Guitarists often find themselves with arthritis in the fingers.

If you’ve seen Keith Richard’s fingers in the past few years, you’ve probably noticed the arthritis. He can still play, and you should be able to as well. There are action steps that you can take to ease the arthritic destruction, pain, and restriction of what are called Heberden’s Nodes.

Heberden’s nodes are bony swellings that can develop at the distal interphalangeal joints (DIP) of the fingers. They are often associated with osteoarthritis. While there is no cure for Heberden’s nodes, the following management strategies can help alleviate symptoms and improve quality of life:
Pain management: Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), suggested by your primary care doctor, may help reduce pain and inflammation. Always follow the recommended dosage and consult a Medical Doctor if you need a formal recommendation or have any concerns.
Topical treatments: Some topical creams and gels containing capsaicin, CBD, THC or NSAIDs can be applied to the affected areas to reduce pain and inflammation. Discuss these options with your doctor to ensure they are appropriate for your situation.
Heat and cold therapy: Applying warm compresses or using paraffin wax baths can help soothe the joints and alleviate discomfort. Cold packs may also be used to reduce inflammation during flare-ups.
Hand exercises: Gentle exercises and stretches for the fingers and hands can help improve joint flexibility and reduce stiffness. Chiropractic, Physical, or occupational therapy can be beneficial in creating a tailored exercise plan.

Joint protection: Avoiding activities that put excess strain on the affected joints can help prevent further damage. Using assistive devices, such as ergonomic tools, can also ease stress on the fingers.
Splints or braces: Wearing splints or braces designed to support and stabilize the affected fingers may help reduce pain and improve function.
Weight management: Maintaining a healthy weight can lessen the load on the joints and reduce the progression of osteoarthritis.

Lifestyle modifications: Avoiding repetitive movements or activities that exacerbate symptoms can be beneficial. It’s essential to strike a balance between activity and rest to avoid overuse of the affected joints.
Injections: In some cases, corticosteroid injections directly into the affected joint may provide temporary relief from pain and inflammation. However, these injections are usually reserved for severe cases and are not suitable for long-term use.
Surgery: If conservative treatments do not provide sufficient relief and the Heberden’s nodes significantly impact the function of the hand, surgical intervention might be considered. Surgery involves removing the bony growths, but it’s essential to discuss the potential risks and benefits with a hand surgeon. This option is not ideal for guitar players, there are too many variables that could lead to an inability to play post surgery.
Assistive devices: Using adaptive tools and devices can make daily tasks easier and reduce strain on the affected fingers. For example, using jar openers, buttonhooks, or zipper pulls can help minimize joint stress, and stress on arthritic Heberden’s nodes.
Natural remedies: Some people find relief from Heberden’s nodes through alternative therapies like acupuncture, herbal supplements, or topical applications of essential oils. However, it’s essential to discuss these options with a healthcare professional to ensure safety and effectiveness.
Low-impact exercises: Engaging in low-impact activities like swimming or cycling can be beneficial for overall joint health. These exercises can help maintain joint flexibility and strengthen surrounding muscles without putting excessive strain on the affected joints.

Diet modifications: Certain foods may have anti-inflammatory properties, which can help in managing symptoms of osteoarthritis and Heberden’s nodes. A balanced diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids may be beneficial.
Psychological support: Living with chronic conditions like Heberden’s nodes can be challenging, emotionally and mentally. Seeking support from friends, family, or support groups can provide encouragement and coping strategies.
Medication review: If you are taking other medications, it’s essential to review them with your healthcare provider. Some drugs may interact or exacerbate symptoms of osteoarthritis. Your doctor can help adjust your medication regimen as needed.
Avoid smoking and limit alcohol: Smoking and excessive alcohol consumption can worsen inflammation in Heberden’s Nodes and may contribute to joint problems. Quitting smoking and moderating alcohol intake can be beneficial for overall health and joint function.

Dr. Lou Jacobs is a chiropractor and acupuncturist in Portland, Maine. He is also licensed in New Hampshire, exclusively for working with musicians at their various venues. He has been working with musicians and their health concerns for over 20 years. As a guitar player himself, he is in tune with the specific needs of guitarists, but has worked with musicians who play other instruments as well. Dr. Lou may be reached by calling his office at (207) 774-6251.

For Musicians outside of Maine and New Hampshire, Dr. Lou reserves Fridays for video consulting calls. To consult with Dr. Lou, or for questions related to consulting, email Dr. Lou directly at