Pain in Thumbs and Fingers when Playing Guitar, Esp. Left Thumb

by guitarist

I've been a guitarist on and off for almost 50 years. Classically trained, I've always been a fingerstyle player.

Back in the late 90's I picked up the guitar after a 13 year absence and within a few weeks developed tenosynovitis ("trigger thumb" - deQuervain's) in the right thumb. Months of various therapies including acupuncture, cortisone, rest, splints did no good and I had surgery, which helped.

Then some more absences from playing and when I went back I could no longer move the right thumb well enough to play so I started working with a pick. After about a year I developed the same trigger thumb in the left hand and that also didn't respond to PT, cortisone and the like, so another surgery. Now I'm trying to play again but still have pain in the left thumb where it meets the wrist.

Got an x-ray, the doctor showed me the osteoarthritis. The cartilage is wearing away and it's easy to see right on the x-ray. I play for half an hour, I have pain.

The right ring finger is starting to hurt. The index fingers of both hands have nodules at the first joint and are starting to bend inward. Yes, it's a sorry mess. As a classical player I had a very relaxed posture with the guitar and in fact the left thumb deQuervain's occurred because I tried to mimic my acoustic teacher's playing style which is definitely NOT classical posture and caused my wrist to twist around and get stressed out.

Last thing I'll mention is that I'm hypermobile. All the joints in my body have too much "play" in them. If I press the fingers of one hand against each other and stiffen them, they splay upwards like a boat. The tip joints of my fingers all collapse and I've never been able to strengthen them, which has limited my technical ability on the left hand especially.

I've gotten tendonitis on other parts of my body from doing yoga because of this hypermobility, which I didn't realize was a problem until I couldn't walk from

That's quite enough. Any thoughts on how to address the arthritis and other tendencies in my hands would be most appreciated.


Joshua Answers:

Hi Guitarist.

The surgery didn't fix anything because surgery doesn't beneficially alter the Tendonitis dynamic.

Tendonitis can showup most anywhere in the body.

See: What Is Tendonitis?

In a Tenosynovitis situation, surgery gets in there and slices open the tendon sheath, so it's not so constrictive on the tendon.

But that's just a symptom. That's not the CAUSE of Tenosynovitis. Which is my big complaint with only goes after the symptom. And by definition, that doesn't fix the source of the problem.

So, from what you describe, it's safe to say you have a long term Process of Inflammation all over your body, from many different sources, which eventually becomes a system ecology of inflammation process and side effect. As you have been experiencing, it's all downhill from there.

1. Make sure you have plenty of Magnesium in you. Magnesium for Tendonitis

2. Omega 3 fats for their anti-inflammatory effect, and other health benefits.

3. Make sure your Vitamin D3 level is between 50-180.

4. Finish every hot shower with cold. You'll get the systemic benefits of a daily ice dip, basically.

5. IceDip your forearms and hands, as described on the How To Reduce Inflammation page.

Start with that. Give me updates.

More questions, more answers.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Comments for Pain in Thumbs and Fingers when Playing Guitar, Esp. Left Thumb

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Nov 22, 2014
Pain in fingers after getting back into classical guitar
by: Barry W

I'm 51 and trying to get back into playing classical guitar after a few years of letting it sit.

I've been working to play only about 60 to 90 minutes a day, and recently had started doing some more aggressive finger strengthening sessions.

Then one day I played two ninety minute sessions, the second of which I played some more serious stuff.

Since then I feel some pain in my fingers - especially second, third, and fourth - where the finger meets the hand.

I experience inflammation on the back of my hand as well. I've rested it for about four weeks, then tried playing again for about 20 minutes. The pain and inflammation are back in the same spots.

I'm also experiencing some pretty bad neck pain at the moment, and am going to the doctor for concerns about a herniated disk in my neck (I hate getting old). Is that what's causing my finger pain?

I just don't think I played so much to create a bunch of microtears in my hand. At the same time I don't know that I'd describe the pain as tendonitis, which I've had.

I have a solo gig coming up next month (my first in 10 years), can you help me?

Thanks very much!


Joshua Comments:

Hello Barry.

Maybe you have 'tendonitis', maybe you don't, but it definitely sounds like you have a 'tendonitis dynamic', which is a variety of negative factors all working together to cause pain and problem.

The neck can certainly be a partial/complete cause of the hand symptoms (except for the inflammation of the back of the hand) -if- something in the neck or surrounding area is stepping on the hose of the nerve.

But if you have inflammation in the back of the hand, chances are very very high that there's something local happening too.

First thing's first: understand the Pain Causing Dynamic

That ultimately explains the bulk of the foundation of everything that's going on.

Maybe you have microtears from playing too much, m(aybe you don't) but realistically it's more that over time your muscles and connective tissue has gotten too tight, you've had a chronic/progressive Process of Inflammation, and nutritional insufficieny has gotten slowly worse.

Microtears aren't the problem, they're more of a symptom of the above factors.

And now you're stuck in a pain dynamic.

Sure you can play your gig in a month, but my advice is to get to work reversing the dynamic.

Follow and read the links in this thread. That's the intellectual start (or jump right to the self care in Reversing Guitar Tendonitis).

Tell me more about the neck pain/symptoms. The neck and hands are one way or another related (maybe a little, maybe a lot), and some of what you do for the hands will help the neck, but create a more complete/detailed picture for me.

See Related: A Classical Guitarist With Dequervains And Trigger Finger Pain Relief And Playing Again

See Related: Classical Guitar Wrist Pain I Want To Play Professionally All My Life

Jul 20, 2014
Trigger fingers and thumbs. Sore finger joints and carpal tunnel
by: Suffering

I have been suffering with the above problems for over three months, prior I had flare ups. A year ago I had surgery for a trigger finger.

I cannot use my hands because they are painful and extremely weak.

I will not have carpal tunnel surgery nor injections. This was diagnosed by a neurologist with a nerve test.

So far I have tried warm wax baths for my hands, and wrist braces,arthritic gloves suggested by my FP. That did reduce some swelling, shooting pains and neuropathy. I recently have been treated by acupuncture 2 times, she advised avoiding anything cold on my hands and cold fluid intake.

I would like to try your ice treatment but if I do, should I stop all other treatments?


Joshua Comments:

Hi Suffering.

You didn't leave your email or check the notifications box, so I hope you find this.

I wouldn't stop all other treatments if you ice dip, there's no need to.

Having said that, wrist braces and arthritic gloves aren't going to fix anything.

Warm wax dips will bring blood to the area, that's good.

I'm not down with the acupuncture thing about avoiding cold. You have a lot of inflammation going on, you need to cool down.

But you also need to deal with the nutritional insufficiency that is playing a huge role in your multiple pain location dynamic.

See Related: Recent Carpal Tunnel Surgery Still Have Weakness Pain And A Grinding Feeling

See Related: Pain In Thumbs And Finger When Playing Guitar Especially Left Thumb

Apr 30, 2014
Thumb tendonitis progress
by: Jim K

Hi Joshua
I'm 7 days into the course and so far, I haven't noticed an improvement. I appreciate results may not always be felt in the first few days and was wondering if I should continue with the ice dips for longer before moving to the ice massage?
Many thanks


Joshua Comments:

Hi Jim.

Use the contact form (tab over on the left) and give me a very detailed descriptions of history of sympmtoms, symptoms, and exactly what you've been doing from the ebook protocol.

Apr 22, 2014
Thank you
by: Jim

Hi Joshua

Thank you for such a quick and helpful reply. I will buy the Guitar Tendonitis ebook in a moment and would like to thank you for such an informative resource.

Hopefully, I'll be able to report back one day with some good news!

Best regards


Joshua Comments:

I look forward to working with you.

Apr 22, 2014
20 years of classical guitar now left hand thumb pain the last 3 years
by: Jim

Hi. I'm a professional classical guitarist. Although I've played for over 20 years, only in the past 2-3 years I've had a problem with increasing, acute pain in my left thumb joint when holding particular shapes.

Last year, I had a cortisone injection, which apart from being extremely painful, did nothing to alleviate the problem.

I'm fairly sure it's not Carpel Tunnel, as I don't have any wrist or elbow symptoms and my other fingers are not affected.

I'm considering buying your Guitar Tendonitis ebook. Do you think this will help me? I'm also going to look into my magnesium intake.

Best regards


Joshua Comments:

Hi Jim.

Sure I'm biased, but yes, following the program in Reversing Guitar Tendonitis ebook will definitely help.

It took a long time for you to feel symptoms, but musculoskeletal pain like tendonitis consists of a few specific factors that all work together, over time, to eventually produce pain etc.

Whether you have Carpal Tunnel Syndrome or Tennis Elbow or Wrist Tendonitis or Dequervains Tendonitis (fancy term for thumb tendonitis) or Guitar Tendonitis, it's all the same dynamic, felt in different locations.

So the good news is you only feel it in your thumb, the bad news is, it's your entire forearm and hand that's involved (plus some systemic aspect re: nutrition).

Should be relatively easy to reverse. You have joint pain, but generally it's because tight muscles and connective tissue are compressing the joint, when then grings and gets inflammed/irritated, etc.


Feb 25, 2011
further follow up
by: Guitarist

Hi again Joshua

To answer your questions: I don't know how much Vitamin D, but my physician, who's an osteopath, checked my levels in my bloodwork and said they were good. Regarding magnesium, I tried two kinds: citrate and glycinate, at minimum doses, and both negatively affected me right away, so I discontinued.

Any suggestions on how I could ingest more magnesium, aside from food, that would be effective? (With or without food, time of day,etc.)

Your insight into hypermobility explains why exercising causes me so much residual pain afterwards, especially in the back and shoulders, although I get great emotional and energetic benefits from it. My hands tolerate very little exercise and I've never been able to strengthen the left hand very much, over many decades of playing the guitar.



Joshua Comments:

1. Call your Osteopath and find out what your levels were.

2. You say you're taking Vitamin D now. How much?

3. Re: Magnesium, what does 'negatively affected me right away' mean?

4. What was the 'minimum dose' amount?

5. Non-oral options for Magnesium are something like this Transdermal Magnesium Gel, and/or Epsom Salt baths. There's lots of magnesium in Epsom Salt, if you put .5 - 1 pound in the tub.

Please give me specifics on the numbers/amounts from the first couple questions.

Feb 13, 2011
Follow-up -- Pain in Thumbs and Fingers when Playing Guitar, Esp. Left Thumb
by: Anonymous

Hi Joshua,
Thanks very much for your reply. Re: what you've written so far - the surgeries definitely helped, although I understand that it's not a cure. I'm not sorry I had them done but I wouldn't want to do them a second time.
Re: supplements - I take Vit. D and have good levels; ditto Omega-3. Magnesium I get in a calcium/mag supplement but can't tolerate it on its own (gives me the runs).
I eat Paleo which has been very helpful for many of my health conditions and I was disappointed that it didn't solve this one.
The hypermobility issue may be at the root of the problem.
I will apply as many of your suggestions as I can, including the cold water at the end of showers and the ice dipping.
Any ideas on the hypermobility of my joints? I don't have the severe type which results in spontaneous dislocations, although my shoulders have popped out on their own a few times (not pleasant).
Overall, I seek a stronger rather than more mobile body.
I thank you very much for your generosity and knowledge.



Joshua Comments:

Hi Guitarist.

1. What does good level of Vit D mean, exactly?

2. What kind of Magnesium were you taking that was gving you the runs? And, how much? And how often?

3. Ironically, if were taking low amounts and still getting intestinal distress, that points to needing MORE magnesium.

4. Hypermobility certainly plays a role. Loose ligaments, to whatever degree they are, send a constant signal to the nervous system that the body is in danger of being injured. So the nervous system tries to defend you in the only way it knows how....with tightness and pain.

It can catch up to you.

Your job is to keep your muscles strong and healthy. Not tight, not too tight, but strong and able to do -work- without irritation.

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