December 13, 2017
Hand Exercise for Arthritis

Hand Exercise for Arthritis

by Jeanine Barone  

Donald Trump may have little hands, but apparently they are strong hands, given his predilection for exchanging white-knuckled handshakes with world leaders, even at age 71. But for many people, hand strength declines with age, especially if osteoarthritis sets in, making it hard to go about daily tasks. A study published in 2017 in Arthritis and Rheumatology estimated that the overall lifetime risk of hand osteoarthritis is close to 40 percent, with twice as many women as men developing it (50 percent of women versus 25 percent of men).

People who are obese are also more susceptible—possibly because obesity increases chronic low-level inflammation, which may contribute to joint damage.

Day in and day out, we all perform countless tasks, big and small, that require our hands, whether it’s opening a jar, grasping a broom, carrying a shopping bag, working on a computer, doing craftwork, lifting a weight in the gym, or swinging a golf club or tennis racquet. Yet hands are often overlooked when it comes time to work out (at least as the primary focus).

Importance beyond the hand

The significance of your grip goes beyond activities of daily living and sports, with many studies finding not only that hand strength correlates with total body strength, but also that it is a marker for overall health. For instance, a 2015 study in The Lancet, which included about 140,000 people in 17 countries, found an association between reduced grip strength and increased risk of death from cardiovascular disease, as well as an increase in all-cause mortality, over a four-year period.

Most recently, a study published online in the American Journal of Clinical Nutrition in August, which included more than 400,000 people in the U.K., linked lower grip strength to higher mortality risk over seven years, independent of body fat level. Measuring grip strength is a quick, cheap method to assess the risk of mortality, researchers have concluded. But it’s unknown if improving it will help you live longer.

Exercise away hand pain

There is plenty of evidence that people with both osteoarthritis and rheumatoid arthritis, who often experience a decline in handgrip strength because of painful joints, can get some symptom relief and other benefits from hand exercises. Among several possible mechanisms, exercise strengthens muscles around joints to better support them, increases circulation of synovial fluid (which helps cushion joints), increases oxygen and nutrients circulating through the joint’s membranes, and triggers a process by which cell debris is removed from joints.

In a study in the Annals of the Rheumatic Diseases in 2013, of 80 women in Norway with hand osteoarthritis, half were instructed to do hand exercises three times a week for three months, while a control group simply received basic information about the condition. The exercises included rolling fingers into a fist, squeezing a rubber ball hard, and spreading fingers as wide as possible. Even though the participants in the exercise group had quite a bit of pain at the start, this decreased as the study progressed, and overall hand joint pain, grip strength, and hand function all improved, compared to the control group.

In another study in The Lancet in 2015, researchers looked at 490 people in the U.K. who were taking medication for their hand rheumatoid arthritis. Half continued with their usual care while the other half added in tailored hand stretching and strength exercises. After a year, the treatment group had greater improvements in hand flexibility, dexterity, and muscle strength compared to the control group (though no changes in pain), indicating that a simple hand exercise program can be useful as an adjunct to drug therapies.

A review this year by the Cochrane Collaboration of seven studies involving 534 people with hand osteoarthritis concluded that hand exercise programs provide some small benefits, including improvements in joint stiffness, hand pain, hand function, and quality of life—at least in the short term. None of the studies measured whether there were changes in actual joint structure.

Pumping up your hands

Hand exercise programs should focus not just on the muscles that flex the fingers but also on those that extend the fingers, since both are important for proper hand function. Yet, many programs don’t give much attention to extension.

There are all sorts of things you can use to improve your hand strength and flexibility, including small soft balls, resistance bands, and therapy putty. These all come in different colors, reflecting different levels of resistance. Among the exercises you can do with putty:

  • Squeeze putty in the palm of your hand, bending your fingers to press the putty as you create a fist.
  • Place a small ball of putty between the side of your index finger and thumb and press until the two fingers touch. This can also be done with three fingers, adding the middle finger, so all three fingers touch as you squeeze the putty.
  • Other exercises include pulling putty using both hands; rolling putty with the flat palm of your hand, while extending each finger back; and pressing a ball of putty between each finger and your thumb, going from index finger to little finger.

In general, exercises should be done several times a week and include both high-resistance exercises to improve muscle strength and low-resistance exercises done repeatedly to build endurance, as well as flexibility exercises that involve moving your hands and fingers through their full range of motion.

This web page from the National Institute on Aging shows a simple handgrip exercise using a tennis ball. Another good source is from Kaiser Permanente. Sand is also a good medium to use for hand strengthening, as shown in this video clip.

Bottom line: If you have arthritis in your hands, exercise may bring some symptom relief and help with day-today activities. Because of differences in individual needs (and injury risks), it’s best to have your physician or a physical therapist evaluate you and determine the best program for you.

Also seeGlucosamine for Arthritis: Yes, No, Maybe?