Tuesday, December 18, 2012

Try a Hand at Exercise

Brushing your teeth, buttoning your shirt, opening a jar -- these are routine daily activities that most people take for granted. But if you have arthritis and it affects your hands, performing these and other basic tasks can be challenging. Fortunately, "exercising" your hands can help reduce the pain, improve your range of motion and, ultimately, enable you to perform more easily the various tasks of daily living. 
Where does it hurt? Arthritis of the hands manifests differently depending on what kind of arthritis you have. 
  • Osteoarthritis. The most common cause of hand arthritis is osteoarthritis (OA). In osteoarthritis, the protective cartilage that covers the ends of your bones gradually deteriorates due to wear and tear or, in some cases, to injury. If your hand pain is caused by osteoarthritis, the affected joints are painful and may swell or develop hard bony nodules. The joints most likely to be affected in hand osteoarthritis are the trapezio-metacarpal (basilar) joint, which is at the base of the thumb; the distal interphalangeal joint, which is closest to the fingertips; and the proximal interphalangeal joint, located in the middle of the finger. 
  • Rheumatoid arthritis. By contrast, rheumatoid arthritis (RA) is an immune system disorder that damages the cells in the tissue that lines and lubricates the joints (synovial membrane). If rheumatoid arthritis is the cause of your hand pain, the joints most likely to be affected are the wrist joint; the index and middle metacarpophalangeal joint, which are the knuckles at the base of your fist; and the proximal interphalangeal joint. Rheumatoid arthritis does not affect the distal interphalangeal joints. In addition, because rheumatoid arthritis is a systemic condition, it typically affects joints on both sides of the body. 
The distinction between osteoarthritis-and rheumatoid arthritis-induced hand pain is important for several reasons. 
  • First, if your pain is caused by rheumatoid, you should not attempt to alleviate it with exercise alone. Prompt aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) has been shown to slow disease progression and limit joint damage, reducing the likelihood that your hand will become permanently disfigured.
  • Second, strengthening exercises can be harmful if performed aggressively and should be done in moderation by people with rheumatoid.
  • Third, you should perform any type of exercise with caution while you're having a flare.
The main message for people with rheumatoid or osteoarthritis is to respect the pain, and whenever you perform the exercises, do them gently to avoid further harm to your joints.

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