Arthritis in the Hands, Fingers, and Neck

Dr. Lou Jacobs – Musician Specialist – Portland, Maine

What Musicians Need to Understand: Why Waiting Is a Bad Idea

If you’re a musician dealing with finger stiffness, joint swelling, reduced range of motion, grip weakness, or neck pain that just doesn’t settle, arthritis is often part of the conversation.

There are many types of arthritis. For musicians, confusing one type for another can lead to the wrong expectations, poor management, and unnecessary loss of function. That all translates into expensive pain and suffering.

Let’s clarify what’s actually happening, and what you can do about it.

Two Very Different Diagnoses:

Osteoarthritis vs. Rheumatoid Arthritis

Osteoarthritis (OA): Mechanical and Degenerative

Osteoarthritis is the most common form seen in musicians’ hands and necks.

What it is:

  • Gradual cartilage wear and joint surface changes

  • Often asymmetric (worse on one side)

  • Related to cumulative mechanical stress over time

  • Common in finger joints, thumb base, and cervical spine

What musicians notice:

  • Stiffness after playing or in the morning

  • Reduced finger independence

  • Pain in cooler more damp weather

  • Grinding, clicking, or loss of smooth motion

  • Neck stiffness that affects hand coordination

OA is not about “aging.” It’s about wear and tear. Wear and tear increases for most with age, but it’s not age but stress on joints, usually over time. All the joints of your body are the same age. If it were age, they’d all be the arthritic in the same way. 
Remember, it’s the result of how joints have been loaded for decades.

Rheumatoid Arthritis (RA): Systemic and Inflammatory

Rheumatoid arthritis is very different—and far less common.

What it is:

  • Autoimmune-driven inflammatory disease – caused by immune system dysregulation often with family ties.

  • Typically symmetrical (both hands involved)

  • Can involve rapid stiffness, swelling, and fatigue

  • Not caused by overuse or playing music

What musicians notice:

  • Prolonged morning stiffness in the hands and fingers

  • Swollen, warm finger joints

  • Reduced endurance and precision

  • Neck involvement that feels inflammatory rather than mechanical

RA requires medical diagnosis and management.
Musicians still need mechanical and neurological care, but expectations and strategies differ.

Dr. Lou and Blackberry Smoke

Dr. Lou and Blackberry Smoke

How Musical Activity Interacts with Each Type

Osteoarthritis

Musical activities that can worsen symptoms:

  • Repetitive finger loading without recovery

  • Forceful fretting, bow pressure, or gripping

  • Limited movement variety during long sessions

  • Neck positions held for hours during practice or performance

These shouldn’t cause OA on their own—but they can contribute,  accelerate symptoms and limit adaptability.

Rheumatoid Arthritis

Musical challenges often include:

  • Reduced tolerance for sustained playing

  • Loss of fine motor control during flares

  • Neck stiffness affecting nerve input to the hands

Music doesn’t cause RA, but unmanaged mechanics can magnify functional loss.

Activities of Daily Living: The Overlooked Amplifiers

This is where arthritis symptoms often spiral.

There are many common ADLs that aggravate both OA and RA. You have seen me write about these before because they are so present in our lives:

  • Smartphone and tablet use

  • Laptop keyboards and trackpads

  • Driving long distances more than shorter distances

  • Lifting cases, groceries, kids, or pets

  • Cooking, chopping, gripping utensils

  • Yard work, shoveling, snow removal

  • Poor sleep positioning affecting the neck and hands

Most musicians spend far more time in daily life than on stage or even practicing.

Ignoring these loads while blaming the instrument is a common, costly, and somewhat confused mistake.

Dr. Lou with Motionless in White Trinity Of Terror Tour

Dr. Lou with Motionless in White – Trinity Of Terror Tour

 

Why Arthritis Feels Worse in the Hands and Neck

Needless to say, you are using your hands to play and your neck to position your head to read music, look at your instrument, maybe even headband in front of your fans. Your hands and fingers are controlled by:

  • Cervical spine mechanics

  • Peripheral nerve function and health

  • Sensory feedback to the brain

Research shows altered sensory processing and joint input play a significant role in chronic joint pain and stiffness—not just cartilage loss (Haavik & Murphy, 2012; Schaible, 2014).

This is why:

  • Neck stiffness can worsen hand pain

  • Finger arthritis can feel unpredictable

  • Pain doesn’t always match X-ray findings

Why “Let’s See How It Goes” Fails Musicians

Waiting is tempting because:

  • Symptoms fluctuate

  • You don’t feel like you have the time

  • You can still play… for now

  • You don’t want to overreact

  • you don’t want to spend the money

But with arthritis:

  • Early management preserves motion and control

  • Delayed care leads to compensation, guarding, pain, greater expense and more time spent on the problem

  • The nervous system adapts – often poorly and worsening more over time.

  • Small losses in mobility compound over time

Once motion is lost, it’s harder to regain.

How a Musician Health Specialist Helps

In my Portland, Maine practice, arthritis care for musicians focuses on function, control, empowerment, precision, strategy, science, experience and not fear.

My role is not to treat autoimmune disease or prescribe medication.
Our role is to help you use what you have—better.

Care often includes:

  • Restoring joint motion in the hands, wrists, and neck

  • Improving cervical spine mechanics that affect hand input

  • Reducing mechanical stress on irritated joints

  • Supporting nervous system control of movement

  • Identifying ADL habits that quietly worsen symptoms and creating a strategy to adapt

  • Helping musicians adapt without abandoning their instrument

This is concierge-level, musician-specific care—rooted in listening, experience, and evidence.

The Bottom Line for Musicians with Arthritis

Arthritis doesn’t mean your playing days are numbered.
But it does mean you can’t afford to ignore early signals.

Whether osteoarthritis or rheumatoid arthritis, the sooner you address:

  • Joint motion

  • Neck mechanics

  • Daily load exposure

  • Nervous system input

…the more control you retain over your hands, your neck, and your music.

Waiting rarely improves arthritis.
Strategic, early management often does.

***For information on how taking over the counter pain killers and anti inflammatory medications may impact your body in a negative way with long term consumption, google it. Research shows that longterm use of NSAIDS (non steroidal anti inflammatory drugs) among others is not desirable.

Dr. Lou Jacobs, Chiropractor and acupuncturist in Portland, Maine, has been working with and specializing in the health and performance of musicians of all types, for over 23 years. His work has been highlighted in Guitar Player Magazine, and his client list is extensive, having worked with some of the best horn players in the world today. Dr. Lou is always accepting new patients and offers tele-consulting for musicians outside of Southern Maine. Dr. Lou also works with families and is board certified in chiropractic care for children and  pregnant moms. Dr. Lou may be reached by calling (207) 774-6251 or by messaging his office manager, Sandra Escobar, at Sandra@DrLouJacobs.com.

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