Features April 2005 Issue

Give Your Joints A Hand

Your hands and fingers work overtime. Here’s how to keep them part of a healthy work force.

Though our hands are always visible, when it comes to staying healthy and fit we often overlook them. Few other parts of our body play such a key role in how we take part in everyday life—from household activities, to hobbies, to outdoor pursuits—yet rarely do we give our hands the level of attention and care that we routinely give our teeth, hair, and overall appearance.

If you want to keep your hands mobile, limber, and pain-free, it’s time to incorporate a daily strategy for hand health into your routine at home, at work, and at play. To help you do that, we’ve put together a brief guide to increased hand wellness that includes steps you can take to protect your hand joints from repeated stress, suggestions for overcoming early morning stiffness and soreness, as well as a few stretches to help you maintain finger flexibility.

Dexterous design
With 15 joints and more than a dozen bones each, as well as a wide array of muscles, tendons and blood vessels, our hands are wonders of compact design. We use them hundreds, if not thousands, of times a day without a second thought. But this free and easy dexterity can start to decline if the cartilage in our palm, wrist, or finger joints begins to erode.

Likely targets
“For many people, osteoarthritis of the hand starts to occur in their 50s and early 60s,” says Sharilee Walker, occupational therapist and certified hand therapist at the Hand and Upper Extremity Center at The Cleveland Clinic. “It most likely occurs in a joint you’ve previously injured, such as a fractured wrist or jammed finger.”

People with hand-intense occupations and hobbies are also more likely to develop early wear and tear. “Anyone who does a lot of pinching, twisting, or squeezing with their hands, such as those who sew or use hand tools, is at higher risk,” says Walker.

Early symptoms
One of the early signs of hand osteoarthritis is a shortening of your activity tolerance—that is, how long you can do something before it starts to hurt. “It’s not fatigue or lack of strength that gets in the way of how long most people with arthritis can use their hands, it’s the pain,” says Walker.

In addition to a shortened activity tolerance, people with hand arthritis also begin to show a loss of dexterity. It just gets harder for you to do things as well or as easily as you once did, whether it’s tying a shoelace, fastening a button, or turning a key.

Delaying strategies
Your best defense against hand arthritis is to postpone it as long as possible. Though that may be a losing battle, especially if you’re more genetically prone to develop it than others, you can take two approaches to protect the cartilage in your hands. Both involve reducing the amount of stress you put on the joints of your hands.

The first involves doing things less—that is, reducing how often you use your hands to pinch, grip, or twist. This can include taking more frequent breaks when using your hands in such a manner, or simply cutting back on how often you engage in such an activity.

For activities where taking a break is not an option, look for a way to modify your technique or tool in such a way that it takes some of the stress off your hands.

“There are many ergonomic tools that can help you redistribute a lot of the stress from the small joints in your hands to your larger, more durable elbow and shoulder joints,” says Walker. In previous issues of Arthritis Advisor, we reviewed some of the more effective ergonomic tools to use around the house (December 2002), the garden (July 2003), and the office (February 2005).

Pain management
Once you develop osteoarthritis of the hands, the focus then becomes how best to manage the pain so you can continue to use your hands to their fullest throughout the day.

“If your hands are most stiff and sore first thing in the morning, use a heating pad or paraffin bath to warm them up,” says Walker. These products are available at most drug stores. Warmed joints help ease the pain and will allow for easier range of motion.Warming up your hands is also recommended before taking your hands through any type of stretches that help with flexibility and range of motion.

As long as your arthritis involves little or no inflammation, a simple pain reliever such as acetaminophen (Tylenol, Excedrin, Anacin) can also be used to minimize pain. Just be sure to limit your daily dosage of such analgesics to 1000mg; when used in greater doses they can pose a burden on your liver.

Stretch, don’t squeeze
If you suffer from hand arthritis, stretching your fingers will do the most good—and the least harm. “Exercises that involve squeezing a ball or a special grip device can put undue stress on already damaged joints,” warns Walker. “Do not use such devices without the guidance of a therapist or physician.”