You need your hands to cook, clean, type, and do just about everything else. But you probably don’t think much about how important manual dexterity is unless you have rheumatoid arthritis (RA) or another type of arthritis that attacks your hand and finger joints.
RA is a disease in which the body's immune system engages in friendly fire against the joints. It often starts in your hands before spreading to the other joints.
“The hands and the feet are usually hit first, and these are the joints that are predominantly involved in everyone with RA,” says Eric Matteson, MD, a professor of medicine at the Mayo Clinic in Rochester, Minn. Hand exercises can help maintain range of motion, flexibility, and strength in your hands.
There is not a one-size-fits-all hand exercise prescription for people with RA, but a rheumatologist, physical therapist, or occupational therapist can help design a program especially for your hands. Here are seven hand exercises your program may include.
- Hand Exercise for Rheumatoid Arthritis: No. 1: Start by holding your hand upright and pointing your wrist, fingers, and thumb upward. This also serves as the neutral starting position for many of the hand exercises that follow.Hold for 5 to 10 seconds.
- Hand Exercise for Rheumatoid Arthritis: No. 2: Keep your wrist straight in the neutral starting position and bend the base joints of your fingers, which connect the fingers to the palm. Keep your middle and end joints and your wrist straight. “This is already a big effort for people with RA,” Matteson says. Hold for 5 to 10 seconds. Repeat twice daily on each hand.
- Hand Exercise for Rheumatoid Arthritis: No. 3: Keep your wrist and the base joints straight, and bend your middle and end joints of your fingers toward your palm, one at a time. Hold each position for five seconds. Repeat on all 10 fingers twice a day.
- Hand Exercise for Rheumatoid Arthritis: No. 4: Bend each finger from the base joint downward using your other hand to move your fingers. Repeat this movement using the second row of knuckles in your finger. Repeat this exercise on the third row of joints in your fingers, closest to the fingertips. Hold for 10 seconds. Repeat on all 10 fingers twice a day.
- Hand Exercise for Rheumatoid Arthritis: No. 5: With your hand straight and fingers pointing upward, bend your fingers downward so they are touching your palm. Do not make a fist. Instead, your fingertips should be touching the palm of your hand. Hold for five seconds. Repeat on both hands twice a day.
- Hand Exercise for Rheumatoid Arthritis: No. 6: Starting with your wrist, fingers, and thumb pointing upward, make an “O” by touching your index finger to your thumb. Hold this for at least 5 and up to 20 seconds. Repeat two to 10 times twice a day.
- Hand Exercise for Rheumatoid Arthritis: No. 7: With your hands in the neutral position and all of your knuckles straight, slowly and gently spread your fingers as far apart as you can, like a fan opening up. From this position, make a fist. Hold each position for five seconds. Repeat on both hands twice a day.
“These hand exercises are really effective for stretching and maintaining mobility in your hands if you have RA,” he says. “We don’t do these exercises for strength because the strength that comes with good hand mobility in the activities of daily living is quite satisfactory.”
Hand Exercises for RA to Avoid
Certain exercises may also do more harm than good, adds Francoise Cherry, a certified hand therapist at the Hospital for Joint Diseases in New York. “Most patients say, ‘I have been squeezing a ball,’” she says. “But don't do this because it puts more stress in the joints.”
Hand Exercises for Rheumatoid Arthritis: Pain Is Not OK
Matteson says there is one rule about hand exercises and RA you should always follow: Hand exercises for rheumatoid arthritis should not hurt.
“If you experience pain, stop the hand exercises," he says. "Once the pain has subsided, you can repeat the exercises with reduced intensity and speed."
If the pain comes back or you can’t perform the hand exercises at reduced intensity, there may be something else going on, like a joint dislocation. If this occurs, “talk to your doctor,” he says.
Hand Exercises for RA: Protect Your Joints
Alexandra MacKenzie, an occupational therapist at the Hospital for Special Surgery in New York, stresses that joint protection is key. “We focus on protecting the joints, making sure inflammation is down and teaching people how to modify their activities,” she says.
Lifestyle changes can also help protect hand and wrist joints and preserve their function.
For example, “using heat first thing in the morning, which is when joints are the stiffest because they were not moving all night, can be helpful,” she says. This can take the form of a heating pad or just soaking your hands in warm water in the shower.
Jar openers and other adaptive equipment may also help, she says.
Cherry says hand and wrist splints are also important for people with RA. Splints help support and align joints. “The pattern of hand deformity is uniform in rheumatoid arthritis, and we have splints that target this deformity,” she says.