Initiating a regular exercise regime at the onset of arthritis - is the key to preventing long-term pain and disability.

The word “arthritis” denotes inflammation of the joints. Our hands and wrists comprise multiple small bones and, therefore, multiple small joints which work in tandem to produce movements.

Osteoarthritis and rheumatoid arthritis are the two most common forms of arthritis. The former is more common and affects elderly people. Rheumatoid arthritis is a chronic inflammatory illness which primarily attacks the linings of the joints. The hands and the feet are most often affected. When inflammation in the joints becomes chronic, longstanding cartilage and bone destruction occurs, leading to permanent deformity. Certain individuals suffer from severe pain while others do not. Hardened lumps called “rheumatoid nodules” occur under the skin of fingers.

Osteoarthritis of the hand involves certain spots more frequently. Small, bony nodes called Heber den’s nodes appear on the distal joints of the finger. Similarly, Bouchard’s nodes appear on the middle joints of the fingers.

On movement, there is pain and stiffness which is relieved on rest.

Hand function impairment vis-à-vis difficulty while writing, grasping objects, buttoning up a shirt, etc.

Morning stiffness due to muscle spasm and contraction, resulting in muscle shortening.

Repetitive pinching grip as is seen in the case of painters and mechanics suffer from more severe pain.

The base of the thumb where it meets the wrist is usually affected. Gripping of objects, opening of lids or turning of keys become agonising.

The goal of treatment is to alleviate pain and stiffness, facilitate enhanced mobility and postpone the progression of the disease.

n Conservative treatment -— medication to decrease pain and swelling.

n Heat modalities such as paraffin bath and warm wax.

n In chronic cases, turning a finger/wrist sleeve/splint during night is helpful.

n Local application of steroid in the case of thumb arthritis provides instant relief.

Excercises increase the lubrication in the cartilage of the joints, thus reducing the symptoms of pain and stiffness. With aging, the muscles and tendons that support the joints tend to get weaker.

The following exercises strengthen the muscles to protect the joints and provide support:

Raising both hands, curling fingers inwards to touch the palm and returning back. Then move your fingers and thumbs simultaneously to make a fist. Repeat several times a day.

Finger flutter exercise:Sitting on a chair, drop your hands on the side of the body. Relax your arms by moving them while shaking hands and fingers. This helps relax muscles and enhance circulation.

Finger extension exercise:The affected hands’ elbow is placed on the side of the chair. The fingers of the affected hand are passively placed into extension with the help of the other hand.

Finger-stretch exercise:Raise both hands with wrists and fingers fully extended. Move the hands like a screw with fingers closed in a smooth continuous movement, starting with the little finger. Finally, the hand is flexed as the fist is closed forcibly with the thumb overlapping the index finger.

Finger extension:Place a rubber band around all five fingertips. Spread fingers till your hands get tired.

Ball squeeze:Place a rubber ball or a tennis ball in the palm of your hand, squeeze it till the hand gets tired several times a day.

Initiating a regular exercise regime at the onset of arthritis is the key to preventing long-term pain and disability.

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