Get a Grip on Rheumatoid Arthritis in the Hands and Wrists

While rheumatoid arthritis (RA) is a body-wide condition, it commonly affects the small joints of the hands. RA inflammation can cause your wrists, fingers, and thumbs to be painful and appear swollen. Your grip strength may be weaker than normal.

Debilitating hand pain and stiffness can get in the way of essential daily tasks, such as getting dressed, as well as work and hobbies. Below are tips to help manage your RA hand pain and minimize its impact on your daily living.

See Hand Rheumatoid Arthritis Signs and Symptoms

Visit an occupational therapist

Occupational therapists are trained to help you strengthen your hand and wrist joints and help improve your hand dexterity. They are typically able to spend more time with patients than a physician, so they may have a better opportunity to learn about your unique daily routines and suggest specific workarounds and products that can help you do everyday tasks.

For example, an occupational therapist may provide guidance regarding:

• Using hand-friendly tools that make bathing and grooming less painful
• Making a few wardrobe adjustments that make getting dressed easier
• Arranging your kitchen to minimize hand strain during meal preparation
• Crafting, playing an instrument, and doing other activities that require significant hand dexterity

Your primary care doctor, rheumatologist, or hand surgeon should be able to refer you to a licensed occupational therapist.

Read more about Arthritis Treatment Specialists

Wear a splint

Immobilizing the hand and wrist can ease pain and stabilize the hand. They may be especially useful if you already have a mild deformity and want to take steps to keep it from getting worse.

There are dozens of types of splints available. For example:

• Single finger splints can help keep a finger straight. This type of splint may be helpful for people who tend to get trigger finger, swan’s neck deformity, or similar conditions.
• Splints that fit over the thumb and wrap across the wrist and palm can support the thumb’s carpometacarpal (CMC) joint. This type of splint may help relieve joint strain and pain at the base of the thumb.
• Larger splints that keep the fingers, thumb, and wrist immobilized can be worn while sleeping. These types of splints may be recommended to people who tend to make fists while they sleep (which may worsen arthritis).

Splints are sold under many different brand names and may be available over-the-counter or by prescription. Your rheumatologist, hand surgeon, or occupational therapist can recommend one suited for your joint symptoms.

Use voice-controlled software

Over time, typing can cause hand strain. Avoid the hand strain and preserve your hands for more important tasks by using voice-to-text transcription software. This type of software is often pre-installed on laptops, tablets, and phones, so you can do hands-free word processing, emailing, and texting.

Take your RA medications as directed

When rheumatoid arthritis medications are taken as directed, they do a better job at reducing symptoms. ¹ Murage MJ, Tongbram V, Feldman SR, et al. Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient Prefer Adherence. 2018;12:1483‐1503. Published 2018 Aug 21. doi: 10.2147/PPA.S167508 The better you control your RA, the less likely you are to experience hand pain and stiffness.

See Pain Medications for Arthritis Pain Relief

Research suggests ¹ Murage MJ, Tongbram V, Feldman SR, et al. Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient Prefer Adherence. 2018;12:1483‐1503. Published 2018 Aug 21. doi: 10.2147/PPA.S167508 ^{, 2} Park DC, Hertzog C, Leventhal H, et al. Medication adherence in rheumatoid arthritis patients: older is wiser. J Am Geriatr Soc. 1999;47(2):172‐183. doi: 10.1111/j.1532-5415.1999.tb04575.x the people most likely to miss taking a dose of medication are relatively young people who may be busy working and raising children. If you have trouble sticking to a schedule, try using a pill organizer and leaving it in a conspicuous location and setting a reminder on your phone. You can also try taking your medication right before you do another regularly scheduled task. For example, if you take medication weekly, do it on laundry or trash day.

See 5 Types of Medication That Treat Rheumatoid Arthritis (RA)

Change your diet

A growing body of evidence suggests what you eat can influence your rheumatoid arthritis symptoms. ³ Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet. 1991;338(8772):899-902. doi: 10.1016/0140-6736(91)91770-u ^{, 4} Tedeschi SK, Frits M, Cui J, et al. Diet and Rheumatoid Arthritis Symptoms: Survey Results From a Rheumatoid Arthritis Registry. Arthritis Care Res (Hoboken). 2017;69(12):1920-1925. doi: 10.1002/acr.23225 ^{, 5} Vadell AKE, Bärebring L, Hulander E, Gjertsson I, Lindqvist HM, Winkvist A. Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity. Am J Clin Nutr. 2020;111(6):1203-1213. doi: 10.1093/ajcn/nqaa019 ^{, 6} Lourdudoss C, Di Giuseppe D, Wolk A, et al. Dietary Intake of Polyunsaturated Fatty Acids and Pain in Spite of Inflammatory Control Among Methotrexate-Treated Early Rheumatoid Arthritis Patients. Arthritis Care Res (Hoboken). 2018;70(2):205-212. doi: 10.1002/acr.23245 ^{, 7} Bärebring L, Winkvist A, Gjertsson I, Lindqvist HM. Poor Dietary Quality Is Associated with Increased Inflammation in Swedish Patients with Rheumatoid Arthritis. Nutrients. 2018;10(10):1535. Published 2018 Oct 18. doi: 10.3390/nu10101535 ^{, 8} Tedeschi SK, Bathon JM, Giles JT, Lin TC, Yoshida K, Solomon DH. Relationship Between Fish Consumption and Disease Activity in Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2018;70(3):327-332. doi: 10.1002/acr.23295 In one study ⁴ Tedeschi SK, Frits M, Cui J, et al. Diet and Rheumatoid Arthritis Symptoms: Survey Results From a Rheumatoid Arthritis Registry. Arthritis Care Res (Hoboken). 2017;69(12):1920-1925. doi: 10.1002/acr.23225 of 217 people with rheumatoid arthritis, 24% (52) said diet affected their symptoms.

Many of the people surveyed reported sugary sodas and desserts worsened their symptoms. Some people said certain foods, such as blueberries and spinach helped improve their symptoms (berries and leafy greens are often cited as anti-inflammatory foods).

See An Anti-Inflammatory Diet for Arthritis

Focus on what you can do

It can be frustrating to experience hand pain, stiffness, and weakness that prevents you from doing certain things. However, focusing on what you can’t do can create emotional stress, and that stress may lead to even more inflammation. ⁹ Maydych V. The Interplay Between Stress, Inflammation, and Emotional Attention: Relevance for Depression. Front Neurosci. 2019;13:384. Published 2019 Apr 24. doi: 10.3389/fnins.2019.00384 Help avoid excess stress and inflammation by focusing on what you are able to do.

What you choose to focus on and be grateful for depends on your circumstances and the severity of your symptoms. For example, if you have mild to moderate hand pain, you may feel grateful that you can play 9 holes of golf—even if you’d prefer to play a full 18 holes. If you have severe hand pain you may be grateful you are still able to cook your own meals.

If you have RA and you’re struggling with symptoms in your hands or wrists, talk with a health care provider. They are likely to have more treatment suggestions for you. If you have tried several home and integrative medical treatments and still don’t have satisfactory pain relief and hand function, surgery may be recommended.

See Surgery for Rheumatoid Arthritis (RA)

Learn more:

Hand Pain and Rheumatoid Arthritis

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