Since a lot of The Arthritis Portal's articles are about knee and hip OA, we took the opportunity to ask Katarina Mortazavi, Freya Kristjansdottir, and Sara Larsson also about training and advice on OA of the wrist/fingers/thumb base.
For hand and wrist OA, the same advice applies as for OA in other joints. For thumb base arthritis, however, there has been a national care program (in Sweden) developed since 2022 that has been implemented in the different regions of Sweden. The program provides recommendations for treatment divided into basic treatment and additional treatment within primary care and surgical treatment with subsequent rehabilitation at a specialized level.
Within primary care, the patient should be offered information about ergonomics and hand-friendly tools to better cope with activities in everyday life. Advice can be given both individually and through an "OA-school". The purpose of offering hand training is to reduce stiffness and increase strength in the hand. Resistance and training intensity should be adapted to each individual and started cautiously. An orthosis (support splint) can both reduce the pain experience and improve function. Depending on which activities you want to perform and for what purpose, you may need more than one orthosis. If basic treatment does not provide sufficient relief, pain-relieving medication and/or cortisone injection may be offered to individuals with a confirmed diagnosis and pronounced problems.
That patients with wrist OA are offered conservative treatment with education and training is not as common within primary care. The reason may be that it is more difficult to diagnose wrist OA compared to OA in the thumb base or finger joints. Many times a more extensive investigation is needed, which includes X-rays. Research on the effect of education and training for patients with wrist OA is ongoing. Patients with wrist OA can be helped by relieving the wrist with a wrist orthosis and training the general stability and strength in the hand and wrist.
Previously, we have some example exercises that can be good if you suffer from knee and/or hip joint OA on the Arthritis Portal. Now we can also offer some tips for you with arthritis in any of the joints of the hand. As usual with exercise exercises, it applies that not everything works for everyone and if you are unsure, we recommend that you contact your health center or physiotherapist directly for individual advice.
- For thumb base arthritis, it is important to train the “opening grip”, i.e., to move the thumb to the side so that it is possible to hold/grip around slightly larger objects.
- To maintain fine motor skills in the hand, the exercise of bringing the thumb tip to the other fingertips is important. Preferably shaped like an “O”, it affects all three joints in the thumb in an optimal way.
- For patients with wrist osteoarthritis, it may be good to train the muscles and tendons surrounding the joint. This can be done, for example, by grip training with therapeutic clay with the wrist in a neutral and stable position.
- It is also possible to train the static strength of the wrist-stabilizing muscles around the joint, either with manual resistance, a lighter dumbbell, or theraband
