Hand pain - Tendonitis?

[wafter]

I have a history of relatively low-level, transient joint pain that usually manifests itself when I've not been staying on top of my diet and eating stuff that provokes inflammation. I'd suggest the pain was typically a low-level grumbling related to joint movement, and didn't seem to worsen significantly when the joint was loaded.

Maybe three months ago I got stung by a bee on my right index finger ( ), causing that finger, the adjacent thumb and part of the hand to swell for several days. I eventually fasted for a day which largely got rid of the swelling and all seemed normal, however some time later (days, weeks - can't remember) I had a lot of something I shouldn't have (probably beer) and the swelling returned to a significant extent.

It's since dissipated again and not really returned, however I've now got significant arthritis-like pain in my right hand - most notably in the thumb but also the wrist. This is particularly unpleasant since unlike the other joint pain I was getting, it intensifies massively (especially at the thumb) when the joints are loaded in a certain way, seems almost constantly present and is noticeably impinging on my daily activities. I have similar, but lesser symptoms in the left hand too.

Pain in the thumb happens when it's loaded from beneath at the tip and being pushed backward - think fitting a tyre or squeezing out the last dregs of toothpaste. The pain is at the top of the joint, concentrated at the inside of the thumb - this area being slightly red / visibly inflamed, and also painful to the touch. The wrist is painful at the inside / underside if loaded when bent back over the arm - as might be the case if you were doing an open-hand pressup.

As usual my GP seemed pretty disinterested and dismissive so I'm once more trying to sort myself out in terms of what's actually wrong, what (if anything) is causing it and what can be done to lessen its severity.

Since the bulk of the issue centres around the inside top of the thumb and inside of the wrist I'm wondering if the issue is more likely associated with tendons rather than the joints themselves.. actually, looking at the summary on the NHS website the symptoms are pretty consistant with Tendonitis.. although it hasn't magically got better in the 2-3wks suggested.

On to causes; obviously there's the bee sting but I also wonder if there are other causal / exacabatory factors that I should be avoiding. The problem roughly correlates with the purchase of my Brompton; which has brought with it both a different format of bike / type of handlebar and a fair hike in the number of miles I'm doing.

I've noticed that the Brompton's grips are wearing heavily near their ends; since the outside of my palms (on the opposite sides of the hand to my gammy thumbs) evidently exert a lot of load on them here. This in itself doesn't cause any pain anywhere while I'm riding. I do find myself subconsciously searching for different hand positions however, and when terrain's not too tough tend to default towards resting my hands inboard on top of the brake assembly. If I grip the bars and leave my thumbs hanging I do feel a slight discomfort in the affected area above the joint due to the vibrations encountered..

I wonder if this problem has been worsened by a combination of a different hand position, increased vibration and increased distance covered; being some sort of RSI-related issue..?

It does feel a fair bit better today and I had to drive to work yesterday so have only done two days on the Brompton this week.. equally I also smashed a load of G&Ts last night and have found the anti-inflammatory effects of the Quinine in the T to noticeably improve the joint situation; so maybe this is responsible.

Anyway, after all that I'm anxious to hear of anyone else's experience as I'm a fairly practical person and rely on cycling to keep me going - so the thought of some degenerative condition affecting my ability to use my hands in these capacities fills me with dread..

Thanks, as always

 

[GuyBoden]

Obviously, you made sure that the Bee sting\barb is not still stuck into the thumb?

 

[vickster]

I've got tendonitis in my thumb too (and weirdly little fingers). Spoke to a physio
- have exercises https://www.versusarthritis.org/abo...s/exercises-for-the-fingers-hands-and-wrists/ (the thumb stretch hurts, typical De Quervains tendonitis)
He said to use a splint (completely impractical when working), anti-inflammatory gel, ice, anti-inflammatory meds.
Maybe see a physio (probably have to wait a while on NHS or go private) and get some ergo grips for Brompton?
Quinine might be ok for malaria, but alcohol is not good for inflammation generally (I'm sure you're aware )

 

[iluvmybike]

If you are putting a lot of pressure on the bars then perhaps you could look at your set up

 

[oldwheels]

I have similar symptoms but not too bad.
My main point is to second the purchase of ergo grips which I fitted to my own Brompton which has straight bars.

 

[Chris S]

I was getting wrist pain until I angled my handlebars slightly upwards. It forced me to lean back slightly and took some pressure of my wrists. Perhaps it would also work with your fingers?

 

[Once a Wheeler]

Wrist pain from arthrosis has been something I have suffered from. However, after following Michael Mosley's Fast Diet for a few months it stopped getting worse and then actually reduced. It is still there, but now a niggle rather than a problem. Worth a try, perhaps.

 

[a.twiddler]

It might be that the Brompton bar layout and distance between shoulders and hands is sub optimal compared to a conventional bike for the sake of the fold -you can't use long bar ends at the ideal angle because of the need to fold, so have to use shorter ones for example. The bars are quite narrow, and if you fit wider ones you have to make compromises. Ergo grips, padded gloves, maybe grips with more padding , might help. I'm quite short, so I don't suffer from being cramped up but if you're average or taller that might contribute to hand and wrist pain.
As suggested above, a small change might provide a solution, if only you can figure out what might work for you.

People do ride long distances on Bromptons but maybe that's a leisure thing. That's different from doing a regular commute on bumpy surfaces day after day, so maybe the effects are cumulative. One good thing, winter is coming, so there's the opportunity to get your hands padded up without overheating to try different solutions.

 

[wafter]

Thanks all - really appreciate the feedback!

Obviously, you made sure that the Bee sting\barb is not still stuck into the thumb?

View attachment 706483

Yes, that's long-gone thankfully. I was in the kitchen when it happened and instinctively grabbed a kitchen knife to run over the sting and pull it out.

I've got tendonitis in my thumb too (and weirdly little fingers). Spoke to a physio
- have exercises https://www.versusarthritis.org/abo...s/exercises-for-the-fingers-hands-and-wrists/ (the thumb stretch hurts, typical De Quervains tendonitis)
He said to use a splint (completely impractical when working), anti-inflammatory gel, ice, anti-inflammatory meds.
Maybe see a physio (probably have to wait a while on NHS or go private) and get some ergo grips for Brompton?
Quinine might be ok for malaria, but alcohol is not good for inflammation generally (I'm sure you're aware )

Sorry to hear that - bloody horrible isn't it?

Thanks for the video, I'll definitely make an effort to try those to see if they make any difference. I found the thumb stretch OK, but the finger tendon glide stretch wasn't so much fun.

I think I have a problem with anti-inflammatory meds and as you suggest a splint's not really going to feasible but I'll look at the other two suggestions. I find (like many other allergy related symptoms I have) heat seems to help.

Yes, I'm aware of the alcohol thing, thanks. Definitely need to cut down on that for many reasons; although at the moment it's proving easier said than done and I don't fancy my chances heading into the cold and dark of winter

If you are putting a lot of pressure on the bars then perhaps you could look at your set up

I think the problem is that the load appears to be concentrated in one spot, on the outsides of my hands. Of course this could be a red herring since there's no obvious, direct relationship between the load at the outside of my hands and the pain at the inside.. although I appreciate that things sometimes aren't obviously connected.

The setup on my other bikes is pretty well sorted, however the Brompton is different given the flat(ish) bars (all my other bikes have drops) and limited adjustability. I have fairly wide shoulders and with bent elbows think that my arms come at the bars from the wrong angle considering they're swept backwards / up at their ends. I think an entirely neutral bar would be better, and standing infront of the bike and gripping the bars from the wrong side (with their ends effectively swept away, rather than towards me) feels more comfortable than the existing setup.

On the Brompton it does seem that I'm maybe putting more load through my hands, which is odd since it should have a more relaxed geometry than my other bikes. It might just be because it's concentrated more in one spot..

I have similar symptoms but not too bad.
My main point is to second the purchase of ergo grips which I fitted to my own Brompton which has straight bars.

Sorry to hear that; I see a lot of Bromptons with ergo grips but I'm not sure how much they'd help in this instance. I guess they couldn't make it much worse considering the very obvious, tiny contact patch my hands currently "enjoy".

I assume by straight bars you mean the lower variant without the up-sweep from the stem..? Are they actually dead-straight or are the bars biased in any particular direction?

I'm happy with the height of mine and went medium by choice as I didn't want it to be to aggressive; however I think would benefit from grips that are co-axial rather than angled..

EDIT: While it looks like the "straight" bars do have some angle to their grips, I imagine they could be rotated in the stem to alter the orientation of these angled sections. On the down side changing bars a ballache (different stem and cable lengths) is it not?

I was getting risk pain until I angled my handlebars slightly upwards. It forced me to lean back slightly and took some pressure of my wrists. Perhaps it would also work with your fingers?

Thanks - unfortunately easier said than done on the Brompton however!

Wrist pain from arthrosis has been somthing I have suffered from. However, after following Michael Mosley's Fast Diet for a few months it stopped getting worse and then actually reduced. It is still there, but now a niggle rather than a problem. Worth a try, perhaps.

Cheers - interested to hear more on the fasting. Is he promoting intermittant, the 5:2 or something else? I've fasted in the past for many reasons and have always found it enormously beneficial - for many reasons. More recently I've fasted to "reset" my chronic food allergy symptoms which I think are exacerbating this joint issue as the allergies usually cause some degree of inflammation.

As it stands I've not eaten since last night and plan to continue until tomorrow morning. I've generally done extended fasts in the past and find that getting past about three days pretty much sorts out all of the allergy symptoms. I'm on anti-histamines constantly, and while these do a decent job of arresting some symptoms, I wonder if they're less effective with others. Really I need to sort my diet out (and ideally include some regular fasting) bit that's easier said than done..

It might be that the Brompton bar layout and distance between shoulders and hands is sub optimal compared to a conventional bike for the sake of the fold -you can't use long bar ends at the ideal angle because of the need to fold, so have to use shorter ones for example. The bars are quite narrow, and if you fit wider ones you have to make compromises. Ergo grips, padded gloves, maybe grips with more padding , might help. I'm quite short, so I don't suffer from being cramped up but if you're average or taller that might contribute to hand and wrist pain.
As suggested above, a small change might provide a solution, if only you can figure out what might work for you.

People do ride long distances on Bromptons but maybe that's a leisure thing. That's different from doing a regular commute on bumpy surfaces day after day, so maybe the effects are cumulative. One good thing, winter is coming, so there's the opportunity to get your hands padded up without overheating to try different solutions.

Thanks - this is my thinking.. bottom line (as above) bars maybe too narrow but I think the big one is that they're angled incorrectly to play nicely with my arms / shoulders. I've not had a problem with the drops on my other bikes (and have got into the habit of gripping the tops fairly near the stem with no obvious issues; but of course the bars are straight in this area rather than angled backwards.

I did think about the gloves situation moving into winter, but of course that would be more than one variable changing as the temp would be dropping too; which might also affect things one way or the other.

The more I look at the bars the more wrong they seem to be.. although granted everyone else seems to get on with them OK..

 

[Once a Wheeler]

Cheers - interested to hear more on the fasting. Is he promoting intermittant, the 5:2 or something else?

The book deals with many possible regimes and associated issues such as auto-immune responses and the diet-exercise relationship. I follow the basic 5:2 regime in normal times but give it a rest during high-activity periods such as cycle touring and mountain walking holidays. As I mentioned, well worth a read even if you do not end up following it in practice.

 

[figbat]

Gout?

 

[wafter]

The book deals with many possible regimes and associated issues such as auto-immune responses and the diet-exercise relationship. I follow the basic 5:2 regime in normal times but give it a rest during high-activity periods such as cycle touring and mountain walking holidays. As I mentioned, well worth a read even if you do not end up following it in practice.

Thanks - sounds like it's well worth a read as I have a lot of faith in fasting. Will make an effort to track down a copy

I'm currently about 43hrs into a near-fast (spoiled by one tiny piece of chicken and a couple of energy drinks), and while feeling generally better for it, it's not done a whole lot for this specific joint pain..

Gout?

Thanks - I guess it's a possibility; hard to nail down symptoms to isolate it from the other potential causes..

Apparently beer is particularly bad as it contains purines which are metabolised into the uric acid that crystallises in the joints, causing the pain./ I did go through a fair amount of beer a whole ago but now it's typically limited to once, maybe twice a week in moderation. I'll pay attention to see if it's noticeably worse after consuming the next pint or two.

I have been drinking a lot of water today (which is supposed to help gout) and the pain seems largely unaffected, although I'm not sure how much effect it should have.

 

[oldwheels]

Thanks all - really appreciate the feedback!


Yes, that's long-gone thankfully. I was in the kitchen when it happened and instinctively grabbed a kitchen knife to run over the sting and pull it out.



Sorry to hear that - bloody horrible isn't it?

Thanks for the video, I'll definitely make an effort to try those to see if they make any difference. I found the thumb stretch OK, but the finger tendon glide stretch wasn't so much fun.

I think I have a problem with anti-inflammatory meds and as you suggest a splint's not really going to feasible but I'll look at the other two suggestions. I find (like many other allergy related symptoms I have) heat seems to help.

Yes, I'm aware of the alcohol thing, thanks. Definitely need to cut down on that for many reasons; although at the moment it's proving easier said than done and I don't fancy my chances heading into the cold and dark of winter



I think the problem is that the load appears to be concentrated in one spot, on the outsides of my hands. Of course this could be a red herring since there's no obvious, direct relationship between the load at the outside of my hands and the pain at the inside.. although I appreciate that things sometimes aren't obviously connected.

The setup on my other bikes is pretty well sorted, however the Brompton is different given the flat(ish) bars (all my other bikes have drops) and limited adjustability. I have fairly wide shoulders and with bent elbows think that my arms come at the bars from the wrong angle considering they're swept backwards / up at their ends. I think an entirely neutral bar would be better, and standing infront of the bike and gripping the bars from the wrong side (with their ends effectively swept away, rather than towards me) feels more comfortable than the existing setup.

On the Brompton it does seem that I'm maybe putting more load through my hands, which is odd since it should have a more relaxed geometry than my other bikes. It might just be because it's concentrated more in one spot..



Sorry to hear that; I see a lot of Bromptons with ergo grips but I'm not sure how much they'd help in this instance. I guess they couldn't make it much worse considering the very obvious, tiny contact patch my hands currently "enjoy".

I assume by straight bars you mean the lower variant without the up-sweep from the stem..? Are they actually dead-straight or are the bars biased in any particular direction?

I'm happy with the height of mine and went medium by choice as I didn't want it to be to aggressive; however I think would benefit from grips that are co-axial rather than angled..

EDIT: While it looks like the "straight" bars do have some angle to their grips, I imagine they could be rotated in the stem to alter the orientation of these angled sections. On the down side changing bars a ballache (different stem and cable lengths) is it not?


Thanks - unfortunately easier said than done on the Brompton however!


Cheers - interested to hear more on the fasting. Is he promoting intermittant, the 5:2 or something else? I've fasted in the past for many reasons and have always found it enormously beneficial - for many reasons. More recently I've fasted to "reset" my chronic food allergy symptoms which I think are exacerbating this joint issue as the allergies usually cause some degree of inflammation.

As it stands I've not eaten since last night and plan to continue until tomorrow morning. I've generally done extended fasts in the past and find that getting past about three days pretty much sorts out all of the allergy symptoms. I'm on anti-histamines constantly, and while these do a decent job of arresting some symptoms, I wonder if they're less effective with others. Really I need to sort my diet out (and ideally include some regular fasting) bit that's easier said than done..



Thanks - this is my thinking.. bottom line (as above) bars maybe too narrow but I think the big one is that they're angled incorrectly to play nicely with my arms / shoulders. I've not had a problem with the drops on my other bikes (and have got into the habit of gripping the tops fairly near the stem with no obvious issues; but of course the bars are straight in this area rather than angled backwards.

I did think about the gloves situation moving into winter, but of course that would be more than one variable changing as the temp would be dropping too; which might also affect things one way or the other.

The more I look at the bars the more wrong they seem to be.. although granted everyone else seems to get on with them OK..

to sit on the rock at the corner of the beach where I like to sit and ponder, meditate and watch the sun set. That's always the problem with good weather, it brings people to all my secluded beauty spots I like to visit. It is better if they go back to sitting in a traffic jam queuing to go to Homebase or somewhere to buy things they probably don't need!

Thanks all - really appreciate the feedback!


Yes, that's long-gone thankfully. I was in the kitchen when it happened and instinctively grabbed a kitchen knife to run over the sting and pull it out.



Sorry to hear that - bloody horrible isn't it?

Thanks for the video, I'll definitely make an effort to try those to see if they make any difference. I found the thumb stretch OK, but the finger tendon glide stretch wasn't so much fun.

I think I have a problem with anti-inflammatory meds and as you suggest a splint's not really going to feasible but I'll look at the other two suggestions. I find (like many other allergy related symptoms I have) heat seems to help.

Yes, I'm aware of the alcohol thing, thanks. Definitely need to cut down on that for many reasons; although at the moment it's proving easier said than done and I don't fancy my chances heading into the cold and dark of winter



I think the problem is that the load appears to be concentrated in one spot, on the outsides of my hands. Of course this could be a red herring since there's no obvious, direct relationship between the load at the outside of my hands and the pain at the inside.. although I appreciate that things sometimes aren't obviously connected.

The setup on my other bikes is pretty well sorted, however the Brompton is different given the flat(ish) bars (all my other bikes have drops) and limited adjustability. I have fairly wide shoulders and with bent elbows think that my arms come at the bars from the wrong angle considering they're swept backwards / up at their ends. I think an entirely neutral bar would be better, and standing infront of the bike and gripping the bars from the wrong side (with their ends effectively swept away, rather than towards me) feels more comfortable than the existing setup.

On the Brompton it does seem that I'm maybe putting more load through my hands, which is odd since it should have a more relaxed geometry than my other bikes. It might just be because it's concentrated more in one spot..



Sorry to hear that; I see a lot of Bromptons with ergo grips but I'm not sure how much they'd help in this instance. I guess they couldn't make it much worse considering the very obvious, tiny contact patch my hands currently "enjoy".

I assume by straight bars you mean the lower variant without the up-sweep from the stem..? Are they actually dead-straight or are the bars biased in any particular direction?

I'm happy with the height of mine and went medium by choice as I didn't want it to be to aggressive; however I think would benefit from grips that are co-axial rather than angled..

EDIT: While it looks like the "straight" bars do have some angle to their grips, I imagine they could be rotated in the stem to alter the orientation of these angled sections. On the down side changing bars a ballache (different stem and cable lengths) is it not?


Thanks - unfortunately easier said than done on the Brompton however!


Cheers - interested to hear more on the fasting. Is he promoting intermittant, the 5:2 or something else? I've fasted in the past for many reasons and have always found it enormously beneficial - for many reasons. More recently I've fasted to "reset" my chronic food allergy symptoms which I think are exacerbating this joint issue as the allergies usually cause some degree of inflammation.

As it stands I've not eaten since last night and plan to continue until tomorrow morning. I've generally done extended fasts in the past and find that getting past about three days pretty much sorts out all of the allergy symptoms. I'm on anti-histamines constantly, and while these do a decent job of arresting some symptoms, I wonder if they're less effective with others. Really I need to sort my diet out (and ideally include some regular fasting) bit that's easier said than done..



Thanks - this is my thinking.. bottom line (as above) bars maybe too narrow but I think the big one is that they're angled incorrectly to play nicely with my arms / shoulders. I've not had a problem with the drops on my other bikes (and have got into the habit of gripping the tops fairly near the stem with no obvious issues; but of course the bars are straight in this area rather than angled backwards.

I did think about the gloves situation moving into winter, but of course that would be more than one variable changing as the temp would be dropping too; which might also affect things one way or the other.

The more I look at the bars the more wrong they seem to be.. although granted everyone else seems to get on with them OK..

Looking at the bars they are for all practical purposes completely flat. The bike is currently folded and not very accessible so just looked at it folded.

 

[wafter]

Boring, largely inconclusive and inconsequential update..

I've only done one ride to work this week and did a 60hr (near) fast that ended on Tuesday; with that evening dedicated to a big, G&T-fuelled night out.

Joints have definitely been feeling better; I think the fast helped, as did the copious amount of G&T as the worst-affected hand felt especially good on Wednesday morning (as I did, compared to how I expected to - another massive reminder that I need to absolutely leave the beer alone). I also acknowledge the point that while the T is probably helping, the G probably isn't... especially not in the quantities I've become used to consuming.

As it stands now the hand that got stung is conspicuous in how much worse than the other one the symptoms are. While improved to the point that I can generally do low-load, daily tasks without being reminded of the problem, there's still pain if I load the joints up in the way discribed in the OP. By contrast the left hand is so much better.

My right index finger was also slightly swollen this morning in additional to the usual stiffness I'm now getting in this hand when I wake up; I think possible because I had some strawberries yesterday - which I know I react to but struggle to leave alone when they're in season as they taste so good (and go so well with G&T).

I've also had a look at possible Brompton bar designs and it seems that everything with a rise has the stupid back-swept grips. I don't think attempting to bend the originals would be wise so it looks like I'm out of options in this regard

Probably ought to start looking at other anti-inflammatory options as it seems that controlling diet is only going to get me so far. The fast has (for now at least) got me back on the low carb thing though which is another bonus.

 

[Ming the Merciless]

and a couple of energy drinks

What were the energy drinks for, fuelling a long period of exercise?