Janet, this really is a very good topic and I hope you don't mind if it branches out into hugging as well. Actually, I think this is the first time I've seen this particular question.
For me the shaking of hands isn't generally a problem. However, like Tam, I have bad elbow days on which I do find it difficult to shake hands with and enthusiastic shaker. On those days, I try to keep the shake to a minimum (especially if they're and enthusiastic limp fish shaker - your arm flops about like, well, like a fish on the dock) - one good firm shake and pull away while trying to keep the pain from showing in my eyes and face. Not easy when you're someone who looks others directly in the eye when shaking hands.
Hugging is another story altogether. My upper back tends to be one of my worst trouble areas. When it's flaring a hug is one of the most horrible dichotemies - the hug is comforting but it HURTS!!! If it's coming from someone particularly close to me, I just ask him or her to please be very gentle. If it's from an acquaintance (usually a theatrical type) I'll try to keep it to one of those upper arm hugs - you know, you hold the person's upper arms, which forces them to keep their hands away from your back, which eliminates the squeeze factor altogether.
Hugs,
With
