Arthritis in left thumb - surgery - Page 2

Glennwillow · #16 03-31-2016, 01:40 PM

Jay,

Best of luck on your surgery and recovery. Let us know how you are doing!

- Glenn

aknow · #17 03-31-2016, 05:02 PM

Best of luck to you for a full recovery.
Since I have been practicing chiropractic and soft tissue/spinal/extremity injury rehabilitation for a long time, I always wonder if the posters (such as yours), ever invest any time in prevention.
When a musician comes in for help, I try to impress on them, that they are athletes, and a stretched motor unit, muscle, tendon, ligament......prevents many types of joint dysfunction.
The main tenet I've learned in 32 years of paying attention, people do the same motions to excess.
What helps is to spend some time doing the opposite action we overdo.
For guitarists, that implies wrist extension, finger/thumb abduction.
Last week, I recommended Chinese Medicine Balls, which increased my own ability to reach frets by two, after about 12 sessions of manipulating them.
One of the professionals here advised not to use tools such as these?

Whether you're in rehab, or in your 1st month of playing guitar, treat your hands and fingers like an athlete.

John F. · #18 03-31-2016, 06:55 PM

I really did mean to ask how the op--Jay--is doing. It's been almost a year

sayheyjeff · #19 03-31-2016, 07:22 PM

Also curious to know how the surgery turned out. My wife had what sounds like very similar surgery on both thumbs. She had a couple of knuckle replacement surgeries on other fingers too. Though not at full strength, these operations were lifesavers. She is totally functional and you wouldn't know if you saw her. If anyone needs a recommendation for a hand surgeon/specialist, let me know.

Jeff

MGordon514 · #20 10-01-2018, 02:09 AM

Reviving this thread.

It's been 4 months since I had arthroplasty LRTI surgery on my left, fretting hand. Recovery is going as expected, but I would appreciate any insights on thumb opposition.

Please see the diagram below based on the Kapandji score for assessing the opposition of the thumb. At 4 months post-op my score is about a 8 out of 10. (On my other hand I can oppose to 9.)

Anyone know how much further improvement is possible?

Thanks.

silverspear · #21 10-01-2018, 06:21 AM

oh dear, I just realized that my score is lower on my left hand, compared to my right hand! do guitarists get this issue over time?

Birdbrain · #22 10-01-2018, 10:53 AM

... that will always be relevant for the next guitarist facing this surgery. I'm certainly happy I had my radius arthroplasty several years ago. Besides making that pain at the thumb/wrist joint a distant memory, it serves as a dry run for the shoulder replacement I'm doing late this month.

Here's one trick from recovery therapy that might prove useful. I found it very enjoyable, and will use it again when hand issues flare up. Fill both sides of a double kitchen sink with water, one side at 40 degrees and one at 110 degrees (measure with a thermometer: it matters, and if you overshoot on the hot side, you could hurt yourself). I believe the routine was, three minutes in the hot water, and one minute in the cold. This creates a pumping action as blood vessels dialate in the hot water and contract in the cold, and that enhanced circulation is just what a post-op hand needs. Try it, it feels good- especially the changes.

This may be harder to do for my whole shoulder...

urlkonig · #23 10-25-2018, 01:56 PM

Just read through these posts, as I'm facing the same decisions. Did anyone who has had the arthroplasty experience any nerve damage as a result of the surgery? I fear that as much as any other aspect of the procedure.

rogerdann · #24 01-02-2019, 10:15 AM

Not sure if anyone is still looking at these posts, but I had this LRTI surgery 30th November 2018, still in recovery mode and final outcome to be determined. The Basal thumb joint wore out from playing guitar and bass for 50 years and pain became increasingly more difficult to play through.
I couldn't find too much online about guitarists having this done and the outcome, but fortunately my surgeon put me in touch with a stand up bass player who he had operated on and he reached out to me and gave me the confidence to proceed. The operation isn't for the faint of heart, its pretty invasive and recovery is lengthy, still can't play a chord 4 weeks after surgery but I can doodle around on piano fortunately to release some of my musical frustrations. Anyone need more info can ask.

godfreydaniel · #25 01-02-2019, 11:14 AM

Hope your recovery goes well. Please keep us posted on how your progress goes. I will probably need the same surgery at some point.

815C · #26 01-02-2019, 01:55 PM

Hope you recover 100%

Tone Gopher · #27 03-03-2019, 01:42 PM

I am reading this thread with great interest. I just had a consult with a hand surgeon last week. His diagnosis is Stage 2 CMC in the left hand. His perspective is that I have several more years before surgery, but surgery will only be for relief of pain, and will result in decreased strength and decreased mobility. Sucks. Therapy may make it stronger, but will come at the cost of exacerbating wear.

The bottom line suggested is that I recognize that I have limited “life” left in my thumb, and to choose how I use it up.

Argghhh...

DMcK · #28 10-24-2019, 07:32 PM

Wanted to say a heartfelt thanks to Acoustic Guitar Forum and the posters on this thread. This discussion, "Arthritis in left thumb - surgery" has helped me more than you can know. I value each person's words and contribution.

I am a semi-professional jazz singer / guitarist in the Pacific Northwest. Since retiring I have devoted a lot of time and practice to my guitar playing. But the pain in my fretting hand--after five years of intense practice--got so bad I had to curtail my playing drastically, especially practicing. I've seen two hand surgeons, and had three steroid injections. The last one of those, administered by a guy who knew what he was doing, helped a lot, but not enough.

I know a lot of musicians in my area, including a lot of guitarists and standup and electric bass players. Not one suffers with this problem (that I know of). So I felt really alone. I believe the first hand surgeon I talked to about how a carpometacarpal (CMC) arthroplasty would affect my guitar playing simply shrugged his shoulders. (It takes a musician I guess to appreciate a question like this.)

I have no illusions about the seriousness of this step, in a number of ways. I am older and heal slowly. Even if I get back to playing (which a realistic guess puts at about six months to a year), my focus and learning ability are not what they once were. And maybe for some this is not an issue, but for me the lurking threat of opioid dependence is not insignificant.

Nevertheless, I have scheduled my surgery for the end of November. Thanks again.

Birdbrain · #29 10-24-2019, 09:38 PM

I just looked up your carpometacarpal (CMC) arthroplasty. I'm no expert, but my radial arthroplasty was just one joint below your problem. My thumb felt fully functional by three or four months, at age 60. It was my picking hand, so there wasn't the repeated pressure on the back of the neck. But maybe that will lead you towards better technique. I've heard several guitarists advise that you should use the least pressure on the back of the neck that will fret cleanly, using careful finger placement and a low-action setup. You can also apply compensating pressure on a guitar body by squeezing in your right elbow. I just managed to play some open and barre chords with my thumb free of the neck this way. It wasn't natural, but it works.

The one thing I can confidently advise is that life after ortho surgery is better than you think. I've had similar hand work to yours, and also a total shoulder replacement. I'd definitekly prefer ortho surgery to any other kind. Joint problems are easier to fix and faster to heal than muscle or ligament injuries, so arthritis heals faster than athletic injuries. My need for opiates was gone after a week or so, and icing helped greatly. My post-op pain was never worse than the worst pre-op symptoms, and it led to a pain-free result. So it may not be as bad as you think. Pick a surgeon who explains things well, listens and does 50 or more of your procedures a year. Then, sit back, he's got this...

MGordon514 · #30 10-25-2019, 02:03 AM

I posted earlier in this thread and now am 17 months post-surgery (including 2 months occupational therapy), on my left fretting hand. Only needed Norco for 4-5 days after surgery. I was back to playing normally at about 5 months.

As a precaution, my strings are lighter (electric sets down from 10s to 9s; acoustics down from 12s to 11s), my strap is a little higher, and I always warm-up and try to lighten my touch.

Diagnosis was basal joint arthritis and the procedure was a trapeziectomy with LRTI (ligament reconstruction and tendon interposition). This is a long-established surgery (40+ years IIRC).

I am 58 years old and have been playing for 50. So glad I had the surgery and wishing the same for you.