Of course if you are using drops all this is completely irrelevant and you might have to wait for The Sage of Oregon for further advice/opinion.
Thanks for the kind reference, Ian. Unfortunately, I am in the same boat, having apparently sacrificed my hands to the Cycling Cause starting well over 250,000 miles ago.
Things started to go south for me at Uni taking extensive classroom notes and riding 12,000mi/year and quickly picked up speed with all the note-taking in graduate school. During this time, I had my own automobile repair shop to help pay the bills and I horribly abused my hands by overuse and using well beyond their limits. Then, further randonneur and extreme touring on very rough roads really finished things off. I also may have suffered a small stroke after surviving a murder attempt in '94, as my left hand was left noticeably weaker and less agile than before the head injury which included a triple skull fracture, shattered left eye orbit, another broken nose and a free fracture of the maxilla (upper jaw) while wearing a helmet.
Really, I think the present problem is a combination of things, all cumulative, but compounded by consistent pounding by very, very rough roads and non-roads over many years. It doesn't help that manufacturers decided to universally change the placement of padding in cycling gloves to leave the very place I need it devoid and innocent of any sort of cushioning whatsoever. I'm not sure what their goal was, but I'm finding my pounded-out gloves from decades ago are still better than current offerings.
I have found several things help with hand pain and drop handlebars, if that's what you're using:
• Gloves with full, thick, dense padding in the palms. If you know where to get some now, please tell me. I have had limited good luck stuffing sheets of wetsuit material (bonded knit-backed blown neoprene) into the palms of my gloves.
• Try to get a posture that will evenly distribute your weight between hands and bottom. For me, this works out to a 45° angle for back and 45° for arms when riding atop the brake hoods. You can see photos of me on my bikes in the Danneaux's Sherpa and Danneaux's Nomad galleries that show this.
Avoid a too-long-reach stem so you're not putting as much weight on the heels of your hands. As time has passed, brake hoods have lengthened (thanks to STI setting the sizing standard, even if you don't use brifters) and now most drop-bar riders are actually perching wholly on the brake hoods, some of which are harder than others. Try switching to slightly softer Cane Creek hoods if you're presently using Tektros. Because brake levers are longer, they can stretch you out too far unless used with compact-reach handlebars with shorter top ramps to compensate for the ~1cm longer reach of the lever-hoods.
• Actual placement of the brake levers can make a big difference to comfort on drop handlebars, as can the handlebar bend. I like randonneur handlebars very much for this reason, and prefer my levers be placed relatively high, with the ends of the lever blades even with the bottom of the drops or a centimeter or so above it. Some prefer their brake levers much higher. Whatever works to aid comfort is fine so long as you can still squeeze the brakes at full force in all needed positions.
• Watch handlebar clamp diameter. I am appalled to see large stem-clamp diameters come into play on some drop-bar tourers, as they can make 'bars *too* stiff. A nice drop 'bar in 25.4-26.0mm diameter will generally be much more comfortable. Already, threadless stems are much stiffer than quills and can add to the problem.
• Buy a tire gauge and set whatever front tire you are using to an appropriate pressure, likely lower than what is in it now. A 15% drop in rim height when loaded with your body and cargo weight is about right. Frank Berto pioneered work in this area, and our own JimK extended it to a wider range of tires. A search of the Forum archives will find both. There's also an Android app for setting differential tire pressures under load, which works pretty well. See:
https://play.google.com/store/apps/details?id=com.edisongauss.bertotirepressure Vittoria also offer one, but I have not found it as useful:
https://play.google.com/store/apps/details?id=com.vittoria.itirepressure• Go to a wider, lower-pressure front tire as Andre suggests, and air it up (down) appropriately.
• Pad the handlebars to increase surface area an absorb vibration. My favorite is Grab-On closed-cell grips compression-wrapped with padded handlebar tape.
• Move your drops upward until the tops are level with the top of the saddle, no more than 2cm below it...or try putting them above, as John Saxby has done. You'll be more likely to actually use the drops if you can reach them easily...another endorsement for shallow-drop 'bars with compact reach.
• Oddly, counter-intuitively, I've found a lot of apparent front-end vibration actually has its source at the rear. Fitting a suspension seatpost (I prefer the Thudbuster LT and ST models, though there are other good ones including StuntPilot's SR-SunTour, which he has reviewed nicely. A parallelogram design will be more responsive and will preserve saddle-to-bb distance more than a telescopic design) will help hand comfort. When the rear tire reacts to a bumps, it pitches the rider forward abruptly, increasing pressure on the hands through the handlebars. My testing showed converting and modulating abrupt rear bumps/shock input to a lower amplitude and frequency or spreading them over a greater time duration between peak loads really helps my hands. In other words, fitting a suspension seatpost also helped my hands as well as my back and neck, so I stay more comfortable overall and my hands do notice the difference. I was as surprised as anyone to find this, but it has helped.
• Fitting a suspension seatpost does address some road shock, but it is half the battle. A suspension fork *might* help, but unfortunately the current telescopic designs aren't best for the sort of low-amplitude, high-frequency road shock that tears up hands on drop 'bars. A telelever design would be be much better (and for the same reasons as the parallelogram sus-seatpost design), but are largely absent after a brief flare of MTB popularity in the 1990s. A parallelogram sus-stem would be nice, but the last go-'round with those, the market found the pivots wore fairly quickly and nobody liked the maintenance or sloppy feel that imparted. For these reasons, the best approach at the front with drop handlebars currently is to fit a tire with wider cross-section/higher profile and fill it with appropriately low pressure and so absorb much of this vibration through an air spring as Andre endorses. I have also grown to hate chip-seal paving with a white-hot, passionate intensity.
Wider, lower-pressure tires help on it as well, perhaps better than anything.
I'm doing all the above and find it helps, but its effectiveness depends on road surface and time on the bike. The roads in Eastern Europe were brutal at times this summer, and my hands are just toast after 300-400km, 17+ hour days in the saddle, especially if some of that is on gravel. I really can't write legibly anymore and depend almost entirely on hard keyboards and (sometimes) styli and "swipe- and gesture-based "soft" keyboards. I seem to be teetering on the edge of carpal-tunnel syndrome (really, I am in denial) and have been diagnosed with Reynaud's syndrome/VWF/HAVS (see:
http://en.wikipedia.org/wiki/Vibration_white_finger ) and still suffer the effects of frostbite from riding in temps lower than -17°C and having my fingers freeze to the handlebars. My hands hurt sometimes all the way to my armpits, and now my fingers also cramp and draw across my palms to the point where I have to sometimes pry them open using the handlebar as a lever.
If I could go back in time and tell my Immortally Youthful Self one thing, it would be that a young body can get away with things for awhile, but the chickens will eventually come home to roost; damage is cumulative over 35+ years of riding like mad. As with sun damage (paying a major price for that as well), prevention is the best cure and you'll always be happier tomorrow if you address some of these things today.
I sound like Grandpa. Ick, but there's hard-won truth there as well.
Best,
Dan.