Brushing your teeth, buttoning your shirt, and opening a jar are routine daily activities that most people take for granted. But if you have arthritis and it affects your hands, these and other basic tasks can be challenging.
The good news is that “exercising” your hands can help:
- Reduce the pain
- Improve your range of motion
- Enable you to perform more easily the various tasks of daily living
Where does it hurt?
Arthritis of the hands manifests differently. It depends 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 the hand are:
- The trapeziometacarpal (basilar) joint, which is at the base of the thumb
- The distal interphalangeal joint, which is closest to the fingertip
- 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
- The proximal interphalangeal joints
It does not affect the distal interphalangeal joints. In addition, because it is a systemic condition, it often affects joints on both sides of the body.
In advanced rheumatoid arthritis of the hand, various deformities may develop. For example, let’s look to the condition known as Boutonnière deformity. In this condition, 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.
The distinction between the types of 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) is best. These medications have 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. Whichever type of arthritis you may have, it’s important to respect the pain. Whenever you exercise, do so gently to avoid further harm to your joints.
Hand exercise routine
Ask your doctor if it’s safe for you to try hand exercises. Or consider asking for a referral to a physical therapist, who can design a program specifically for you.
Most of the exercises help improve range of motion, but two of them are muscle-strengthening exercises. 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 the 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 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.
Finger joint blocking
(A) Lay your hand palm side up on a table. With your opposite hand, grasp and hold the affected finger at the middle section just below the joint closest to your fingertip. Bend and straighten the finger at this joint only while holding the rest of the finger straight. Repeat for each finger.
(B) Now hold the finger you’re exercising just below the middle joint. Bend and straighten the finger at the middle joint only, while holding the rest of the finger straight. Repeat for each finger.
Wrist turn
With your arm outstretched on a table, turn your palm toward the ceiling, then turn it down to face the floor.
Finger curls
Keeping your wrist straight, extend and spread your fingers. Then make a loose fist, keeping your thumb on the outside of your fingers.
Wrist bend
With your arm outstretched, bend your wrist backward, then forward.
Fingertip touch
Starting with an open hand, touch your thumb to the pad just below your pinkie finger. Release and then touch your thumb to the tip of your pointer finger, ring finger, index finger, and pinkie finger, in sequence.
Thumb stretch
Start with your hand outstretched. Bend your thumb toward the base of your pinkie finger. Return to original position.
Muscle strengthener 1
Hold a piece of paper by the corner, and using only one hand, crumple it into a ball as fast as you can.
Muscle strengthener 2
Place your hand palm down on a table. Place your other hand on top of that hand, and lift up with the fingers of the hand on the bottom. You can lift the fingers all at once or one at a time.
