Gary, twisted fingers or contorted hands is a symptom of PD. I get it on my left side both hand and foot. You can ask your neuro doc about getting botox injections to control this. I get hand cramping while driving and I have to bend my fingers backwards to compensate. best regards Alex

Hi, Gary.

I'm sorry for the difficulties that you are having but am glad that you will be meeting with your neurologist next month. While Bradykinesia (the slowness in movement) is bothersome, I sense from what you are describing that Dyskinesia and/or even Dystonia may be the more troublesome problems for you. To help define and distinguish between the two, I am including an excerpt below from http://parkinsons.about.com/od/treatmentoptions/fl/Dystonia-vs-Dyskinesia.htm. There are medications that will help alleviate both conditions, but I would also recommend a daily meditation routine to help relax muscles. There are many good guided meditation CD's available that will teach and guide you alone.

Here now is the excerpt re: Dystonia and Dyskinesia:

Dystonia can be defined as a prolonged contraction in a particular muscle or increased muscle tone that results in abnormal posturing or a muscle spasm. It usually contorts the body part in a painful manner and depending on which muscle group is involved, is usually quite debilitating. In some people this presents as a curling of their toes, making it difficult to walk for example. Or it may manifest primarily in the neck muscles causing the head to turn painfully to one side.

Dyskinesia on the other hand, is distinguished as an abnormality of voluntary movement that is more like a rhythmic contraction of large muscle groups, often described as a rolling or writhing motion. Not everyone experiences these symptoms but being able to recognize the difference between these two features is important and is even more informative when placed in the context of medication dosing.

Dyskinesias are often thought to be a side effect of dopamine replacement, occurring at the time levodopa is at its peak concentration in the blood; a level that may be effective in controlling your Parkinsons symptoms but high enough to cause this uncomfortable side effect. But there is also a phenomenon called diphasic dyskinesia where this abnormal movement occurs at the beginning and end of the dosing cycle when the concentration of medication in your system is at its lowest instead of at its peak.

Similarly dystonias can be a symptom of inadequately controlled Parkinsons or somewhat less commonly can actually be a side effect of levodopa rather complicated.

That is why not only recognizing the difference in the type of movements but also when they occur in relationship to your medication is invaluable - the reporting of one scenario may result in a medication increase while the other will bring about a lowering of the dose or change in the dosing schedule.

Managing medications and your symptoms can be a difficult task both for you and your medical team. But knowing what to look for and what information to convey is vitally important. In fact having greater knowledge and understanding about your disease manifestations and the potential side effects of your medications will ultimately go a long way in helping your physician make decisions regarding your management.

Botox injections may help. Unfortunately, they didn't work for my mother. Have they helped you, hisknobs?

HI GARY,

I BID YOU GREETINGS FROM DOWN UNDER AUSTRALIA.
YES GARY, BRADYKINISIA IS I THINK, FEEL AND BELIEVE THE WORST OF ALL THE MANY SYMPTOMS OF PARKINSON'S CONDITION.

RE YOUR GUITAR PLAYING.
MY GUITAR PLAYING IS AFFECTED TOO. THIS IS DUE SMALL MOTOR ISSUES.
MY HANDWRITING IS INDECIPHERABLE, THIS IS ANOTHER SMALL MOTOR ISSUE.
MY SPEECH IS AFFECTED TOO, YET ANOTHER SMALL MOTOR ISSUE.
I HAVE BEEN THROUGH ALL THE SYMPTOMS YOU MENTIONED.
THE THING THAT HAS HELPED ME IS MY ADOPTING OF A POSITIVE ATTITUDE. LOOKING AT THE WHOLE THING IN A DIFFERENT WAY. LAMENTING AND BEMOANING GOT ME NOWHERE.
NOW IS NOT THE TIME TO GIVE IN, NOW IS THE TIME TO GO HARDER AT IT. THERE IS NO EASY FIX, HARD WORK IS THE KEY. IT IS VITAL TO KEEP ACTIVE.

I WISH YOU WELL GARY,
SENT IN GOOD FAITH,
MAINTAIN A WINNING POSITION.

STEWART/ ALIVEO
..>

Gary,

Sorry to hear about your difficulty playing guitar. I used to play lead guitar in a garage band on the weekends but had to quit from the loss of fine motor control, cramping and loss of dexterity. Also have trouble remembering parts of songs and just didn't have the energy to keep up with it. Hopeful that you can still keep playing. I have turned to another hobby that I really enjoy which is Photography & Infrared Photography. It helps me get outside more and I usually go to different parks to take nature & landscape pictures. I wish you the best of luck and keep plucking on that guitar.

I am a legal secretary and typed all of the time. My fingers would become very slow and rigid and I had to force them to move/type. Because of my slowness in moving my neuro gave me a script for a PT and I got lucky and picked a PT who did the BIG exercises. I told him that I was thinking of going to an OT for typing and he said give BIG a chance and see if it helps with your fingers, he thought it would. You can see the BIG exercises on YouTube or get a script like me but they have to be trained in BIG. They are very simplified exercises mostly involving stretching. It takes me no longer than 10 min. to do them. Anyway after about a month of BIG exercises my hands were much improved.

It is all about stretching and your using the hand strengthener would be the opposite of stretching. He told me to stay away from yoga. . BIG brings our body out from the ball our body tries to go into.

The PT told me that the intricate movements made by our fingers take more dopamine than walking and using the leg muscles as the leg muscles are large and strong and the finger muscles are small and not as strong.

Don't pull the fingers in but stretch them outward. Hope this helps you out.