Has anyone here definitively recovered from chronical tendonitis?

[MBE]

Originally Posted by devellis

I always get more than a little worried at threads like this in which people recount their personal experiences. People want to be helpful and we'd all like the remedy to our ailments to be quick and simple. Some suggested remedies may be harmless. But some may actually be harmful. If pain persists, it's really a good idea to see someone with professional qualifications and experience treating the ailment in question. They may or may not offer an effective solution but their odds are better than grasping at straws based on other people's anecdotal experiences, or sometimes not even personal anecdotes but stories from others they're relaying indirectly.

I don't fault people for sharing their experiences when someone asks. But the asker should exercise due diligence in filtering the information and, more often than not, some expert guidance in that process can be well worth the expense it entails. Being able to use our hands is important to everybody and more so to guitar players. It's not something to mess around with if you're having persistent difficulties.

I agree 100%.

See a doctor. Follow their advice. Get the right diagnosis and treatment.

There has been some confusion between tendinitis and epicondylitis in this thread already. The point about tendinosis was spot on as well. Just highlights the importance of being seen by a doctor and not following advice from well-meaning people on the internet.

Unless that advice is to see a doctor, that is.

[Aaron Smith]

Originally Posted by dmbfan32

Depending on how long you have had it, you may have tendonosis vs tendonitis. Treatment is vastly different.

Tendenosis is very unhealthy tissue but no swelling/inflammation. Current treatment options include aggressive manual therapy, dry needling, PRP injections, or surgery with worse case scenario. You need to induce inflammation and bleeding in the tissue to get it to heal. If it is tendonosis, the worst thing you could do right now is ice it & use anti-inflammatories.

Respectfully, there is a lot of debate in the medical community on the nature of tendinosis. While it may not be acutely inflamed upon presentation, chronic inflammation is certainly at the heart of the long-term degeneration of the tendon. There is a big difference between acute and chronic inflammation.

Some of the regenerative therapies are emerging from pretty high level clinical trials, with good results. This is a pretty fast-changing field.

I agree with the above poster- medical advice from the internet is usually worth exactly what you paid for it. See a well-qualified orthopedic or plastic hand specialist.

[rogthefrog]

I didn't fully recover, but a combination of ergonomic adjustments, acupuncture and tui na massage have made it so my attacks are less frequent and last less long.

[815C]

About a year ago I spent 14 hours one weekend practicing Van Halen's solo on Michael Jackson's BEAT IT for an upcoming gig. There are some significant fretting hand stretches in that solo and I overdid it on the practice. A tendon in my left arm between the elbow and wrist gave me quite a bit of pain when I'd play guitar.

I did a lot of ice, anti-inflammatory supplements, prayer/faith, heat, massage, etc. as well as limiting how much time I spent no guitar and carefully playing in such a way that did not aggravate the tendon. This meant limiting my guitar time and being very cognizant of whether or not I was aggravating the issue or not.

It took several months - not sure exactly how many (maybe 6-7) to get over it. But I'm over it 100% now. HOWEVER, I don't plan on working up the solo to BEAT IT ever again.

[flaggerphil]

Go to a doctor you trust and do what he says to make it better. If that includes not playing or limiting playing for awhile, well, so be it. That's how you get over it.

And yes, I have had tendonitis in the past and that's what I had to do. It worked.

Now, saying that, I also have chronic pain from past serious injuries and arthritis/degenerative disc/joint disease that comes in my family. That never goes away and best I can do is try and control the pain. It simply can't be "cured."

Not the same as tendonitis, though. Go to the doctor.

[bobdcat]

Originally Posted by devellis

I always get more than a little worried at threads like this in which people recount their personal experiences. People want to be helpful and we'd all like the remedy to our ailments to be quick and simple. Some suggested remedies may be harmless. But some may actually be harmful. If pain persists, it's really a good idea to see someone with professional qualifications and experience treating the ailment in question. They may or may not offer an effective solution but their odds are better than grasping at straws based on other people's anecdotal experiences, or sometimes not even personal anecdotes but stories from others they're relaying indirectly.

I don't fault people for sharing their experiences when someone asks. But the asker should exercise due diligence in filtering the information and, more often than not, some expert guidance in that process can be well worth the expense it entails. Being able to use our hands is important to everybody and more so to guitar players. It's not something to mess around with if you're having persistent difficulties.

Good advice.

I will add that my issue arose from a statin drug. Once I went off that particular statin and started another, the symptoms subsided, although it took about a year. So, whatever you think may be causing you joint pain, it may be something else entirely. It's definitely something to see a licensed, certified professional for.

[yandz]

I don't see any reason someone can't ask for experiences concerning something. I wouldn't cut my arm off on the advice of someone on the internet, but something that isn't life threatening and something you've been living with? Why not?

Getting treatment when you have some basis from which to make a decision certainly isn't a bad thing. a couple posts in talking about the difference between an actual tendonitis or the more chronic tendinosis is pretty good stuff and something to consider. it was what I was getting at with my questions, but someone took that bull by the horns.

and there's lots of ways to treat it. I've had people that have gone in for what amounts to doing a diagnostic ultrasound and then poking the tendon with a needle to stimulate more inflammation and restart the healing process, to nothing more than therapeutic ultrasound coupled with a time or 2 a week of aggressive soft tissue work (has all sorts of names) on the tendon with great results too. Some people have had results from laser, some not. if you've tried 2 and haven't heard of the 3rd, why not ask on the internet?

If you've been diagnosed with something and are looking at a treatment you're not comfortable with, why not ask others what they did? It seems more and more providers are told by administrators and insurance companies how to treat symptoms x,y, and Z anyway, so it's not like going in with symptoms of tendonitis are going to result in you getting a whole lot of "doctoring" in a lot of cases anyway. You have X insurance and they'll cover this, let's try it, seems to be how a lot of treatment is doled out these days. Right or wrong it's the nature of the beast.

[dmbfan32]

If it makes anyone more comfortable, I am a practicing physical therapist (15 years) who specializes in orthopedic conditions. I have a doctorate from USC and currently have a practice in Orange, CA.

[dmbfan32]

Originally Posted by Aaron Smith

Respectfully, there is a lot of debate in the medical community on the nature of tendinosis. While it may not be acutely inflamed upon presentation, chronic inflammation is certainly at the heart of the long-term degeneration of the tendon. There is a big difference between acute and chronic inflammation.

Some of the regenerative therapies are emerging from pretty high level clinical trials, with good results. This is a pretty fast-changing field.

In my neck of the woods (Orange County, CA) we are having much better success rates with healing patients with chronic presentations of "tendonitis" using the tendinosis model. We do a lot of aggressive tissue mobilization, ART/tendon glides, and eccentric loading. A lot of my referring orthopedists are having great success with a combination of PRP injections and aggressive therapy. In all of the latest conferences, courses, and journals I have read, using heat and inducing inflammation is getting the best results at this point.

But yes, the OP needs to get evaluated by a specialist since every patient's case can be different. I was just trying to point them in the right direction and let them know the most probable cause of their symptoms based on the history given.

[Less'sMore]

I suppose someone should weigh in on suggestions on preventing the problem at the start or how to prevent reinjures after recovery.

By coincidence I was watching Joe Pass on YouTube last night with the sound off…so I could pay attention to his fretting hand and how his fingers moved on the fretboard. He was like Fred Astaire on his fingers. He seemed to use no effort at all. He seems entirely comfortable playing.

When I started playing, I was willing to tolerate a good deal of hand discomfort to get from A to B. Then I realized that any stress or pain was going to make playing difficult in the long run. Long story short, I think you have to find hand positions that are ergonomic and comfortable, the location of the guitar close or far, how to get the fingers comfortably on the fret…no matter how long it takes to learn those things and to feel relaxed.

Don.

[Aaron Smith]

Originally Posted by dmbfan32

In my neck of the woods (Orange County, CA) we are having much better success rates with healing patients with chronic presentations of "tendonitis" using the tendinosis model. We do a lot of aggressive tissue mobilization, ART/tendon glides, and eccentric loading. A lot of my referring orthopedists are having great success with a combination of PRP injections and aggressive therapy. In all of the latest conferences, courses, and journals I have read, using heat and inducing inflammation is getting the best results at this point.

But yes, the OP needs to get evaluated by a specialist since every patient's case can be different. I was just trying to point them in the right direction and let them know the most probable cause of their symptoms based on the history given.

I think the course of treatment you describe is pretty standard, is considered gold-standard therapy, and is likely to be similar to what a specialist would recommend. I am a tissue engineer and work in regenerative medicine research with orthopedists; a lot of the newer research and treatments looking into immunomodulation to organize the inflammatory process. PRP has been widely used for a long time, but there haven't been many studies that show that it's efficacious.

The direction that things appear to be headed is that we will better organize the healing process with a set of instructions, rather than just inducing inflammation (which may be as much a part of the problem as the solution).

My only point was that the OP should find a good physician, and keep an open mind. It's a fast changing field, and there's a lot of subtlety to making good clinical decisions.

[BluesyRob]

Originally Posted by Sixfir

As mentioned in the title of this topic I am wondering if any of you has recovered totally from chronical tendonitis, while still practicing the instrument without any major restriction?

I have it in my left elbow. I've been working with my physician on treatment. Right now I am using Rx cream, alternating with Topricin every few days, elbow band when needed, exercises, and slow warm-ups with guitar. It seems more stiff lately than sore. I am seeing my physician in another week to discuss further options, but hopefully I'm on the mend!

[dmbfan32]

Originally Posted by Aaron Smith

I am a tissue engineer and work in regenerative medicine research with orthopedists

Sweet job!!!

[Methos1979]

Yes, I did.

I had a very bad case of tendinitis in my left elbow several years ago when I was in my early 40's. I'm left-handed and I played hardcore tournament-level tennis most of my adult life. Oddly, the tendinitis (classic 'tennis elbow) occurred when I was on a hiatus from the sport for a few years due to a bad shoulder and surgery to correct that.

The pain came on quick, was VERY painful, and made life, pardon the pun, a pain. It impacted work and shooting. (I was active in combat handgun shooting at the time.) I tried the forearm band which worked very well but after several months I finally went to see a specialist to get some feedback from the professionals as to whether it was something that I could/should have fixed surgically.

He did a thorough work up and in the end told me to just ride it out, that in almost all cases, it eventually goes away. I was shocked. He said most people who die from old age do not have elbow tendinitis when they go. I'm not sure this was supposed to be helpful.

He said to just keep using the compression band and avoid things that make it worse. I switched from my beloved .45 ACP round to the much softer recoil of the 9mm which helped. And then one day... it was just GONE. It went as fast as it came. And it hasn't come back. I even started playing hardcore tennis again and it still has not come back. It's been several years.

So, for me at least, the answer is: Yes.

[jjtrain]

I had a minor case of it about three months ago. My left hand really started to hurt, especially the tenons. I deduced that I was playing too much/too hard (I kid you not, I was going about 2 hours per day). So I immediately stopped and left guitar out of my schedule for a few days.

The key to recovery is to do it right. If you change nothing, you'll further injure your hand, so something must be changed.

Based on that logic, I did hand stretches, and finger exercises. I improved my form on the guitar so my left hand wasn't stretching as much and I played lightly for a while. It seems to have subsided now, and I'm back to playing for long periods. Now though, I'm sure to keep my form up and keep my hands lose. Overtime I hope my fingers will strengthen and such an issue will cease to exist.

I had a minor case, those that had it harder than me would naturally take longer to recover. As someone mentioned, severe cases may never fully heal.

--James