What if changing the way you walk could really relieve arthritis?

From futura-sciences.com

Nearly one in four adults over 40 lives with the daily discomfort of osteoarthritis, a condition that gradually wears down the cartilage cushioning the joints. Once that cartilage is damaged, there is no way to restore it. For many patients, treatment becomes a long road of pain medication, eventually leading to joint replacement surgery 

A study published in The Lancet Rheumatology on August 12, 2025 suggests there may be another option: gait retraining. Researchers from the University of Utah, New York University, and Stanford University found that adjusting the angle of the foot while walking can significantly reduce pain. Also slowing cartilage deterioration in the knee. The findings come from a year long randomized controlled trial.

                                              What if changing the way you walk could really relieve arthritis? © Harbucks

First placebo controlled proof

Co-led by Scott Uhlrich, assistant professor of mechanical engineering in Utah’s John and Marcia Price College of Engineering, the study is the first placebo controlled trial to show that a biomechanical intervention can effectively treat osteoarthritis symptoms. “We’ve known that for people with osteoarthritis, higher loads in their knee accelerate progression, and that changing the foot angle can reduce knee load,” Uhlrich said. “So the idea of a biomechanical intervention is not new, but there have not been randomized, placebo-controlled studies to show that they’re effective.”

Participants who modified their walking pattern reported pain relief comparable to common medications. Furthermore, MRI scans revealed slower cartilage deterioration in those who adopted the personalized walking adjustments, compared to those who received a sham treatment. “The reported decrease in pain over the placebo group was somewhere between what you’d expect from an over-the-counter medication, like ibuprofen, and a narcotic, like OxyContin,” Uhlrich said.

A personalised approach to knee osteoarthritis

The researchers focused on individuals with mild to moderate knee osteoarthritis affecting the medial compartment. Specifically the knee’s inner side, which bears more load than the outer. Earlier studies often prescribed the same foot angle change to everyone. Not every knee responds the same way. For some participants, a standard adjustment did little to reduce joint loading and could even worsen it. This time, the team opted for a personalized strategy.

Lead researcher Scott Uhlrich measures a participant’s gait. At the beginning of the study, participants received a baseline MRI and walked on a force-sensitive treadmill while motion-capture cameras recorded their walking mechanics. © Utah Movement Bioengineering Lab

Using motion capture cameras and a pressure sensitive treadmill, researchers measured how each participant’s knee responded when they walked with their toes pointed slightly inward or outward. They then determined whether a five or ten degree shift reduced stress most effectively. Participants for whom no foot angle change reduced knee stress were excluded. That careful selection required screening 1,582 volunteers to recruit 68 participants, and may explain why previous trials produced inconclusive results.

Placebo versus intervention

After baseline MRI scans and gait assessments, the 68 participants divided into two groups. One group received a sham intervention, walking with a foot angle identical to their natural gait. The other adopted a customized foot angle shown to reduce knee loading. Both groups attended six weekly training sessions, during which a device attached to the shin delivered gentle vibrations as biofeedback, helping participants maintain their prescribed foot position while walking on a treadmill.

After the supervised phase, participants practiced their new gait for at least 20 minutes daily. Follow-up visits confirmed remarkable precision, with most staying within one degree of their assigned angle. After a year, participants reported their pain levels and underwent a second MRI. The reduction in pain fell somewhere between an over-the-counter anti-inflammatory and a stronger prescription painkiller. Meanwhile, imaging showed measurable protection of cartilage health.

A long term option for pain management

Beyond the numbers, participants expressed enthusiasm for the approach. One told researchers:

“I don’t have to take a drug or wear a device — it’s just a part of my body now that will be with me for the rest of my days, so that I’m thrilled with.” For many, the appeal was its simplicity. No daily medication. No device to wear indefinitely.

The motion capture technology used in the study is expensive and time consuming. However, researchers are developing mobile solutions using smartphone video and smart footwear to make personalization feasible in physical therapy clinics. “Especially for people in their 30s, 40s, or 50s, osteoarthritis could mean decades of pain management before they’re recommended for a joint replacement,” Uhlrich said. “This intervention could help fill that large treatment gap.” Further studies are needed before the approach can be rolled out broadly, but the trial’s scale and design give the findings more credibility than most early stage interventions can claim.

https://www.futura-sciences.com/en/what-if-changing-the-way-you-walk-could-really-relieve-arthritis_26670/

Is the cold weather affecting my arthritis?

From the-independent.com

Some people report that their symptoms, such as stiffness and joint pain, get worse in winter, but everyone’s experience is different

For many people living with arthritis, the arrival of colder weather seems to bring a familiar unwelcome guest: increased stiffness and aching joints.

The idea that low temperatures can worsen arthritis is a long-held belief – but is this claim backed by science?

We turned to the experts to get the full picture…

What types of symptoms do people with arthritis often report during cold weather?

“Arthritis can be worse in cold and damp weather and some people experience an increase in pain sensitivity, reduced blood circulation, muscle spasms and increased joint stiffness,” says Tamsin Joyce, physiotherapist and integrated clinical services manager at Nuffield Health Bournemouth Hospital.

What parts of the body does it usually impact?

“That depends on what type of arthritis they have, because different types of arthritis tend to affect different joints,” explains Will Dixon, professor of digital epidemiology at The University of Manchester and an honorary consultant rheumatologist at Salford Royal Hospital.

“Rheumatoid arthritis commonly affects the joints in the hands across the knuckles, whereas osteoarthritis will commonly affect people’s knees and hips. So, it really depends where people have the arthritis as to where that joint pain then gets worse.”

                               Here are a few tips to help you stay warm and healthy during the winter months (Alamy/PA)

Is there any research about how the weather affects people with arthritis?

Research in this area is limited, however, a study led by The University of Manchester called Cloudy with a Chance of Pain, funded by Arthritis UK, found that days with higher humidity, lower pressure, and stronger winds were associated with days where pain increased significantly.

The study ran throughout 2016 and recruited over 13,000 people from all 124 postcode areas of the UK living with chronic pain conditions, such as arthritis.

Using a smartphone app, participants recorded daily symptoms while the local weather was determined from location data provided by the smartphone’s GPS.

“We knew that so many people believed that there was a relationship between weather and the pain, but nobody had previously worked out the nature of that relationship,” says Dixon, who led the study.

“The study ran for 15 months and we were able to track people’s symptoms over many months and see those changing weather patterns, and the analysis tells us what weather influenced pain the most.”

After analysing daily data from 2,658 patients, the researchers found that days with higher humidity, lower pressure, and stronger winds – in that order – were more likely to be associated with high pain days.

“We found that more painful days were associated with low pressure and high humidity,” says Dixon. “It made sense that we found a relationship with low pressure, as many people believe that they can forecast the weather based on their joint pain. The only reason that you could do that would be that something early in the cycle of the weather is influencing the pain, and that’s likely to be pressure.

“The findings that were somewhat surprising was that we didn’t find an association with pain and temperature.”

What was the main benefit of this study?

“Although we can’t change the weather, we can forecast the weather,” says Dixon. “If you understand the relationship between the weather and pain and know that there’s going to be a change in the weather, then that might tell you that your pain might be worse on a Thursday, for example, and therefore you can plan your activities accordingly.”

What strategies can help people manage arthritis symptoms and reduce discomfort?

Keep moving

“Exercise is the single best thing you can do to help arthritic pain,” says Joyce. “The general guidelines are to aim for 150 minutes of light to moderate exercise each week, working on strength and flexibility.

“It is important to find something that works for you as an individual, it might be a walk or exercise in water, start small and build on this.”

Take vitamin D 

“Vitamin D deficiency is known to be very common, so it is worth checking your vitamin D levels with your GP, as low levels are also thought to contribute to arthritic pain,” says Joyce.

Keep to a healthy body weight 

“Maintaining a healthy body weight is key, as the more excess weight we carry, the more pressure on our joints and tissues and this in turn will increase arthritic pain,” says Joyce. “There is a lot of help and guidance available to help with this, and it should be something your GP should be able to help signpost you towards.”

Keep warm

“Keeping warm is really important as it helps joints not to become too stiff and painful,” says Joyce. “Think about putting on extra layers and using electric blankets when having a nap or at night.”

https://www.the-independent.com/life-style/health-and-families/arthritis-exercise-research-pain-b2929001.html

Six red flags of inflammatory arthritis you can’t ignore

From indianexpress.com

An orthopaedic doctor outlines six red flags, stressing that early intervention with targeted therapies and lifestyle changes is vital to prevent irreversible joint damage

Joint pain is often brushed off as a sign of ageing, overexertion, or temporary strain. But when discomfort becomes persistent, symmetrical, or accompanied by stiffness and swelling, it may signal a more serious condition: inflammatory arthritis.

We spoke with an orthopaedic surgeon, who outlined six warning signs of inflammatory arthritis and urged people not to ignore early symptoms. Unlike wear-and-tear arthritis, inflammatory arthritis is driven by the immune system mistakenly attacking the joints, which can lead to progressive damage if left untreated. Early diagnosis and intervention are critical to prevent long-term disability.

Recognising these red flags early could significantly change outcomes. However, many people are unsure how to distinguish inflammatory arthritis from common joint pain or when to seek specialist care. This makes expert clarification essential.

                                                         What is inflammatory arthritis? (Source: AI Generated)

Key differences between inflammatory arthritis and age-related osteoarthritis

Dr Raghu Nagaraj, director at the Institute of Orthopaedics, Sports Medicine and Robotic Joint Replacement at Kauvery Hospitals, Bengaluru, tells indianexpress.com, “Osteoarthritis is primarily a degenerative condition caused by the gradual wear and tear of joint cartilage over time. It usually affects older individuals and often involves weight-bearing joints, such as the knees, hips, and spine. Pain typically worsens with activity and improves with rest.”

“Inflammatory arthritis, on the other hand, is driven by an abnormal immune response in which the body’s immune system mistakenly attacks the lining of the joints,” notes Dr Nagaraj, adding that it can affect people at any age, including younger adults. Early symptoms often include prolonged morning stiffness lasting more than 30 to 60 minutes, joint swelling, warmth, and fatigue. Unlike osteoarthritis, pain and stiffness may improve with movement rather than rest.

Another important distinction is symmetry. Dr Nagaraj says that inflammatory arthritis commonly “affects the same joints on both sides of the body, such as both hands or wrists, whereas osteoarthritis is often asymmetric.” Early recognition of these differences is critical because inflammatory arthritis can lead to irreversible joint damage if treatment is delayed.

6 warning signs of inflammatory arthritis that people should be aware of

Inflammatory arthritis often begins subtly, but certain warning signs should prompt early medical evaluation. According to Dr Nagaraj, they are:

Persistent morning stiffness

Stiffness lasting longer than 30 to 60 minutes after waking is one of the hallmark signs. This differs from mechanical joint stiffness, which usually resolves quickly.

Joint swelling

Visible or persistent swelling, especially in small joints of the hands, wrists, or feet, may indicate active inflammation within the joint lining.

Pain at rest or during inactivity

Inflammatory joint pain may occur even when the joint is not being used and can disturb sleep, unlike mechanical pain, which typically worsens with activity.

Symmetrical joint involvement

Pain or swelling affecting similar joints on both sides of the body is a strong indicator of inflammatory arthritis.

Warmth or tenderness around joints

Inflamed joints may feel warm to the touch and remain tender even with gentle pressure.

Systemic symptoms such as fatigue or low-grade fever

Because inflammatory arthritis is an immune-mediated condition, patients may experience unexplained fatigue, reduced energy levels, or mild fever in addition to joint symptoms.

Early lifestyle changes or medical intervention to slow or prevent joint damage 

“Yes, early diagnosis combined with timely medical intervention plays a crucial role,” states Dr Nagaraj, adding that current evidence strongly supports the concept of a therapeutic window of opportunity, meaning treatment initiated within the first few months of symptom onset can significantly alter disease progression.

Modern treatment approaches, including disease-modifying anti-rheumatic drugs and targeted biologic therapies, are designed to control inflammation at a molecular level. Lifestyle measures also complement medical therapy. Maintaining a healthy body weight reduces stress on joints, regular low-impact exercise improves mobility and muscle support, and anti-inflammatory dietary patterns may help overall disease control. Smoking cessation is particularly important, as smoking is linked to more severe disease and poorer treatment response,” concludes Dr Nagaraj.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

https://indianexpress.com/article/lifestyle/health/inflammatory-arthritis-vs-osteoarthritis-morning-stiffness-treatment-10547241/

Coping With Brain Fog When You Have Rheumatoid Arthritis

From everydayhealth.com

While rheumatoid arthritis (RA) is not commonly thought to affect the brain, research shows that many people with the condition have some level of cognitive impairment.

“Brain fog is a pretty common symptom that a lot of my patients complain about,” says Nilanjana Bose, MD, a rheumatologist practicing in Houston. Cognitive functions in people with RA are often reduced and the impairment is worse in those with active disease compared with people in remission.

Learn what causes brain fog, what it feels like, and how you can minimize your cognitive symptoms.

What Does RA Brain Fog Feel Like?

People describe brain fog as a hazy feeling or cobwebs in their brain. It’s a non-scientific term that’s used to describe a range of cognitive symptoms, including trouble thinking clearly, focusing, remembering, and making decisions. It’s often associated with fatigue, a common symptom of RA.

When researchers study brain fog, they assess cognitive deficits in attention, working memory, processing speed, and executive function skills.

                                                                                                                             Getty Images

Causes of Cognitive Impairment in RA

The leading theory behind brain fog in RA, and in many chronic conditions, is inflammation. Chronic inflammation, specifically the activity of cytokines like tumour necrosis factor (TNF), is known to affect neural activity in the brain — the way brain neurons communicate with each other.

One study of people with RA found that those who had cognitive impairment had more inflammatory activity over the course of their illness than those without cognitive impairment. When RA is well controlled, meaning inflammation is kept at bay, symptoms like fatigue and brain fog tend to improve as well.

While the disease itself can cause inflammation, there are other conditions — some common in people with RA — that may also cause brain fog, as well as certain medications.

“Attributing the symptoms of brain fog to RA should be a diagnosis of exclusion as other possible causes should be investigated,” says Dallas-based rheumatologist Scott Zashin, MD. These include:

• Cardiovascular Disease Narrowed arteries from atherosclerosis can lead to reduced blood flow to the brain and this condition has been linked to cognitive decline. Likewise, major events like stroke and heart attack may also contribute to cognitive impairment.
• Fatigue Poor sleep or other chronic conditions can cause mental fatigue, which contributes to brain fog. “In my mind, low energy and brain fog are intertwined,” says Dr. Bose.
• Pain Chronic pain is a known contributor to brain fog. Some researchers have theorized that pain processing uses up mental resources, so your brain can’t carry out other functions as easily.
• Depression The prevalence of depression in rheumatoid arthritis has been shown to be two to three times higher than in the general population.
• Menopause has been associated with brain fog, and treatments like hormone therapy may help relieve symptoms.
• Medications Long-term use of certain medications, such as methotrexate and steroids, may contribute to cognitive impairment, while some medications that control the overall inflammation may help preserve cognitive impairment or decline. Speak to your healthcare provider about which medications are right for you.
• Obesity is known to increase inflammation, and obesity can also contribute to sleep apnoea, which can cause fatigue.
• Thyroid Disease An underactive thyroid can cause symptoms similar to brain fog. RA patients are at risk for thyroid disease, so it’s important to have your healthcare team review your entire history if you’re experiencing any memory impairment.

Treating Brain Fog in RA

It’s not easy to treat brain fog, often because it’s hard to determine the exact cause. But the first thing you can do is make sure that your RA is being treated aggressively, so that your RA is in remission or at the lowest disease state possible. Reducing inflammation is the most effective thing you can do, says Bose. That may mean increasing or changing medications if yours are not effective enough.

Your doctor should also check you for other conditions that may be causing brain fog. They can order screening or diagnostic tests for any of the conditions mentioned above. They should also check if any of your medications may be contributing to the RA.

Lifestyle Measures That May Help

While there’s limited research on how effective lifestyle measures are, several approaches are generally recommended to reduce inflammation or fatigue, both of which contribute to brain fog.

Nutritional Issues If you’re deficient in certain nutrients, it can exacerbate fatigue and brain fog, so it’s a good idea to check your levels of vitamin B12, vitamin D, and iron. Also, your doctor can check your electrolyte levels, which may contribute to brain fog, says Zashin. A few supplements are known to have anti-inflammatory properties, like fish oil, which is high in omega‐3 fatty acids. Check with your providers to see if these are appropriate for your condition.

Adequate Sleep When you’re sleep deprived, it affects your ability to focus and make decisions, and can also make symptoms like pain and depression worse. “Sleep is an issue in 90 percent of my patients with RA,” says Bose.

The first step is to treat any conditions that may affect sleep, like sleep apnoea, depression, pain, or night sweats from menopause. It’s also helpful to follow good sleep habits, like reducing screen time, dimming bright lights at night, and avoiding alcohol at night and caffeine after noon.

Healthy Diet An anti-inflammatory diet, such as the Mediterranean diet, is recommended for anyone with inflammatory conditions. These diets are usually rich in fruits, vegetables, whole grains, and lean protein.

Regular Physical Activity Exercise can reduce inflammation. It also has a positive effect on your energy and mood, and can ease pain and stiffness.

Stress Management Stress can lead to a number of risks for brain fog including poor sleep, increased pain, and mood disorders. Consider some stress-reducing techniques such as deep breathing, meditation, and yoga.

The Takeaway

• Effective management of rheumatoid arthritis (RA) through medication can reduce inflammation, which may, in turn, alleviate symptoms like brain fog and fatigue.
• Identifying and treating other underlying conditions, such as cardiovascular issues, sleep problems, or nutrient deficiencies, can address cognitive impairments associated with RA.
• Lifestyle changes, including a balanced diet like the Mediterranean diet, regular physical activity, and stress management techniques, may provide additional relief from cognitive symptoms.
• If you experience persistent or worsening brain fog, it's essential to consult with a healthcare professional to ensure comprehensive treatment and rule out other serious health concerns.

https://www.everydayhealth.com/rheumatic-conditions/brain-fog-when-you-have-rheumatoid-arthritis/

Clinical trials reveal the best shoes to manage osteoarthritis pain

From independent.co.uk 

Kade Paterson The Conversation & Rana Hinman

• New research challenges the common belief that stable, supportive shoes are always the best option for people with osteoarthritis.
• A recent clinical trial found that for hip osteoarthritis, flat flexible shoes were no more effective than stable supportive shoes in reducing pain.

• People with hip and knee osteoarthritis are advised to wear “appropriate footwear” to minimise their pain.

  Does that mean heels are out? Does it matter if you wear runners or something a little stiffer? How about using insoles?

  Our research, including our latest clinical trial published today in Annals of Internal Medicine, provides some answers.

• We show that stable, more supportive shoes aren’t necessarily the best option, despite what you might have heard.

  What is osteoarthritis?

  Osteoarthritis is a condition that affects the tissues in and around a joint, including bone, cartilage, ligaments and muscles. It is more common in older people, and people with excess body weight. It causes joint pain and stiffness, and can lead to disability.

• About 2.35 million Australians have osteoarthritis and this number is predicted to increase as the population ages and obesity rates rise.

  

  Osteoarthritis is a condition that affects the tissues in and around a joint (PA)

  Osteoarthritis commonly affects the hip and knee joints, making it difficult to walk. There is no cure, so self-management is important.

  That includes wearing the right type of shoes.

  How can shoes affect symptoms?

  There are many causes of osteoarthritis, but excessive force inside the joint when someone is walking is thought to play a role. Excessive joint forces can also increase the chance of osteoarthritis worsening over time.

• Shoes are our connection to the ground and can influence how forces are transmitted up the leg during every step. Some shoe features are particularly important.

  Shoes with higher heels increase joint forces. For example, shoes with six-centimetre heels increase knee forces by an average 23% compared to walking barefoot.

• Some shoes come with supportive features, such as insoles that support the arches. Other supportive features include being made with a stiffer material in the sole or heel.

  Many people, and clinicians, think these stable and supportive shoe features are best for people with osteoarthritis.

  But biomechanical research shows shoes with these supportive features actually increase knee force by up to 15% compared to shoes without them. Arch-supporting insoles also increase knee force by up to 6% when added to shoes.

  So, are flatter, flexible shoes without stable supportive features – such as ballet flats – better for knee and hip osteoarthritis?

  Not necessarily. We also need to look at people’s pain.

  What we found

  Our biomechanical research from 2017 in people with knee osteoarthritis showed flat flexible shoes reduced knee forces by an average 9% compared to stable supportive shoe styles.

  This suggests flat flexible shoes could be better for osteoarthritis. To find out, we conducted two clinical trials to look at people’s pain levels.

  Our new clinical trial involved 120 people with hip osteoarthritis.

  They were randomised to wear different types of flat flexible shoes, such as flexible ballet flats, or different types of stable supportive shoes, such as supportive runners. People were asked to wear their shoes for at least six hours a day. After six months we measured the change in hip pain when they walked.

• We found that flat flexible shoes were no better than stable supportive shoes for reducing hip pain.

  These findings differ to those from our 2021 clinical trial in 164 people with knee osteoarthritis. In that trial, we found wearing stable supportive shoes for six months reduced knee pain when walking by an average 63% more than wearing flat flexible shoes.

  It’s unclear why findings differed between the knee and hip. But it might be because joint forces are higher in knee compared to hip osteoarthritis, and so there may be greater potential for stable supportive shoes to reduce knee forces, and therefore knee pain.

  In both trials, more complications, such as foot pain, were reported by people who wore flat flexible shoes. This might be because these shoe styles provide less protection for the feet.

  So which shoes should I wear?

  For people with knee osteoarthritis, stable, supportive shoes are likely to be more beneficial than flat, flexible ones.

  For people with hip osteoarthritis, neither shoe type is better than the other for improving hip pain.

  But for all older people – including those with hip and knee osteoarthritis – it is sensible to avoid ill-fitting shoes, as well as shoes with high or narrow heels, due to an increased risk of falls.

  For younger people with knee or hip osteoarthritis but who are not at risk of falls, it may still be advisable to avoid high heels given their potential to increase joint forces.

• Who should you talk to?

  If you are concerned about your hip or knee osteoarthritis, talk to your GP or other health-care provider, such as a podiatrist or physiotherapist.

  Other non-surgical treatments, such as exercise, weight management, nutrition and some pain medicines can help.

• https://www.independent.co.uk/life-style/arthritis-best-shoes-knee-osteoarthritis-b2926484.html
  

Psoriatic Arthritis: Hand Strength, Dexterity, and Fine Motor Control

From everydayhealth.com

If you have psoriatic arthritis (PsA), you may be familiar with sore fingers, stiff wrists, and the frustration of struggling with formerly simple tasks like buttoning a shirt or chopping vegetables. Psoriatic arthritis is an inflammatory form of arthritis that causes painful, swollen joints. It frequently affects the hands.

When PsA impacts your hands, this can reduce strength, dexterity, and fine motor skills, all of which can interfere with your daily life.

“In severe cases, it may be almost impossible to open and close the hand or make a fist,” says Norman Gaylis, MD, a rheumatologist and board member of the American College of Rheumatology in Miami. “This drastically reduces the quality of life when people are unable to complete household chores, pursue hobbies they enjoy, or take care of their daily hygiene needs because they are unable to use their hands.”

How PsA Takes a Toll on Hand Function

In the most basic terms, psoriatic arthritis affects hand function through chronic inflammation. This can degrade cartilage and bone over time.

These are the ways that PsA can change your hands:

• Reduced Strength and Muscle Atrophy When your hands are painful, swollen, or stiff, you might use them less. This can lead to a loss of strength and muscle mass.
• Stiffness Inflammation from psoriatic arthritis can make your hands feel stiff. This is due to synovitis (inflammation of the joint capsule) and enthesitis (inflammation where your tendons and ligaments attach to your bones).
• Difficulty Gripping Grip strength decreases as the severity of psoriatic arthritis increases. This affects the ability to both grasp an object with your whole hand, like when you pick up a water bottle, and pick up small items with your thumb and index finger.
• Swelling Psoriatic arthritis can cause severe swelling in the fingers, called dactylitis. You might also hear this called “sausage fingers.”
• Nail Changes Up to 80 percent of people with PsA experience changes in their fingernails. “With some patients, nails start to look broken, become brittle, and even separate from the nail bed,” says Dr. Gaylis. Not only can this feel embarrassing but it can be painful and make it difficult to use the tips of your fingers (like you do when typing on a computer or phone).
• Deformities Actual deformities in the hands are rare these days, thanks to better treatment. However, they can still develop if psoriatic arthritis isn’t treated. “In the most severe cases, arthritis mutilans develops and dissolves tissue and bones in the fingers,” says Gaylis. This occurs in about 5 percent of psoriatic arthritis cases.
• Loss of Fine Motor Skills Hand swelling, pain, and stiffness can all make it challenging to perform tasks that require precision, dexterity, and coordination. You might find it increasingly difficult to manipulate small objects like zippers or buttons.

All these symptoms add up to real difficulty completing functional tasks in your everyday life.

Who Can Help Restore Hand Function

There are a few health professionals you can reach out to if psoriatic arthritis is affecting your hands. The primary ones are rheumatologists and certified hand therapists (CHTs).

Rheumatologists are doctors who specialize in autoimmune diseases and inflammatory diseases that affect the joints, bones, and muscles. If you’re diagnosed with PsA, you’ve most likely already seen a rheumatologist.

“Fortunately, rheumatologists can treat psoriatic arthritis with many new biologics and medicines that are very effective,” says Gaylis. These medications help manage inflammation and swelling from psoriatic arthritis, which can noticeably improve hand function.

CHTs are also an essential part of the team for anyone with psoriatic arthritis affecting their hands. These health professionals can either be occupational therapists or physical therapists who’ve gone through extra training to specialize in treating hand conditions like psoriatic arthritis.

A CHT will assess your mobility and function and give you tailored treatment that might include splints, exercises, and assistive devices. You can ask your doctor to refer you to a CHT, or depending on your health insurance, you may be able to make your own appointment.

Strategies to Improve Strength and Control

We use our hands constantly, from turning on the tap at a sink to sliding a credit card out of a wallet. Bringing back strength and control to your hands can improve your quality of life.

Therapeutic Exercises

Therapeutic exercises can reduce pain and improve coordination, strength, and function. Common exercises for PsA include the following:

• Isometric Exercises These are static exercises during which your muscles stay the same length. “Isometric exercises are safer for the arthritic hand to perform because the joints are not moving,” says Kristin Valdes, a certified hand therapist and professor at Touro University Nevada, in Henderson, Nevada. In this type of exercise, you squeeze an immovable object, and your joints are supported by the object you’re holding. Valdes suggests squeezing a firm racquetball or tennis ball to improve grip strength.
• Passive Range of Motion With psoriatic arthritis, the fingers can flex (or “claw” inward) over time as the skin contracts. Anyone experiencing this “should use the other hand or pull their fingertips over the edge of the table to try to straighten out the fingers daily,” says Valdes.
• Tendon Gliding This set of exercises encourages smooth movement of your finger tendons within their sheath.

Be cautious when starting hand exercises with psoriatic arthritis. “If treatment is too aggressive, it can increase hand pain and cause skin breakdown,” says Valdes.

Consider seeing a CHT for a personalized program of exercises, since everyone’s psoriatic arthritis is different.

Assistive Tools

When your wrist is sore, twisting open a jar can be very painful. And when your fingers are stiff, it can feel near impossible to pick up small items. Assistive devices can help you achieve these everyday tasks with less effort and therefore less pain.

Assistive devices for psoriatic arthritis include these examples:

• Wide-grip pens or utensils
• Electronic jar or can openers
• Ergonomic kitchen tools
• Button hooks
• Elastic shoelaces
• Electric toothbrushes
• Gripping materials (to hold a mixing bowl in place, for example, or grip a lid)
• Tap turners or lever handles (to avoid twisting)
• Tongs
• Adaptive cutting boards
• Motion sensor dish soap or shampoo dispensers

Orthoses

For those seeing a hand therapist for treatment, “The therapist can also fabricate a custom orthosis to rest the joints,” says Valdes. This might look like a ring to keep your finger joint straight or a brace that wraps around your thumb.

You can also get premade orthoses like wrist splints online or in pharmacies, but talk to your hand therapist or doctor first to ensure that you’re getting the right one.

Joint Protection and Skin Protection

Joint protection techniques, which are usually taught by a CHT, are ways to perform daily tasks so that less stress is applied to your joints. The following techniques are common:

• Practice the large joint rule. Use larger and stronger joints for tasks instead of smaller ones. Valdes gives the examples of pushing instead of pulling, carrying bags with your forearm instead of hands, and using a shoulder bag rather than a handbag.
• Limit repetitive hand movements. For example, use an electric can opener instead of a hand-operated one. You can still knit or do hobbies involving your hands, but Valdes recommends limiting these to no more than 30 minutes at a time.
• Use a light grip. “Try not to grip so forcefully that the hand fatigues easily,” says Valdes. One way to achieve this is to bulk up the handles of tools or utensils. For example, when cooking, wrap a potholder around a pot handle to make it larger; that reduces the pressure on your hand.
• Don’t forget skin protection. Applying cream to tight skin can help protect both the skin and joints.

Heat and Cold Therapy: Using Paraffin Baths for Stiffness vs. Ice for Acute Inflammation

If your fingers are swollen, try cold therapy with a cold cloth or ice pack. This can help reduce inflammation in the affected joints.

Heat therapy can’t bring down acute inflammation, but it can provide pain relief. If your hands are stiff or painful, consider applying a warm cloth or heating pad.

Warm paraffin, or wax, baths, which a CHT can perform, can also be soothing. A hand therapist might do this to loosen up your joints before exercising them. However, you’ll want to avoid paraffin baths if you have any open cuts or inflamed skin on your hands.

Lifestyle and Daily Habits

Breaking tasks into smaller, more manageable steps can help you conserve energy and manage pain. Be sure to take frequent breaks to rest your hands. “For example, when making a meal, break up cutting or chopping tasks throughout the day,” says Valdes.

You’ll also want to make a daily habit out of your therapeutic exercises, particularly stretching and range of motion exercises. However, avoid strengthening exercises when your hands are painful, says Valdes.

Overall, do your best to maintain an active lifestyle and keep up with the activities that bring you joy and meaning. You can also try new hobbies that don’t tax your hands as much, such as singing, line dancing, learning a language, or hiking.

If you’re struggling with hand pain or stiffness, talk to your rheumatologist or CHT. Your rheumatologist may adjust your medication, and your CHT can strategize personalized solutions, whether that’s a new hand splint or exercise program.

The Takeaway

• A rheumatologist can help you manage psoriatic arthritis hand symptoms with newer biologics and medications that control inflammation.
• Certified hand therapists can tailor exercises to your specific hand symptoms, recommend assistive tools, and educate you on joint protection to preserve and restore hand function.
• Therapeutic hand exercises can help enhance grip strength, dexterity, and control for performing daily tasks.

https://www.everydayhealth.com/rheumatic-conditions/psoriatic-arthritis-hand-strength-and-dexterity/