Osteoarthritis in our hands — how to live with it, how to manage it — was the fascinating topic of a recent lecture by Stephanie Kiel, a certified hand therapist and occupational therapist at Benchmark Physical Therapy in Hoschton. She spoke to a roomful of residents at the Village at Deaton Creek, a retirement development.
BY the time we reach our 60s and 70s, most of us will probably have some osteoarthritis simply because with increased age, there is some degeneration or wearing away of certain body tissues such as cartilage and bone. It’s been called the “wear-and-tear” disease, but researchers say it’s not the result of how active or inactive you’ve been. In fact, they don’t really know the exact cause. It’s often related to age for the reasons mentioned, but gender plays a role, too.
In people under age 45, more men have the condition; beyond 45, more women have it. Sometimes, there’s a family history; other times, it’s the result of specificphysical activity. Ballet dancers and football players both can develop it at a young age because of stress on certain joints. Regardless of the cause, our hands, which perform countless small and large tasks each day – from pouring coffee, brushing teeth, buttoning shirts to gardening or using our various electronic devices – can become progressively stiff, painful, and weak. What should we do?
“Heat is your best friend,” Kiels says. Paraffin (wax) treatments at a nail salon are helpful, and similar products for home use at local big box retailers or from specialty catalogs are “excellent.” So are heat gloves. “But never use ice,” she cautioned.
She said most over-the-counter creams are ineffective because they don’t penetrate the skin. The exceptions are creams with capsaicin and lidocaine. The prescription cream Voltaren also can help.
Most of Kiel’s lecture concentrated on the need to avoid prolonged or tight pinching or gripping, which both contribute to osteoarthritis. She explained that the tiny muscles in the hand are very vulnerable; whenever possible, you should consciously choose to use bigger muscles–such as those in the arm. Here are some specific recommendations:
- Buy products with big grips for kitchen utensils. For writing Dr. Grip pens are excellent; for cutting, try spring-loaded scissors. There are even new “rocker” knives that make cutting and slicing easier, she said.
- You can make your own modifications of existing utensils with pipe insulation; wrap it around toothbrushes, pens, mixing spoons.
- Re-learn how to hold utensils. For example, grip wooden spoons in the center across your palm and use your arm to stir, instead of pinching the tip.
- Move heavy bags and purses to your elbow so your big arm muscles are carrying weight, not your fingers.
- Use both hands to pick up pots and pans, or any large object.
She also showed many specialty devices for pain relief or that enable certain grips for sports such as golfi ng. She even had a lovely silver ring that looked like jewelry but actually helps straighten fingers that are beginning to overlap.
Kiel also creates devices for some conditions, while others can be bought off the shelf, or ordered. The bottom line is there are functional solutions and activity changes that will keep your hands working for you.
More hand care tips
Jeremy Cryder, certifi ed hand therapist with Athens Orthopedic Clinic, points out that there is no cure for osteoarthritis but you can prevent the speed of its advance.
“By taking the stress off your hands, you won’t have as much break down,” he advises. “We do a lot of education so patients can keep as much range of motion as possible, and use efficiently what strength and flexibility they have.” So when you first notice symptoms of stiffness, a little pain, weakness, don’t delay changing some daily habits.
Cryder says moist heat, habit changes, using some handy gadgets, and a routine of exercise will go a long way toward keeping hands healthy.
Some more advice:
- Avoid placing pressure on fingertips; transfer work to other, stronger body parts; for instance, using body weight to push doors open or to close them.
- Avoid picking up items with one hand, and slide them whenever possible.
- Avoid leaning on knuckles; open your fingers and use the pad of the hand when needed.
- Avoid positions that cause fingers to lean sideways toward the little finger; instead use devices like jar openers.
- At the computer, avoid holding the wrist in a tilted up position. Change your work height so the wrist can be held straight.
www.handcare.org (a blog created by the American Society for Surgery of the Hand and American Society of Hand Therapists); they have a variety of one-page flyers on subjects ranging from biceps rupture to trigger finger; safe cooking to safe gardening to safe I-pad use.
Healthy Hands: Strategies for strong, pain-free hands, an 18-page report by Harvard Medical School (www.health.harvard.edu); reports on over 50 health topics (price range: $18 to $26).
Functional Solutions, a 64-page catalog of gadgets, utensils, and a large variety of other functional items for living independently; published by North Coast Medical (ncmedical.com).