Like 1
  • Hi Michael, greetings from Strasbourg, France.  I have had tynosinovitis in three fingers of both hands and the symptoms being similar I think what helped me could perhaps be of use to you.  I woke up with swollen hands in the mornings, two of the fingers were 'trigger' fingers and I could not bend my fingers from middle knuckles down.  I had an operation in one hand. I had cortisone injections that helped only for a few weeks. What helped me in the long run were: 

    a) hot hand baths every morning for about 10 minutes,

    b) sessions with a physiotherapist specialised in hands  (she works on each finger using some strange  equipment that allows her to isolate fingers and stretch and bend them slowly) who also gave me

    c) finger exercises to be done at home everyday (you can find a list of 41 exercises here: https://www.tessadit-aissaoui-kinesitherapie.com/auto-reeducation/

    and, finally d) a ball of play-doh to knead which I still use everyday  while I am watching sth or reading.  Although some swelling and pain still occurs, I can at least play my cello and the piano. I had to  reduce the duration of my practice sessions and increase the frequency though.

    Bon courage!

    Like 1
    • Sedef CANKOCAK Merci, Sedef. Je connais un peu Strasbourg.
      I will definitely look up your suggestions.
      I took up the cello myself, but had to stop because of the pain. I wonder whether for me the cello made the arthritis worse, particularly for the right index finger.

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    • Michael Dunning
    • Retired Elementary Music Teacher
    • Michael_Dunning
    • 8 mths ago
    • Reported - view

    Started an anti inflammatory diet and have noticed less pain the next day after practicing.  You might want to explore further.

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    • Michael Dunning Thank you, Michael. I eat some foods already that are anti-inflammatory. I will investigate further if there are more such foods. 

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      • Janice
      • Janice.1
      • 7 mths ago
      • Reported - view

      Michael Dunning I was wondering what foods are/aren’t allowed on your anti-inflammatory eating protocol? Thanks in advance.

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    • Janice Janice, these are the anti-inflammatory foods I eat regularly.

      • blueberries and raspberries
      • salmon and sardines
      • broccoli
      • avocados
      • peppers
      • grapes
      • extra virgin olive oil
      • dark chocolate 85%
      • tomatoes

      Hope this helps.

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  • Hi Michael, it may be helpful to know what type of arthritis you have. I believe rheumatoid arthritis is caused by inflammation and is treatable. Osteoarthritis, which I suffer from, is degenerative, unfortunately. I have the opposite problem from you, the pain is mostly in my thumb joint where it meets the palm.

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    • Victoria Macdonald Thanks, Victoria. I have osteoarthritis. I wish you luck.

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  • Thank you for starting this topic.   I have searched online for a few years and haven't really found any cures so far, but I haven't given up!

    I have arthritis in both of my hands. 

    I tried Celebrex a few years ago and I did not notice any difference at all.  My doctor recommended Triple Strength Osteo Bi-Flex which I do believe helps.  He also recommended this hand cream which provides temporary relief.  I've provided pictures of both.  I once told him that nothing seemed to be working and he told me to go ahead and take Ibuprofen in that case. Just this week I had a severe flare-up in my hands so I took 600 mg of Ibuprofen twice a day for 2 days and it definitely helped.  I would not recommend long-term use of Ibuprofen because of the long term effects.

    My observations... Ironically I do not have pain when I practice.  Practicing I think actually HELPS my arthritis.   My worst pain is always in the morning when I first wake up.  Sometimes I have those scary trigger fingers, but usually within a few minutes my hands will limber up.

    I'm not positive but about 5 years ago when I returned to the piano I incorporated a chord scale regimen to my stretching routine.  I love to play big chords and as a church pianist I thought this might help limber up my hands again.  I had not played in almost 30 years.  Now I'm wondering if those big stretches exacerbated the arthritis.   I've been focusing more on scales and arpeggios again, and Bach and Mozart, and that music seems to help with my arthritis - as long as I practice regularly. 

    I'm going to watch those videos to see if I get any new ideas.  Best wishes to you.  If I stumble upon any relief I will post it here.

    • Steve Mendoza Steve Mendoza Many thanks, Steve, for your informative reply. It’s worth looking at Penelope Roskell’s videos in tonebase as she focuses on the healthy use of the hands when playing the piano. I have found them eye-opening and very handy, particularly the Parachute touch. I bought her book too, The Complete Pianist, which is a hefty treasure trove of information about how to play the piano - full disclosure: I have no financial interest :). 

      Like 1
    • Judith M
    • Retired MBA/IT Director
    • Judith
    • 8 mths ago
    • Reported - view

    I broke my wrist last year and had to have a metal plate inserted to hold the bones together. It’s now 9 months later and my thumb is still not the same - plus the hand gets stiff after playing and still aches at night. I can finally do an octave again (my hands are small anyway…). I will try the heat for my thumb. Thanks for the ideas. I tried Voltarol but doesn’t seem to help me. 

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