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Hand Exercises Can Improve Grip Strength, Function, Pain and Fatigue in Women With Hand Osteoarthritis

Osteoarthritis is commonly called "wear and tear" of the joints and happens when the cartilage that surrounds the bone ends and normally protects the joints from impact becomes worn and thinner.

New research led by Ingvild Kjeken, Professor in Occupational Therapy at the University of Oslo, Norway, has shown that hand exercises can significantly help women with the pain of hand osteoarthritis, improve grip strength, hand function and also fatigue.

Osteoarthritis is commonly called "wear and tear" of the joints and happens when the cartilage that surrounds the bone ends and normally protects the joints from impact becomes worn and thinner. This can cause the joints to feel stiff and painful and there can also be swelling of the joints and difficulty using them. In the hands, osteoarthritis often affects the small finger joints and the joint at the bottom of the thumbs and can cause pain when using the hands for example when writing or doing up buttons, picking up cups, when peeling vegetables or after gardening. Grip strength can be reduced making it difficult to turn taps or open jars and sometimes the pain can disturb sleep.

The Cochrane library is home to reviews of medical research on many different health-related topics and is considered to be one of the best places to look for the most up to date and highest quality evidence-based medical advice. Cochrane reviews have already shown that exercise is effective for improving pain and function in people with osteoarthritis of the knee and hip. Hand exercises in osteoarthritis are also already recommended, but until this study there has not been much evidence that they are effective.

In Professor Kjeken's study, 80 women of average age around 60, with osteoarthritis of the hands were divided into 2 groups. Both groups were assessed before the start, and their hand function and grip strength as well as measures of pain were recorded. Both groups were given advice on hand osteoarthritis by an occupational therapist and one group received an exercise programme as well. Exercises were aimed at improving grip strength and increasing the flexibility of the fingers, for example performing exercises with elastic bands used to provide resistance to the thumb to improve muscle strength, and by squeezing a 7cm rubber ball.

Patients were also telephoned eight times in the three month study period by their therapist to check on their progress and give reminders. Participants were asked to exercise three times per week for 3 months with each exercise being performed 10-15 times. Before the study, participants were asked to identify several activities they found difficult because of hand pain.

Women who completed the exercise programme were much more likely to notice an improvement in these functional activities after the study than those who had only information provided. Exercise participants also had less pain and improved grip strength and surprisingly reported less fatigue.

We already know that exercising the hands is effective for reducing pain and maintaining hand function in rheumatoid arthritis and this new study has also shown that exercising the hands does not cause any harm and can help with the pain of osteoarthritis and improve function.

Hand exercises are very easy to do and simply regularly squeezing a soft rubber ball may make a difference to hand function and pain. No other special equipment is needed but people with arthritis should seek medical advice prior to starting a new type of exercise. They may wish to find or ask for a referral to an occupational therapist, a physiotherapist or hand therapist who will be able to help them with an exercise programme.

Arthritis Action, a charity that believes that self-management is one of the most effective ways to deal with arthritis, encourages people living with the condition to do regular exercise which can help alleviate the pain and stiffness associated with it.