If you have been recently diagnosed with arthritis or have been diagnosed for a long time, you are not alone. According to The Arthritis Foundation, approximately fifty million people are diagnosed with arthritis. That is equal to one in five adults. Arthritis is more common in females than males and the symptoms we experience increase with age. Arthritis is also the leading cause of disability in the U.S.
The most common types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis or OA is the most common type and affects us more as we age. In OA, the cartilage or cushioning between the joints wears away over time causing the bones to rub against each other. Symptoms include pain, stiffness and swelling. These symptoms can come and go and can be mild, moderate or severe, leading to a loss of function. In the hands, OA most commonly occurs at the base of your thumb, where your thumb meets your wrist, and in the small joints in your fingers.
Rheumatoid arthritis or RA is an inflammatory disease where the immune system attacks the lining of the joint causing the tissues that support the joint to stretch. As these structures stretch, the joint becomes unstable and causes deformity. RA is a chronic systemic disease that often starts in the hands and feet. Symptoms include warmth, redness, swelling, stiffness and most commonly, pain.
Pain is often the first symptom one experiences and it generally occurs in the hands after gripping or pinching activities such as opening a door or turning a key. There are several ways to manage your hand pain including splinting, the use of heat, joint protection techniques and adaptive equipment.
Splinting helps to rest and support a painful joint. It can correctly position a thumb or digit. Splints can be worn when performing everyday activities, when at rest or when sleeping. There are soft neoprene splints available to purchase at a local drug store or custom splints that can be fitted to you by an Occupational Therapist. A custom splint is made out of a thermoplastic material and is rigid to prevent movement and allow for rest. Neoprene or soft splints tend to be more comfortable to wear. However, if a joint has too much pain or inflammation, these types of splints may not be the best choice because they allow for joint movement. Often a combination of both custom and soft splints works best for people.
Heat treatments such as microwavable hot packs, warm baths or paraffin wax baths can be used to decrease pain and stiffness. Heat relaxes muscles and increases circulation. Cold treatments such as cold packs and ice massage are usually used for inflammation and help to decrease swelling. Cold treatments would not be used for joint stiffness. The benefits of heat or cold treatments are only temporary but can provide that much needed relief to get through the day.
Inflamed arthritic joints feel stiff especially first thing in the morning when you have not moved your fingers all night. Stiffness also can occur following exercise but only when there is significant damage to the joint. Arthritis gloves or Isotoner gloves can help to ease arthritic pain and swelling as they provide gentle compression and are designed to warm the hands.
Another way to help decrease joint stiffness is through light to moderate exercises. These exercises can maintain flexibility of your fingers. Light strengthening can be done to increase grip strength needed for everyday activities, as long as it does not cause pain lasting longer than one to two hours after completion.
Although it is important to keep your hands moving you do not want to place added stress on the small joints in your hands. Arthritic joints cannot tolerate as much stress as a healthy joint. Some principles of joint protection include avoiding a tight grip on objects, taking frequent rest breaks during activities, using both hands to lift an object, or using a larger set of muscles like your shoulder or elbow to carry a heavy bag. Adaptive equipment can lessen the stress on your joints. Using large-handled utensils or pens for cooking or writing and using a jar opener or electric can opener will help to protect your joints and decrease overuse.
If your pain persists despite some home remedies, consult your doctor to determine if occupational therapy should be recommended. Occupational therapists can help provide specific exercises to maintain joint flexibility, increase hand strength, decrease pain, fabricate splints, and provide education on joint protection and adaptive equipment to manage your symptoms and allow you to perform your everyday activities.
Michelle Cormier, OTR/L, CHT is a senior occupational therapist at Spaulding Outpatient Center Framingham. Michelle is also a certified hand therapist and her specialty is treating upper extremity orthopedic injuries and conditions.