The Challenges Of Musicianship, Pain, and Arthritis

Posted: September 3, 2015 in DIY, Guitar, Modification
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I am very ill.  In January of 2014, I began having pain in my shoulder.  By the next week, both shoulders, my wrists and hands were affected, more significantly on the right side.  By the end of February, I couldn’t walk very well and I felt very sick.  Since that time, I have had periods of being restricted to bed, short periods of relative wellness, and situations in between, but the pain and arthritis continue.  I was diagnosed with Seronegative Rheumatoid Arthritis and chronic pain (Edit June 2016: this was misdiagnosed Lupus).  Among the things it affected was my ability to play music.

Music and playing music are central to how I identify with the world.  It’s kind of a cliché, but it changed my life and I don’t want to completely give it up.  I started this blog around the time I became ill.  As I was losing my physical abilities, I felt the need to put forward my knowledge and contribute information -I’m hoping it is completely accurate information- to help people along.  At the time, I could still build pedals.  I was starting with odds and ends, but my end goal was covering concepts for new designs that weren’t just copies of older pedals.  That isn’t going to be and I switched up the content to still contribute something that can be helpful.  The information for Dual Rectifiers and other newer topics is to fill a gap regarding questions or needs, or to dispel really blatantly false myths I’ve read.  I can see that the help was needed, because my traffic has exploded by comparison to the year before.

With all of that in mind, what I want to write about today is setting up a guitar for ease of playing, specifically for arthritis or pain conditions.  Since there is a trade-off for everything, this will trade a bit of sustain and volume to be able to play at all.  I used to blaze trails up and down the fretboard; crazy, outside playing that avoided common licks.  Being unable to properly grip the strings, being unable to stretch my fingers, and problems properly using a plectrum forced me to back up and take a new direction and take a new approach to my setups.

For many years, I’ve used strings that are 10-46.  It’s a medium tension at standard tuning and rides the fence between low and high gauges.  To compensate for my illness, I tuned down to Eb or D Standard tuning.  D is super easy to play, but I ran into some problems.  At a certain point, there was not enough tension being placed on the neck.  It wasn’t so bad as to create back bow, but the 5th through 7th frets would develop dead spots: it was warping.  It was difficult to see and took many months to set in.  After re-crowning the frets, the 5th fret of the 6th string was an issue until I tuned up to Eb and let it settle for a couple of weeks.

I don’t want to bump the gauge for a few reasons.  The main one is needing to file the nut and the bridge saddles.  Another is my preference for having the strings thin and easy to fret and bend.  In my experience, the way the tension is increased by changing string sizes makes it harder to fret in some areas.  It also needs a larger space to vibrate and produce the notes.  Putting the emphasis on a higher height with a lighter string requires no additional work to the guitar and keeps the feel the way I like it.  Being on pitch with fretted notes can be a challenge due to reduced arm/wrist/hand/finger strength, but practice over time will help with so called “muscle memory” to be at the correct pitch.  Your mileage may vary.

With my SG, the neck is shorter (24.5″) and can be set to a higher neck relief than the 25.5″ LTD.  It seems that the longer the neck, the flatter it needs to be set.  I haven’t been playing the SG as much, because the pickups and nut need to be replaced.  I might try to get another, because the shorter scale is much easier to play.

“Nailed it”

D’Addario has a great resource for string tension at different frequencies of the open string for a 25.5 scale length.  I don’t have a precise total of the tension required, but it seems that anything lower than about 80-83 lbs total begins to be an issue.  I’m sitting around 85 lbs right now and it seems to be working.  This setup took 16 months to come to.  The guide linked above, trial, and error have taught me a few things.

  • One thing that became immediately clear was the way tuning down to D Standard was like switching to a lower string gauge.  Using 10s for D is about like using 9s for E.  Keep in mind the tension considerations and move up a gauge if you want retain similar tension for lower tunings.
  • The truss rod adjustment is tricky when working with the combination of low-ish action, down tuning, and low to medium string gauges.  If going in blind, it might take a lot of time to find a sweet spot and not eventually damage the neck.
  • The easiest way for me to setup my guitar for my condition is to have a height/tension requirement in mind and work toward it.  Because neck relief is so slight, correlating string height, angle, and feel is easier to imagine.
  • If you are reducing tension from your normal settings, consider increasing the height you might normally use by a small fraction of 1 mm.
  • Mine is set like this: from fret 12, I want my 6th string to be about a hair below 2 mm and the 1st string to be about 1.5 mm  I used to shoot for about 1.5 mm on the 6th string and 1 mm on the first, but down tuning with 10s does not create enough tension at that height.  Increasing the height introduced just enough tension to keep the neck stable and flat.
  • To have a blank slate to work from, I set my neck pretty much straight with the truss rod and set the string height at the selected height (2 mm/1.5 mm in this case).
  • Loosen the truss rod by very small amounts (1/8th turns), re-tune to pitch, reset the string height by measuring at fret 12, and tune up again.
  • Play a few notes and chords up the neck to check the feel and listen for fret buzz and double check the relief.  If the frets buzz, I repeat the steps above.
  • When the 6th string doesn’t cause fret buzz between frets 4 and 8, and is comfortable, stop.
  • After about 24 hours, check it all again and ensure that it is going to work.  If it isn’t comfortable or there’s a problem executing a technique due to the setup, pick another height and try again, beginning with a flat truss rod setting and adjusting everything from there.  Always give time for the neck to settle before you consider yourself finished with the job.

In addition to the initial setup, here are some things to keep in mind:

  • If you find that the truss rod is requiring a LARGE amount of relief, make sure the action is not too low.  Increase it if you have to.
  • The reverse is also true: very high action is often due to too little truss rod relief (all other things being fine).  High action is less damaging to the guitar, unless it is resembling gargantuan telephone wires.
  • I check my setup at least every 3 months, if not sooner.  Making small adjustments for the seasons or for periods of extreme weather conditions will keep your guitar in shape.  I’m pretty sure my neighbors appreciate that consideration during monsoons, when the humidity rises and the guitar needs to be reset.
  • Because I tuned down and didn’t bump the string gauge up, I can’t get extremely low action.  It isn’t necessary in every case and one thing or the other shouldn’t be a hangup; the important thing is balance between all the individual parts.  If the tension is light enough, the height can be at a more normal spot and still be very easy to play.
  • All other things being equal, if your nut is not the correct height, or your bridge saddles are badly worn, replacement will be necessary to correctly intonate the instrument or for the guitar to be setup properly.  These things can be repaired to a certain extent, but realize when it’s time to change them.
  • Above all: when playing the guitar hurts too badly, stop.  I know.  It sucks, but you’ll be able to play another time, perhaps quickly, if you do not injure yourself.  (Full disclosure: this is the hardest thing for me.)

Good luck and have fun.  No matter how you go about it, the main point is to consider the amount of tension and how you would like to keep it in the right zone.  My way is one of many and I hope it helps.

In the future, I will try a combo of an extremely flat neck and lower action and I’ll try to report on it afterward.


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