How can hand exercises help manage rheumatoid arthritis symptoms. What are the best exercises for improving hand flexibility and strength with RA. Which techniques can increase range of motion and dexterity in arthritic hands.

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 function. Hand exercises play a crucial role in managing these symptoms and maintaining hand mobility. But why are these exercises so beneficial?

Hand exercises for RA serve multiple purposes:

• They help keep tendons flexible
• Improve circulation through the joints
• Maintain and potentially increase hand strength
• Enhance overall hand function

According to Alice Pena, a certified hand therapist and physical therapist, these exercises provide a gentle way to strengthen hands and help patients gauge their activity levels. Regular practice can significantly reduce pain and stiffness while improving joint function.

Guidelines for Performing Hand Exercises with Rheumatoid Arthritis

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

1. Stop if you experience pain during any exercise
2. Aim to repeat exercises up to five times per session, once or twice daily
3. Consult your doctor or physical therapist for personalized recommendations
4. Use moist heat before exercising to ease motion and prevent discomfort

How can you apply moist heat before exercises? Consider these options:

• Soak hands in warm water for 5-10 minutes
• Use a warm paraffin wax bath
• Wrap hands in a towel soaked in hot water
• Perform some exercises, like making a fist, during a warm shower

Enhancing Flexibility: Flat-Hand Finger Lifts

One of the primary goals of hand exercises for RA is to increase flexibility. The flat-hand finger lift exercise is an excellent starting point. How do you perform this exercise?

1. Place your hands flat, palm down, on a table or against a wall
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

This exercise helps maintain individual finger mobility and can improve overall hand flexibility. It’s particularly beneficial for those experiencing stiffness in their finger joints due to RA.

Improving Range of Motion: The Fist Exercise

Range of motion is often compromised in hands affected by rheumatoid arthritis. The fist exercise is a simple yet effective way to address this issue. How is it performed?

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 beneath)
4. Hold this position for up to one minute
5. Open your hand slowly
6. Repeat a few times on each hand

This exercise gently works the joints through their full range of motion, helping to maintain and potentially improve flexibility. It’s important to perform this exercise slowly and gently, especially if you’re experiencing a flare-up of RA symptoms.

Enhancing Grip Strength: The Towel Exercise

Grip strength often diminishes with RA, making everyday tasks challenging. The towel exercise is an excellent way to work on improving your grip. How do you do this exercise?

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

This exercise not only helps improve grip strength but also allows you to monitor how RA might be affecting your grip over time. It’s a practical exercise that mimics real-world actions, making it particularly beneficial for maintaining hand function.

Boosting Dexterity: Finger Pinches

Dexterity is crucial for many daily activities, from buttoning shirts to tying shoelaces. Finger pinches can help maintain and improve this essential skill. How are finger pinches performed?

1. Start with your hand in a relaxed position
2. Touch your thumb to the tip of your index finger
3. Press firmly, like a pinch
4. Hold for 1-2 seconds, then release
5. Repeat with each finger individually

This exercise helps maintain the precision movements of your fingers and thumb, which are often affected by RA. Regular practice can make a significant difference in your ability to perform fine motor tasks.

Maintaining Thumb Mobility: The Thumb Stretch

The thumb plays a crucial role in hand function, and maintaining its mobility is essential for people with RA. The thumb stretch is a simple yet effective exercise for this purpose. How is it done?

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

This exercise helps maintain the thumb’s range of motion and can improve your ability to grip circular objects, such as a hairbrush handle or a glass. It’s particularly beneficial for those experiencing stiffness or limited mobility in the thumb due to RA.

Promoting Overall Hand Flexibility: Finger Spreading

Overall hand flexibility is crucial for maintaining function with RA. The finger spreading exercise is a simple way to work on this. How do you perform this exercise?

1. Start with your hand in a relaxed position
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 several times

This exercise helps reduce stiffness and strengthens the muscles around the joints in your hand. It’s particularly beneficial for maintaining the ability to open your hand fully, which can be compromised by RA.

The Importance of Listening to Your Body

While hand exercises are generally beneficial for managing RA symptoms, it’s crucial to know when to take a break. During flares or periods of worsening symptoms, it might be best to temporarily stop exercising and instead use supportive braces or splints. This approach can help prevent additional joint damage.

How can you tell if you should take a break from hand exercises? Look out for these signs:

• Increased pain during or after exercises
• Swelling in your joints
• Warmth or redness in your hands
• Decreased range of motion

If you experience any of these symptoms, consult with your healthcare provider. They can guide you on whether to continue exercises or take a break, and may suggest alternative ways to manage your symptoms during flares.

Incorporating Hand Exercises into Your Daily Routine

Consistency is key when it comes to hand exercises for RA. How can you make these exercises a regular part of your day?

• Set a specific time each day for your exercises, such as right after waking up or before bed
• Pair your exercises with a daily activity, like watching TV or waiting for your coffee to brew
• Use reminders on your phone or sticky notes to prompt you to do your exercises
• Keep a log of your exercises to track your progress and stay motivated

Remember, these exercises don’t require special equipment and can be done almost anywhere. This flexibility makes it easier to incorporate them into your daily routine, regardless of your schedule or location.

The Role of Professional Guidance in Hand Exercise Programs

While these exercises can be beneficial, it’s important to remember that every case of RA is unique. Professional guidance can ensure you’re doing the most appropriate exercises for your specific condition. Who can provide this guidance?

• Rheumatologists: They can assess your overall RA management and recommend appropriate exercise levels
• Physical therapists: They can create a personalized exercise program and teach proper technique
• Occupational therapists: They can help you adapt exercises to your daily activities and teach joint protection techniques
• Certified hand therapists: They specialize in hand rehabilitation and can provide targeted exercise recommendations

These professionals can not only guide you on which exercises to do but also help you modify them as your condition changes over time. They can also provide valuable insights into other aspects of RA management that complement your exercise routine.

Complementary Approaches to Hand Exercises for RA Management

While hand exercises are a crucial component of managing RA symptoms, they’re most effective when combined with other treatment approaches. What other strategies can complement your hand exercise routine?

• Medication: Prescribed by your rheumatologist to manage inflammation and pain
• Joint protection techniques: Methods to reduce stress on your joints during daily activities
• Assistive devices: Tools designed to make tasks easier and reduce joint strain
• Nutrition: A balanced diet rich in anti-inflammatory foods can support overall joint health
• Stress management: Techniques like meditation or deep breathing can help manage pain perception

By combining these approaches with your hand exercise routine, you can create a comprehensive strategy for managing your RA symptoms and maintaining hand function.

The Future of Hand Exercises for Rheumatoid Arthritis

As research in rheumatology continues to advance, new approaches to hand exercises for RA are emerging. What might the future hold for this aspect of RA management?

• Technology-assisted exercises: Apps and devices that guide and track hand exercises
• Virtual reality exercises: Immersive environments that make hand exercises more engaging
• Personalized exercise prescriptions: Using genetic and biomarker data to tailor exercise programs
• Integration with wearable devices: Syncing exercise data with overall health monitoring

These advancements promise to make hand exercises more effective, engaging, and personalized for individuals with RA. As always, staying informed about new developments and discussing them with your healthcare provider can help you make the most of your RA management strategy.

In conclusion, hand exercises play a vital role in managing rheumatoid arthritis symptoms and maintaining hand function. By incorporating these exercises into your daily routine, listening to your body, and working with healthcare professionals, you can take an active role in managing your RA and preserving your hand mobility and strength. Remember, consistency and patience are key – the benefits of these exercises often accumulate over time, contributing to better long-term outcomes in your RA journey.

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.

If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions.

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Translation notes:

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