Hand Health: Coping with Carpal Tunnel and Arthritis as a guitarist

Posted on by Jay Hale


As a guitarist, your hands are your life. Any discomfort or injury can seriously hinder if not impede one’s ability to play to the best of your capabilities. It kind of goes without saying that punching things is generally a bad idea, try to avoid that if at all possible. But if you have any sort of pain or stiffness issue it’s not only a physical hindrance, it’s psychological too –  you’re hesitant to play that expansive lick that even though it would be perfect, you know it’s going to hurt so bad you may not pull it off correctly.

Some guitarists to supplement their non-gigging income take data entry jobs or other jobs that increase the chance of repetitive-strain injuries to the the hand that can, over time, result in lifelong maladies like carpal tunnel syndrome and arthritis, which can rob even the best guitarist of the ability to execute even the most mundane licks without pain and discomfort. Some cases of carpal can be so painful it requires surgery, but most guitarists try to find workarounds to allow them to continue to play at acceptable levels. This article will outline a few steps I’ve found that you too can take to minimize discomfort and continue to play relatively pain-free.

Stretch ’em out..

My non-musical job (as a data analyst) requires me to sit at a computer and enter data for operational databases, spreadsheets and reporting all day, which can play havoc on one’s hands. Cramping and muscle strain is the norm, but the work has to be done, and it certainly beats work that requires heavy lifting, or standing all day. However, sometimes after work it takes a good deal of time for my hands to be able to get out of typing claw-mode and return to a more relaxed, limber, normal state for playing.

I find one of the best things one can do, and one that is often overlooked by guitarists is to warm up – extensively. Once upon a time I could play silly shred licks with minimal warm-up, but now it’s not as much fun. Even the best athletes employ warm-up routines, and guitarists shouldn’t think themselves any different. Allow yourself a good 15-30 minutes of warm-up time before attempting any weird stretches or speedy runs, you’ll get a lot fewer cramps, I find.

Find a warm-up routine that works, and stick with it. I personally find in addition to some stretching, a session of running basic major and minor scales and patterns up and down the neck (say major and minor scales from the “G” on the 3rd fret low-E string to the octave at the 15th fret and back) limbers the fingers sufficiently enough to get through a recording session of gig. I appreciate a noticeable difference in dexterity (and overall comfort level) when I do this as opposed to when I skip it.

Just sayin’….

As for medical or pharmaceutical assistance, anti-inflammatory medications like ibuprofen can reduce pain and swelling in the knuckles, and for serious pain, or for example, when you have a pain issue but have a gig or a session to get through, there are topical remedies like a cream I’m prescribed called Ketogabalido (though I’d bet there are over-the-counter equivalents); it’s quite helpful but it may work a little too well. I would strongly recommend applying such cream with a cotton swab or Q-tip if you’d like to be able to feel the pick between your thumb and index finger at the gig later! Also avoid getting it on your fingertips if you’d like to feel the strings under your fingers, too. But applied it to an achy knuckle before a gig or session is very helpful.

Here’s another trick I discovered quite by accident – and some tough guys may scoff at it, but believe me it works: As a boxing fan, I was checking out an episode of HBO’s 24/7 series one night and noticed Floyd Mayweather Jr. getting a parrafin wax hand massage treatment as part of his pre-fight training and physical therapy regimen. I was curious, but wasn’t the massage type of guy. As luck would have it, as part of a health fair at my office one day they were offering the exact same treatment, free of charge – I had no excuse not to try it.  It was amazing, as if it took years off my hands. I was surprised to find upon returning home and picking up my guitar, it felt as though I’d already warmed up for the usual amount if not longer, and flexibility was greatly improved. I was shocked, but I’ll be having them again, that much is certain.

Remember, I’m not a doctor and can only tell you what works for me. But if you look at your hands as the tools of an athlete of sorts, you can see the importance of warmups particularly, and some sort of maintenance/health regimen to ensure the tools you need to play your instrument function well for years to come, hopefully the rest of your life. What do you do to keep your hands in shape?

Written on November 14, 2012, by Jay Hale

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Comments (9)

  • Jay Hale 6 years ago

    The supplement BCQ is a natural anti-inflammatory. Also, here are some great exercises: http://www.youtube.com/watch?v=hUyMNyrOHJQ&list=FLqM7pdEaK7Mz4ZnAlUp1Rnw&index=37&feature=plpp_video

    • Jay Hale 6 years ago

      Oh man
      This is insane, thanks for posting this video, gonna be a huge help

  • Jay Hale 6 years ago

    I work in IT and tech support so I also type all day, but over the last couple years I had been having problems that luckily didn’t require surgery; I’d built up enough scar tissue between the muscles that control my fingers that they were starting to hurt when I typed and especially when I played. Now I’m just finishing up a course of several months of “active release technique” therapy which seems to have done a lot of good, the muscles/fingers work more like they used to now. It’s not invasive (although it is kinda painful at first), basically a chiropractor or PT assessing the condition of the affected muscles while “massaging” them apart manually.

    “They” say a lot of players who’ve been at it for long years wouldn’t be able to continue without getting these treatments regularly. I’m not going to name names or websites (I don’t work for any ART providers or promoters, I just pay one of them 😉 ) but I’m sure you can find details and whether it’s likely to help your situation through your favorite search-engine. I can say it seems to be working for me, although I do make sure to stretch before and during work as well as before warming up on the guitar now! I’ll try the paraffin wax treatment, that sounds interesting too. Thanks for the post, I hope everybody reads it!

  • Jay Hale 6 years ago

    Warm ups and exercises and all that are good, but it’s worth looking at ways to make other parts of your life have less impact on your fingers and wrists too. As a computer geek, I too spend all day (and a chunk of evenings and weekends) sat at a keyboard. The traditional rectangular slab is known for being a bad design ergonomically. It’s simple and cheap to produce, and works well in a laptop shape too. There are a bunch of keyboards out there designed to fit us better, ranging from a slight curve, to the sort of funky designs of the “typical” ergonomic keyboards that you might see in a local computery shop, then off into crazy (and expensive) land with things like the kinesis advantage or the datahand.

    It’s worth seeing if you can get your company to spend a few quid on a decent keyboard that will benefit your health if you use it for long periods of time. And even if they won’t pay, it’s probably a small investment for you to get your own that you can bring in.

  • Jay Hale 6 years ago

    If you keep your hand/forearm muscles properly exercised you can minimized these kind of problems and even shorten your guitar warmup time (stiff&sloppy to fluid).

    My day gig is as a computer programmer so I’m always on a computer keyboard. One thing that has helped me tremendously is hand exercising – and it has a side benefit of improving my playing.
    I use those ‘V’ shaped spring hand exercisers (google “fixed resistance hand exercise”).

    I personally avoid the ones that use a rubber ball as a fulcrum to create resistance – the tension curve (amount of resistance vs amount of compression) is not natural and the only time I have hurt myself was when using one of that type.

    Like any kind of exercise use a little common sense – the goal is to create strength & endurance, not blow out your wrists. The exercisers come in various stiffness (easy, hard, etc.). Start off with one that you can do 10 or more squeezes with.

    I’m not a doctor but this has worked for me. When my wrists start hurting its usually because I’ve gotten lazy & stopped during my hand exercises.

    BTW if you’ve never used these before you’re probably going to experience s little stiffness in the beginning so don’t start the day before you go into the studio or the night of a big show.

  • Jay Hale 6 years ago

    Thanks for the pointers!

  • Jay Hale 6 years ago

    For two years, I have rheumatoid arthiritis, and I now deal with compression at C4-C6, and problems with fatigue and pain. I also cannot lift very much weight or apply as much pressure as before. I’ve been playing more than 20 years. When the bad symptoms hit 2 years ago, I was unable to play for several months and finally playing was disappointing, but I stuck with it. I cannot reach the level I was at, but some things are better.

    To make things easier, I modified my guitars. I regularly setup the guitars. The neck is just less than flat; The action is 2 mm on bass side and 1.5 to 1.9 mm on the treble side; The strings are now 9-42 Super Slinky; I tune down a whole step to D Standard or use altered tunings; I have a really fat, neoprene, padded strap. I use a massively thick pick and allow it to do most of the work.

    To make stringing and tuning easy, I have locking tuners and I oil the nut to reduce drag and keep the guitar in tune to reduce the time I have to spend messing with it.

    To make the controls easier to use, I have metal, textured, knobs that I can easily turn with the side of my hand or a finger. There are also rubberized options, but I haven’t tried them, yet.

    It still hurts to play and I’m limited, but I can play a bit of blues or golden oldies and simpler rock/metal/pop. Single note runs, double stops, and bending with the use of more than one finger (for support) are working. Certain chord shapes, chord fragments, and using altered shapes with the notes stacked in different ways is also helping, when it’s possible to do so.

    I accept that I will not be playing complex or fast songs. Instead of being upset, I focus on what I can still do and enjoy the hell out of it when I can. If you’re like me and music is ingrained into your soul, I really recommend you adjust everything you possibly can and make the best of it. I can still play with feeling and that gets me further than the flash ever did.

    • Jay Hale 6 years ago

      Often times the strap is the culprit that is creating the issues for me. As I have gotten older I am finding that a regular width strap leaves me with a pain in the neck and shoulder. A wide strap prevents the shoulder muscle from knotting up, putting excess pressure on your brachial nerve running down the arm. Good post!

  • Jay Hale 6 years ago

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