The Best Hand Exercises for Rheumatoid Arthritis
Stiff and painful hands, unfortunately, go hand-in-hand with rheumatoid arthritis (RA). In fact, up to 70 percent of folks with RA have hand issues. What can help manage the pain? “Meds and exercise,” says Nasim A. Chowdhury, M.D., a physical medicine and rehabilitation expert at Weill Cornell Medicine and New York-Presbyterian in New York City. “If you don’t do hand and wrist exercises, you run the risk of decline in your hand function.” Consult your physical therapist about trying these moves. Go slow, and remember, none of these movements should hurt. (Pain is your cue to take a rest.)
Warm up in the Shower
“I like to start my day with basic range-of-motion exercises in the shower,” says Kimberly Steinbarger, PT, the director of clinical education at the school of physical therapy at Husson University in Bangor, Maine, who has RA herself. “Moist heat penetrates more deeply than dry heat, relieving morning stiffness.” Steinbarger recommends curling your fingers into a fist to loosen up your joints. But be gentle. You’re not looking to knock anyone out here. Hold your right hand out in front of you and slowly bend your fingers into a fist. Squeeze lightly and re-open your hand. Repeat with your left hand.
Give Your Thumbs a Stretch
About one-third of people with RA experience basal (or 1st carpometacarpal) joint involvement. That’s the joint at the base of the thumb that’s pretty crucial for everyday tasks, like buttoning your shirt and opening a door. To keep limber, try this: 1) Hold your hands open, palms up, fingers spread. 2) Fold your thumb over your palm, bending the joint that’s near the wrist, pointing the tip of your thumb toward the base of your pinkie. Hold 10 seconds. 3) Repeat 10 times on each hand.
Roll Your Fingers
“The main benefit of hand exercise in RA is that it prevents the joints from stiffening, allowing for maintained hand flexibility,” says Dr. Chowdhury. “But RA exercises also increase blood circulation to the area, which can ‘wash out’ pain-producing molecules.” An exercise to do just that: The Finger Roll. 1) Hold your hand out, palm up, fingers straight and together. 2) Roll your fingers (sans thumbs) toward you, one knuckle at a time until you have a loose fist. Hold 10 seconds. 3) Repeat 10 times on each hand.
Heat up Your Hands
“There’s a clear improvement in RA hand pain when people soak their hands in a paraffin wax bath,” says Dr. Chowdhury. “It’s thought that paraffin heats the hands superficially, allowing for improved circulation and pain relief.” Paraffin is especially helpful to quell pain and loosen hand joints prior to exercising them. Before you dip your hands, however, know that heat should be avoided when you’re experiencing an RA flare. “Here, heat can actually make symptoms worse,” says Dr. Chowdhury. (Always talk to your physical therapist before adding anything new to your hand exercise routine.)
Do the Tip-to-Tip Move
This range-of-motion hand exercise can be done anytime, anywhere, and throughout the day—in a meeting, in the car, while relaxing on the couch, you get the idea. Try to repeat this process three times with each hand: 1) Bend the tip of your index finger toward the tip of your thumb until they touch. 2) Take turns touching the tips of each finger, one at a time.
Work Out in Water
Resistance training doesn’t just mean lifting weights. (In fact, when you’re dealing with RA, it’s not a good idea to use hand weights. Ask your physical therapist about using a cuff weight instead.) For RA, it means adding some gentle push-back to maximize the benefits of your hand exercises. To do this, practice your hand exercises, but in a sink full of warm water or a bucket of sand. “This provides gentle resistance to the entire hand, not just one joint,” says Steinbarger. “It’s a low-impact exercise, but it still builds strength.”
Make a Circle With Your Wrist
Your wrist is made up of several small joints, and when the lining of those joints (called the synovial lining) becomes inflamed due to RA, it can cause damage to the bones and tendons in your wrist. And that’s why it’s imperative to keep your wrists loose via exercises like this: 1.) Lay both of your wrists at the edge of a table, allowing your hands to dangle off the edge. 2) Move your wrists clockwise in circles; shoot for about five rotations. 3) Next, move them in counterclockwise circles, aiming for five rotations.
Do the Lift-and-Tuck
This exercise works to maintain your range of motion, but it’s also a fantastic way to stretch your muscles and tendons. “It’ll even stretch those long tendons that go from your elbow all the way to your fingertips,” says Steinbarger. 1) Lay your hands flat on the table, palms down. 2) Lift your fingers up toward the ceiling (“you can either use your other hand to help or rely on your own muscle power,” says Steinbarger), and hold for a few seconds. 3) Curl your fingers under, then straighten your fingers out again. Repeat about five times.
Let Your Fingers Do the Walking
Chronic inflammation can cause what’s called an ulnar deviation (or ulnar drift). This is when your fingers begin to shift toward your pinky, while your wrist bends toward your thumb. This exercise is a great way to protect against this happening. 1) Place your hands on a table, palms down, fingers stretched out. 2) Keeping your thumbs stationary and flat on the table, horizontally scoot your fingers (still on the surface of the table) toward your thumb. 3) Next, creep your fingers back to their starting position Repeat the whole process 10 times.
Add Some Reinforcements
Increase your hand strength and flexibility by incorporating resistance props, like a stress ball or therapeutic putty. “Anything you can squeeze works,” says Steinbarger. “Putty comes in different densities with some easier to manipulate than others—and you can do so much with it.” You can squeeze it, roll it, or pinch it. “You can stick a marble in it and exercise your grasp by fishing it out. Or you can place your fingers in it and gently open them up for a strengthening exercise,” says Steinbarger.
Try the Press-and-Lift
One of the most effective exercises to help combat stiffness and pain! “Plus, I love that you are able to work your muscles without involving your joints,” says Steinbarger. Try to complete the circuit twice. 1) Lay your forearms and hands on a table, fingers extended. 2) Firmly press your fingers into the table. 3) Lift your thumbs off the table and hold for a few seconds before returning to starting position. 4) Next, lift both index fingers, holding briefly; return to starting position. 5) Continue lifting with each finger while keeping your other fingers and thumb pressed into the table.
Record Your Progress for Success
Create a chart that lists your favorite hand exercises, followed by the number of desired reps and how long each position should be held. Across the top, list the days of the week. Each time you do your routine, fill in your chart. Not only with this remind you which exercises you should do, it helps you—and your care team—gauge how you’re doing. The best part? Research from the American College of Rheumatology suggests that keeping this type of hand exercise diary helps you stick with your plan.
RA and Hand Function Stat: BMC Musculoskeletal Disorders. (2016). "Patient and physician perspectives of hand function in a cohort of rheumatoid arthritis patients: the impact of disease activity." (bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1246-x
Compromised hand function and RA: BMC Musculoskeletal Disorders. (2016). “Patient and physician perspectives of hand function in a cohort of rheumatoid arthritis patients: the impact of disease activity.” bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1246-x
Basal joint challenges and RA: Postgraduate Medical Journal. (2007). “Basal thumb arthritis.” pmj.bmj.com/content/83/975/40
Paraffin wax and pain relief: Physiotherapy. (2000). “Efficacy of Paraffin Wax Baths for Rheumatoid Arthritic Hands.” sciencedirect.com/science/article/abs/pii/S0031940605609637
Tracking training sessions: Arthritis Care & Research. (2006). “Do training diaries affect and reflect adherence to home programs?” onlinelibrary.wiley.com/doi/full/10.1002/art.22086