How can hand exercises help manage rheumatoid arthritis symptoms. What are the best exercises for improving hand flexibility and strength with RA. Which hand movements can reduce pain and stiffness in arthritic joints.

Understanding the Importance of Hand Exercises for Rheumatoid Arthritis

Rheumatoid arthritis (RA) often affects the small joints of the hands, leading to pain, stiffness, and reduced functionality. Hand exercises play a crucial role in managing these symptoms and maintaining joint health. Regular hand exercises can help keep tendons flexible, improve circulation through the joints, and maintain hand strength and dexterity.

Alice Pena, a certified hand therapist and physical therapist, emphasizes the benefits of hand exercises for RA patients: “It’s a nice way to get a little strengthening going and lets patients sense what their level of activity might be.” These exercises not only help in pain management but also improve overall hand function, making daily tasks easier for those living with RA.

Guidelines for Performing Hand Exercises with Rheumatoid Arthritis

Before diving into specific exercises, it’s important to understand some general guidelines for practicing hand exercises with RA:

• Stop immediately if any exercise causes pain
• Aim to repeat exercises up to five times per session, once or twice daily
• Consult with your doctor or physical therapist to determine the optimal number of repetitions for your condition
• Consider using moist heat before exercising to make movements easier and prevent discomfort

Applying moist heat can be particularly beneficial before starting your exercise routine. Some effective methods include:

1. Soaking hands in warm water for 5-10 minutes
2. Using a warm paraffin wax bath
3. Wrapping hands in a towel soaked in hot water
4. Performing certain exercises, like making a fist, while taking a warm shower

Flat-Hand Finger Lifts: Enhancing Finger Flexibility

The flat-hand finger lift exercise is an excellent way to improve finger flexibility and range of motion. Here’s how to perform it:

1. Place your hands flat on a table or against a wall, palms down
2. Starting with your thumb, slowly raise each finger individually
3. Hold each finger up for 1-2 seconds
4. Gently lower the finger back down
5. Repeat with each finger on both hands

This exercise helps maintain individual finger mobility, which is crucial for performing precise hand movements in daily activities.

Making a Fist: Improving Range of Motion

The fist-making exercise is simple yet effective in improving overall hand range of motion. Follow these steps:

1. Start with your fingers straight out
2. Slowly draw your fingers together, down into the center of your palm
3. Form a loose fist, keeping your thumb across your fingers (not tucked underneath)
4. Hold this position for up to one minute
5. Open your hand slowly
6. Repeat a few times on each hand

This exercise helps maintain flexibility in all finger joints and can be particularly soothing when performed under warm water.

Towel Grip Exercise: Enhancing Hand Strength

The towel grip exercise is an excellent way to improve hand strength and assess your grip capabilities. Here’s how to do it:

1. Place a hand towel or kitchen towel flat on a table
2. Cup one hand lightly, supporting it with your fingertips and thumb
3. “Walk” your fingertips toward you, pulling the towel up into your palm
4. Gather as much of the towel into your fist as possible
5. Gently squeeze the gathered towel
6. Repeat a few times, then switch to your other hand

This exercise not only strengthens your grip but also helps you stay aware of how RA might be affecting your hand strength over time.

Finger Pinches: Improving Dexterity for Daily Tasks

Finger pinches are particularly useful for improving dexterity needed in everyday activities like tying shoelaces or buttoning shirts. To perform finger pinches:

1. Touch your thumb to the tip of your index finger
2. Press firmly, as if pinching
3. Hold for 1-2 seconds, then release
4. Repeat with each finger individually
5. Perform the exercise on both hands

Regular practice of finger pinches can significantly enhance your ability to perform fine motor tasks, which are often challenging for individuals with RA.

Thumb Stretch: Maintaining Thumb Mobility

The thumb plays a crucial role in many hand movements, making thumb-specific exercises essential. Here’s a simple yet effective thumb stretch:

1. Start with your thumb pointing outward, away from your palm
2. Move your thumb across your palm
3. Try to touch the base of your little finger
4. Hold for a few seconds, then return to the starting position
5. Repeat several times on each hand

This exercise helps maintain thumb flexibility and can improve your ability to grip circular objects, such as a hairbrush handle or a glass.

Finger Spread: Reducing Stiffness and Strengthening Hand Muscles

The finger spread exercise is excellent for reducing stiffness and strengthening the muscles around your hand joints. Here’s how to perform it:

1. Start with your hand relaxed
2. Slowly and gently spread your fingers and thumb as wide apart as possible
3. Hold this position for several seconds
4. Relax your hand
5. Repeat the exercise several times on each hand

Regular practice of this exercise can help maintain hand flexibility and reduce the feeling of stiffness often associated with RA.

Recognizing When to Rest: Balancing Exercise and Recovery

While regular hand exercises are beneficial for managing RA symptoms, it’s equally important to know when to take a break. During flare-ups or periods of increased symptoms, it might be advisable to temporarily pause your exercise routine. Instead, consider wearing a supportive brace or splint to protect your joints from further damage.

Alice Pena emphasizes the importance of listening to your body: “Succeeding with RA treatment means knowing when to temporarily lay off exercising.” This approach helps prevent overexertion and allows your joints time to recover during periods of increased inflammation.

Signs That Indicate a Need for Rest

• Increased joint pain or swelling
• Unusual warmth around the joints
• Reduced range of motion
• Increased fatigue
• General feeling of malaise

If you experience any of these symptoms, it’s advisable to consult with your healthcare provider. They can guide you on how to modify your exercise routine or suggest alternative pain management strategies during flare-ups.

Incorporating Rest into Your Exercise Routine

Even when not experiencing a flare-up, incorporating regular rest periods into your exercise routine is crucial. This allows your joints time to recover and helps prevent overuse injuries. Consider the following tips:

• Alternate days of hand exercises with rest days
• Perform exercises in shorter sessions throughout the day rather than one long session
• Use supportive devices like splints during rest periods to maintain joint alignment
• Practice gentle range-of-motion exercises on rest days to maintain flexibility without straining the joints

Complementary Therapies for Hand Arthritis Management

While hand exercises form a crucial part of RA management, combining them with other therapies can enhance their effectiveness. Here are some complementary approaches to consider:

Massage Therapy

Moderate pressure massage can help reduce pain and stiffness associated with RA. It improves circulation, reduces muscle tension, and can enhance the overall effectiveness of your hand exercises. Consider incorporating self-massage techniques or seeking professional massage therapy as part of your RA management plan.

Heat and Cold Therapy

Alternating between heat and cold treatments can provide significant relief from RA symptoms:

• Heat therapy: Helps relax muscles and increase blood flow, making it ideal before exercises
• Cold therapy: Reduces inflammation and numbs pain, making it beneficial after exercise or during flare-ups

Experiment with both to find what works best for your joints at different times.

Mindfulness and Relaxation Techniques

Stress can exacerbate RA symptoms. Incorporating mindfulness practices, deep breathing exercises, or meditation can help manage stress levels, potentially reducing the frequency and severity of flare-ups.

Dietary Considerations

While diet alone cannot cure RA, certain nutritional choices may help manage symptoms:

• Omega-3 fatty acids: Found in fish oil, flaxseeds, and walnuts, may help reduce inflammation
• Antioxidant-rich foods: Colorful fruits and vegetables can help combat oxidative stress
• Avoiding processed foods: These often contain ingredients that may increase inflammation

Consult with a dietitian or your healthcare provider to develop a dietary plan that complements your RA management strategy.

Adaptive Tools and Devices for Daily Living with RA

In addition to exercises and complementary therapies, using adaptive tools can significantly improve quality of life for individuals with RA. These devices are designed to reduce strain on affected joints while performing everyday tasks.

Kitchen Aids

• Jar openers with large, ergonomic handles
• Electric can openers
• Utensils with padded, enlarged grips
• Rocker knives that require less force to cut

Dressing Aids

• Button hooks for fastening buttons
• Zipper pulls for easier zipping
• Long-handled shoe horns
• Elastic shoelaces that don’t require tying

Writing and Computer Use

• Pen and pencil grips
• Ergonomic keyboards and mice
• Voice recognition software for dictation

Incorporating these tools into your daily routine can help conserve energy and reduce joint stress, allowing you to focus more on your exercise regimen and overall health management.

The Role of Professional Guidance in RA Management

While self-management techniques like hand exercises are crucial, professional guidance remains an integral part of comprehensive RA care. Regular check-ups with your rheumatologist, physical therapist, and occupational therapist can ensure that your management plan stays aligned with your changing needs.

Benefits of Professional Oversight

• Customized exercise plans tailored to your specific joint involvement and overall health status
• Regular assessment of disease progression and treatment effectiveness
• Timely adjustments to medication regimens as needed
• Guidance on incorporating new management strategies or adaptive tools
• Early intervention for potential complications

Remember, RA is a complex condition that requires a multifaceted approach. While hand exercises and self-management strategies are powerful tools, they work best when integrated into a comprehensive care plan overseen by healthcare professionals.

Embracing a Holistic Approach to RA Management

Managing rheumatoid arthritis effectively requires a holistic approach that goes beyond medication and exercises. It involves lifestyle modifications, emotional well-being, and a proactive attitude towards health management. Here are some additional aspects to consider in your RA journey:

Stress Management

Chronic stress can exacerbate RA symptoms and trigger flare-ups. Incorporating stress-reduction techniques into your daily routine can have significant benefits:

• Practice mindfulness meditation or deep breathing exercises
• Engage in gentle yoga or tai chi, which combine physical activity with stress relief
• Consider joining a support group to share experiences and coping strategies with others living with RA
• Explore hobbies or activities that bring joy and relaxation

Sleep Hygiene

Quality sleep is crucial for managing RA symptoms and overall health. Poor sleep can increase pain sensitivity and fatigue. To improve your sleep:

• Establish a consistent sleep schedule
• Create a relaxing bedtime routine
• Ensure your bedroom is cool, dark, and quiet
• Consider using supportive pillows or mattresses to reduce joint discomfort during sleep

Regular Physical Activity

While hand exercises are important, maintaining overall physical fitness can significantly impact RA management. Low-impact activities that don’t strain your joints can help maintain muscle strength, improve flexibility, and boost overall well-being. Consider:

• Swimming or water aerobics
• Stationary cycling
• Walking on even surfaces
• Gentle stretching routines

Always consult with your healthcare provider before starting a new exercise regimen to ensure it’s appropriate for your condition.

Emotional Well-being

Living with a chronic condition like RA can take an emotional toll. Prioritizing your mental health is as important as managing physical symptoms:

• Consider counseling or therapy to address any emotional challenges related to living with RA
• Practice self-compassion and acknowledge the challenges you face
• Engage in activities that boost your mood and self-esteem
• Stay connected with friends and family for emotional support

Continued Education

Staying informed about RA and its management can empower you to take an active role in your treatment. Consider the following:

• Attend educational seminars or webinars about RA
• Read reputable health publications and research updates
• Discuss new findings or treatment options with your healthcare team
• Connect with patient advocacy groups for resources and support

By embracing a holistic approach that includes hand exercises, complementary therapies, lifestyle modifications, and emotional well-being, you can develop a comprehensive strategy for managing RA. Remember, every individual’s experience with RA is unique, so it’s important to work closely with your healthcare team to create a management plan that best suits your needs and lifestyle.

Living with rheumatoid arthritis presents challenges, but with the right tools, support, and attitude, it’s possible to maintain a high quality of life. Regular hand exercises, combined with a multifaceted approach to health management, can help you navigate the ups and downs of RA with confidence and resilience. Stay committed to your health, remain open to new strategies, and don’t hesitate to seek support when needed. Your journey with RA is ongoing, but with persistence and the right approach, you can continue to lead a fulfilling and active life.

Hand Exercises for Rheumatoid Arthritis (RA) Relief

A few quick and simple exercises can ease RA pain and stiffness in your hands and make everyday tasks far easier.

By Madeline R. Vann, MPHMedically Reviewed by Alexa Meara, MD

Reviewed: February 14, 2023

Medically Reviewed

Hand exercises help keep your fingers moving by keeping tendons flexible and improving circulation through your joints.iStock

Losing hand strength and flexibility in your fingers is a common complaint for people with rheumatoid arthritis (RA). Fortunately, practicing a few easy hand exercises — no special equipment or much time needed — can be hugely beneficial both for stopping pain and stiffness and for improving joint function.

“It’s a nice way to get a little strengthening going and lets patients sense what their level of activity might be,” explains certified hand therapist Alice Pena, a physical therapist who is a former spokesperson for the American Physical Therapy Association.

Some Rules of ‘Thumb’ for Hand Exercises With RA

While hand exercises are typically good for rheumatoid arthritis, if anything hurts, stop. In general, you can repeat the following exercises up to five times per session, once or twice a day. Talk to your doctor or physical therapist about the best number of reps for you to avoid strains.

Moist heat can make the motion of hand exercises for rheumatoid arthritis easier and help prevent discomfort. One option is to soak your hands in warm water for 5 to 10 minutes before you begin. Treating your hands with a warm paraffin wax bath or wrapping them in a towel soaked first in hot water are other options. You can also practice some of these exercises, such as making a fist, while taking a warm shower.

1. Increase Flexibility With Flat-Hand Finger Lifts

Start by placing your hands flat, palm down, on a table or against a wall. Then, starting with your thumb, slowly raise each finger individually off the table or surface. Hold each finger up for one or two seconds, and then gently lower it.

2. Increase Your Range of Motion by Making a Fist

Start with your fingers straight out, then draw them together down into the center of your palm to make a loose fist. (Keep your thumb across your fingers and not tucked beneath them.) Hold this position for up to one minute, then open your hand slowly and repeat a few times on each hand.

3. Improve Your Grip by Walking Your Fingers

Place a hand towel or kitchen towel flat on a table. With one hand lightly cupped and supported by your fingertips and thumb, “walk” your fingertips toward you to pull the towel up into the palm of your hand. “Get as much towel into your fist as you can and gently squeeze,” says Pena. This keeps you aware of how RA might be affecting your grip and how strong your grip is, she explains. Repeat a few times then switch to your other hand.

RELATED: Don’t Lose Your Grip: Rheumatoid Arthritis and Grip Strength

4.

Increase Your Dexterity With Finger Pinches

Pinching your thumb to the tip of each of your fingers one at a time can help make everyday tasks — such as tying shoelaces or doing up buttons — easier if you have RA. Take your thumb and touch it to a finger and press it firmly like a pinch. Hold for a second or two and release. Do this with each finger individually.

5. Keep Your Thumb Nimble With a Simple Stretch

Focusing on your thumb is necessary because it is so important to so many different hand motions. A key exercise for maintaining the thumb’s function begins with your thumb pointing outward, away from your palm. Then move your thumb across your palm to try to touch the base of your little finger. This kind of motion can help you grip circular objects, such as the handle of a hairbrush.

6. Maintain Hand Flexibility by Spreading Your Fingers

Simply spread your fingers and thumb as wide apart as possible, slowly and gently. Hold for several seconds. This is a great way to reduce stiffness and strengthen the muscles around the joints in your hand.

Know When It’s Best to Take a Break

Succeeding with RA treatment means knowing when to temporarily lay off exercising, Pena says. For example, during flares or a worsening of your symptoms, it might be best to wear a supportive brace or a splint and forgo exercising to avoid additional damage to your joints. Listen to your body.

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Hand Exercises for Rheumatoid Arthritis

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The joints in the fingers, thumbs, and wrists can become stiff and swollen from certain types of autoimmune arthritis, especially rheumatoid arthritis. Everyday tasks, such as opening car doors and brushing teeth, can become challenging and painful. Hand exercises can help stretch and strengthen muscles and tendons, help relieve symptoms, and improve hand function.

Read more about Hand Pain and Rheumatoid Arthritis

The best hand exercise program is one that has been customized for a person’s unique anatomy and circumstances. A qualified health care practitioner, such as an occupational therapist or physical therapist who specializes in the hand, can tailor a program to an individual’s needs.

While a personalized hand exercise program is ideal, the 4 hand exercises described below are okay for most people who have rheumatoid arthritis. The goal of these exercises is to:

• Strengthen muscles and tendons in the hand and forearms
• Improving range of motion in the fingers and thumbs
• Improve hand function, including the ability to grip, pinch, and hold objects

If hand pain is present, it is a good idea to clear these exercises with a qualified health care practitioner. During each exercise, keep the wrist in a relaxed, neutral (straight) position. Stop any exercise if it triggers sharp or severe pain.

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Thumb Crosses

Rheumatoid arthritis can make the joint at the base of the thumb (the carpometacarpal joint) feel stiff, achy, and weak. Since the thumbs are used during many daily activities, it is important to maintain these joints’ range of motion and muscle strength.

Doing this exercise regularly may help alleviate stiffness and improve strength:

• Extend your fingers and thumb straight up, like you are about to give a high-5
• Bring your thumb across the palm of your, hand toward the base of your pinky

Hold for a few seconds and then relax. Repeat 8 to 12 times, then switch hands. Do 1 to 3 sets a day.

Knuckle Bends

These exercises are designed to ease stiffness in the knuckles and strengthen the forearm muscles that control the fingers.

• Start with fingers extended in the high-5 position
• Make a claw by bending your 4 fingers at their top two knuckles (called the proximal interphalangeal joints and the distal interphalangeal joints)
• Try to bend the knuckles so much that the tips of the fingers curl around and touch the palm. Due to stiffness or deformity, it might not be possible to reach all the way to the palm, in which case simply proceed as far as is possible and comfortable for you.
• Keep the thumb extended throughout this exercise

When doing this exercise, try to resist the urge to bend the large knuckles (called the metacarpophalangeal joints) where the fingers meet the palm. Repeat the exercise 8 to 12 times, then switch hands. Do 1 to 3 sets a day.

In This Article:

• Therapy for Rheumatoid Arthritis in the Hand

• Hand Exercises for Rheumatoid Arthritis

Fist Stretches

Stiff, swollen hand joints can make it difficult to make a fist. Making a fist requires a lot of the same muscles and tendons that are used for gripping. Regularly performing this fist stretch may help improve grip strength.

• Make a fist
• Extend your fingers and thumb, so they are straight and fanned out

It may be challenging to make a tight fist or fully straightening the fingers and thumb. Do your best. Repeat 8 to 12 times, then switch hands. Do 1 to 3 sets a day.

Thumb to Fingertip Touches

This exercise can increase dexterity and strength in the thumb and finger joints. Regularly performing this exercise may help improve the ability to pinch small objects, such as credit cards, papers, and eating utensils.

• Start with the thumb and fingers extended in the high 5 position.
• Touch the tip of your thumb with the tip of your index finger, similar to an “okay” sign.
• Return the index finger to the starting position, and repeat with the other 3 fingers, touching the tip of the thumb to the tips of the middle, ring, and pinky fingers.

When touching a thumb to fingertip, try to keep the other 3 fingers straight up. Repeat this series 8 to 12 times, then switch hands.

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When done regularly, these hand exercises will probably get easier over time. Once hand strength improves, regular exercises may still be necessary to maintain functional gains.

Read more about Treatments for Rheumatoid Arthritis in Hands

A licensed health care practitioner with specialized knowledge about rheumatoid arthritis in the hands can suggest additional exercises as well as other treatments to help alleviate rheumatoid arthritis symptoms in the hands.

Cheryl Crow is a licensed occupational therapist. A rheumatoid arthritis patient herself, Ms. Crow combines her personal experiences and professional expertise to help others navigate the everyday challenges associated with chronic joint pain.

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Exercise for rheumatoid arthritis | Hello

In rheumatoid arthritis, the disease affects small joints, gradually spreading its harmful effect to larger ones. In the process, the inner surface of the articular bag and cartilage tissue are destroyed. Most often, the disease affects women and teenagers, as well as people who are regularly exposed to physical activity. By resorting to exercise therapy for rheumatoid arthritis (exercise therapy), you can ease the symptoms and improve well-being. Treatment of the spine and joints is prescribed by exercise therapy doctors, orthopedists or rheumatologists. The program is compiled taking into account the patient’s condition, his physical capabilities and existing contraindications.

What does exercise therapy do

Due to therapeutic exercises, rheumatoid arthritis maintains joint mobility. With a decrease in activity, muscle tissue atrophies, blood circulation slows down, and edema develops. At the same time, body weight increases. This is important because being overweight interferes with movement and puts more stress on your joints.

Thanks to the exercises, muscle and connective tissues, tendons are strengthened. As a result, the risk of injury is reduced. Simultaneously, during exercise, muscle relaxation occurs, and in rheumatoid arthritis, this helps prevent pain and accelerates regeneration processes.

Classes have a positive effect on the processes of metabolism and oxygen absorption, weight is reduced. But exercise therapy for rheumatism is contraindicated if the disease is in an advanced stage, and also when:

• inflammation in the internal organs and the cardiovascular system is detected;
• the acute stage of a chronic disease has begun;
• infection has occurred;
• there is intoxication of the body;
• infection develops;
• have heart or lung failure;
• suffering from fever;
• the temperature has risen;
• a hernia appeared;
• diagnosed with cancer.

Physical activity in rheumatoid arthritis should be regular and feasible. It is necessary to perform the exercises three times a day: in the morning, in the afternoon and before bedtime. At the same time, you should try to evenly distribute the load, equally working with both right and left limbs. Breathing should be measured, deep, and the load should be increased gradually, taking into account well-being.

Caring for the hands

Hand exercises for rheumatoid arthritis include exercises for fingers, wrists, shoulders and elbows. Classes begin with the development of the wrists, gradually rising up:

1. Stretch your arms forward. Turn open palms in different directions.
2. Close fists and repeat turns.
3. Sit down at the table. Place open palms on it. Now you need to raise your fingers up so that everything that is below the interdigital spaces lies motionless on the table.
4. Press palms together (as if in prayer) and raise to the level of the face. Put your elbows on the table. Then you need to slowly spread them, while the fingers should still touch each other.
5. Squeeze an expander, a special ball or an anti-stress toy in the palm of your hand.

To develop the elbow joints, it is necessary to bend and then raise the arms so that the hands are down and the elbows are at shoulder level. Now you need to reduce and breed the shoulder blades. Then you need to go to the wall, lean on it with your elbows and start push-ups.

Physical exercises for rheumatoid arthritis to develop the shoulder girdle include classic movements. First you just need to take turns raising and lowering your shoulders. After that, you need to make circular movements back and forth with them. To stretch from behind, behind the back at waist level, you need to interlock your fingers into the lock and lift them up, bringing the shoulder blades together.

Footwork

Orthopedists have developed a standard set of exercise therapy exercises for the lower extremities in rheumatoid arthritis. There are also proprietary methods. The classic exercises are as follows:

1. Tighten your toes and relax them.
2. Stand up straight and roll from heel to toe and back.
3. Rise on your toes and try to stay in this position for 1-2 minutes.
4. Place small objects on the floor and then try to pick them up. The exercise can be done both sitting and standing.
5. Rotate the foot, raise and lower it. You can also sit down.
6. Lie on the floor and do a “bike” with your hips up and your feet imitating the motion of the pedals.
7. Still lying on the floor, stretch out your arms and legs. Then you need to slowly bring the left heel to the buttocks, and then raise the leg so that the knee touches the chest. Repeat the movement on the right side.
8. Lying on your back, bend your knees and spread them to the maximum distance.
9. The exercise is similar to the previous one, but is performed with outstretched legs.

It is very useful to walk barefoot on the ground or grass as often as possible. Periodically, it is desirable to make swing movements: just stand up straight and stretch your legs, and then make wide swings with one limb, then the other.

Emphasis on the knees

Very effective exercises for rheumatoid arthritis of the knee joint, developed by Dr. S.M. Bubnovsky. The main goals of the complex he proposes are to activate the blood supply in the knee area, stimulate the production of synovial fluid, and strengthen the ligaments and muscles. Also in the process, the spinal column is strengthened, due to which the pressure of body weight on the knees is reduced. The complex proposed by the doctor consists of only three exercises:

1. Lie down on the floor and roll over onto your back. Then, in turn, raise one leg, then the other, bending it at the knee. Fix the limb at the top point for 1 minute. Legs should always be lowered slowly. While one limb is up, the other should lie on the floor. Repeat the movement 10 times. Hands can be extended along the body or placed on the stomach.
2. Same starting position. It is necessary to raise the pelvis with support on the feet and outstretched arms. You should get a “bridge” with the legs as bent as possible. Next, you need to stand like this for at least 1 minute and gently lower yourself. Exercise is done 15 times.
3. Lie on your back with your arms and legs extended. Then slowly bring one knee to the nose, then the other. You can help yourself with your hands, pull yourself up with your head. Do 10 sets for each leg.

To practice Bubnovsky on the floor, you need to prepare a soft surface. You can work on an orthopedic mattress. The complex cannot be called easy to perform, but the result of the classes appears quite quickly.

Summary

Exercise therapy does not cure rheumatoid arthritis. In severe situations, the pain will not go away, and you still have to go for surgery. But the body prepared by exercises recovers faster and easier. In the initial stage of the disease, classes will help to maintain joint mobility for longer and lead a full-fledged lifestyle.

Exercises for rheumatoid arthritis of the hand

What is rheumatoid arthritis and what is exercise?

Rheumatoid arthritis is a joint disease that often affects the hands and wrists. Hand exercises include mobility, strengthening (with equipment such as putty), or functional training.

Study profile

We found seven studies comparing hand exercise with no exercise therapy in 841 adults with rheumatoid arthritis.

Main results

In a short-term follow-up (less than 3 months), people who did hand exercises rated their function 1.1 points higher on an 80-point hand function test (0 to 80 points, higher score means better function) . People who didn’t exercise rated their functions 75 points.

At medium-term follow-up (3 to 11 months), people who did hand exercises rated their function 5 points higher on a 100-point scale (0 to 100 points, higher score means better function), and 4 points higher with long-term follow-up (more than 12 months). People who did not exercise rated their functions at 52.1 points.

In a short-term follow-up, people who exercised rated their pain 28 mm lower on the 100 mm pain scale (0 to 100 mm, lower value means less pain). People who didn’t exercise rated their pain at 68mm. At the mid-term follow-up, people who exercised rated their pain 3 points lower on a 100-point pain scale (from 0 to 100, lower means less pain), and 4 points lower at long-term follow-up. People who didn’t exercise rated their pain at 51.4.

In short-term follow-up, exercisers had 3% and 4% improvement in their left and right hands in grip strength. For individuals who did not exercise, strength indicators were 14. 3 kg and 15.6 kg, respectively. In both medium and long-term follow-up, exercisers had a 1% improvement in both hands in average grip strength. In individuals who did not exercise, strength indicators were 13.2 kg.

In short-term follow-up, exercisers had 4% and 6% improvement in left and right hands in pinch strength. For individuals who did not exercise, strength indicators were 1.2 kg and 1.2 kg, respectively. At medium and long-term follow-up, exercisers had 2% and 3% improvement in both hands in average pinch grip strength. In individuals who did not exercise, strength indicators were 4 kg.

It should be noted that while there were apparently better measures of hand function, pain, grip strength, and pinch grip with hand exercises, these improvements may not equate to clinical benefit.

No study evaluated the American College of Rheumatology Criteria 50 (a measure that indicates greater than or equal to 50% improvement in a patient’s symptoms when receiving treatment).

Compared with participants who received regular care, those who also received hand exercises with strategies to stick to this program were 19% and 5% are more likely to stick to their program for a year or more.

One study reported no adverse effects associated with exercise. The remaining studies did not measure this outcome.

Quality of evidence

The quality of the evidence was very low to high quality across outcomes. We downgraded the quality of the evidence due to problems with participants not being blinded to their prescribed treatments and measurements, problems with how participants were assigned to study groups, and small study sizes.

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Translation notes:

Translation: Ziganshina Lilia Evgenievna. Editing: Yudina Ekaterina Viktorovna.