Brushing your teeth, buttoning your shirt, opening a jar-these are routine daily activities that most people take for granted. But if you have arthritis and it affects your hands, performing these and other basic tasks can be challenging.
Fortunately, exercising your hands can help reduce the pain, improve your range of motion, and ultimately, enable you to perform more easily the various tasks of daily living.
Where does it hurt?
Arthritis of the hands manifests differently depending on what kind of arthritis you have.
- Osteoarthritis. The most common cause of hand arthritis is osteoarthritis. In osteoarthritis, protective cartilage that covers the ends of your bones gradually deteriorates due to wear and tear or injury.
If your hand pain is caused by osteoarthritis, the affected joints are painful and may swell or develop hard, bony nodules (Heberden’s and Bouchard’s nodes).
The joints most likely to be affected in hand osteoarthritis are the trapeziometacarpal (basilar) joint, which is at the base of the thumb; the distal interphalangeal joint, which is closest to the fingertip; and the proximal interphalangeal joint, located in the middle of the finger.
- Rheumatoid arthritis. By contrast, rheumatoid arthritis is an immune system disorder that damages the cells in the tissue that lines and lubricates the joints (synovial membrane).
If rheumatoid arthritis is the cause of your hand pain, the joints most likely to be affected are the wrist joints; the index and middle metacarpophalangeal joints, which are the knuckles at the base of your fist; and the proximal interphalangeal joints.
Rheumatoid arthritis does not affect the distal interphalangeal joints. In addition, because rheumatoid arthritis is a systemic condition, it typically affects joints on both sides of the body.
In advanced rheumatoid arthritis of the hand, various deformities may develop. For example, in a condition known as Boutonnire deformity, the proximal interphalangeal joint flexes and can’t be straightened, while the distal interphalangeal joint extends back away from the palm.
Another example is flexor tenosynovitis, also known as trigger finger. In this condition, the finger becomes frozen in a bent position, as if poised on the trigger of a gun.
Why the distinction?
The distinction between osteoarthritis-and rheumatoid arthritis-induced hand pain is important for several reasons. First, if your pain is caused by rheumatoid arthritis, don’t attempt to alleviate it with exercise alone. Prompt, aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) has been shown to slow disease progression and limit joint damage, reducing the likelihood that your hand will become permanently disfigured.
Second, strengthening exercises can be harmful if performed aggressively and should be done in moderation by people with rheumatoid arthritis. Third, you should perform any type of exercise with caution while you’re having a flare.
Whether you have rheumatoid arthritis or osteoarthritis, it’s important to respect the pain; whenever you perform the exercises, do them gently to avoid further harm to your joints.
Exercise hands safely
Ask your doctor if it’s safe for you to try hand exercises. Or consider asking for a referral to a physical therapist or an occupational therapist, who can design a program specifically for you.
A physical therapist or an occupational therapist who is also a certified hand therapist is a professional who has extensive training and experience in hand therapy.
A certified hand therapist can also advise you on other therapies that might be helpful, such as the use of adaptive equipment, protective splinting, and other techniques to reduce pain and swelling.
Hand exercises may help improve range of motion or strengthen muscle. It’s best to start with a few slow repetitions once a day as pain permits and gradually work up to 10 slow repetitions. If both hands are affected, repeat the exercise on both your right and left hands.
To reduce pain before you perform hand exercises, try soaking your hands in warm water or dipping them in warm paraffin wax. You may even want to try performing some of the hand exercises with your hands submerged in warm water or while you’re in a heated pool. This is a gentle way to exercise joints and muscles.
The buoyancy of the water supports and lessens stress on the joints, enabling you to move your hands more easily. Water may also act as resistance to help build muscle strength.