Using Joint Protection to Manage Arthritic Pain
If everyday tasks like opening jars, turning door knobs, or holding a coffee mug have become more difficult and painful, you’re not alone. Osteoarthritis (OA) in the hands is a common, progressive condition that affects millions. I tell people that these are “wear and tear” changes from joints that you have used and abused over time. Our hands are constantly in motion.
While OA can’t be reversed, there are many ways to protect your joints, and reduce pain with the help of occupational therapy. We can help your hands to function well over the long-haul.
What Is Hand Osteoarthritis?
Osteoarthritis is an often painful joint condition where the protective cartilage at the ends of bones wears down over time. Without the cartilage, the joint spaces lack both cushion and a “bumper”. In the hands, it commonly affects:
- Distal interphalangeal joints (DIP) – the joints closest to the fingertips
- Proximal interphalangeal joints (PIP) – the middle knuckles
- Thumb CMC joint – the base of the thumb
In advanced cases, the bones rub together (“bone-on-bone”), causing pain, stiffness, swelling, and reduced range of motion. It is not uncommon to have soft tissue conditions such as tendinitis or trigger finger related to the OA.
Joint Protection: The Core of OT Intervention
Joint protection is more than just being careful—it’s a way of life. It’s important to learn how to use your body mindfully, taking time to reduce joint stress with daily activities. Here’s how occupational therapists help:
Activity Modification
This principle of joint protection involves adjusting the way we perform our daily life activities to be more gentle on the body such as pushing (this exerts less effort by using momentum) versus pulling. Other examples in day-to-day life include:
- Wearing silicone hot mitts to use two hands instead of one for tasks like lifting heavy pots–or slide that pot along a countertop to avoid needing to lift it altogether.
- Placing heavy items, such as laundry detergent, in the child seat of a shopping cart to minimize the need to reach when loading and unloading.
- Buying items in smaller sizes, such as a quart of milk to make it easier to hold the container and pour.
- Using larger joints when carrying, such as placing wide straps of a tote bag around your forearm and carrying with the elbow bent. This uses the large muscles of the arm, rather than the small muscles of the hands that would be required when grasping handles.
Adaptive Equipment
Various “gadgets” that can be used to eliminate the need to firmly grasp, pinch or hold objects. For example:
- Jar openers, easy-grip utensils, and electric can openers reduce joint stress.
- Having a utility scissors in the kitchen can eliminate needing to pinch packages when opening.
- Built-up pens or voice-activated software help with writing.
- Book stands and phone holders eliminate the need to hold when reading.
Orthotic Support
Thumb splints or soft hand-based orthoses support painful joints, and can be especially helpful if the base of the thumb is painful or if you have tendinitis or trigger finger.
Wearing splints during high-activity periods can reduce pain and are thought to prevent further joint damage.
Energy Conservation
Thinking about ways to build your “energy bank account” to make conscious “withdrawals” throughout your day or your week. For example, if you sit at a table top to fold your laundry, you spend less energy than if you perform the same task standing. This allows you to “save” to your energy bank account. Now, you have more energy to get outside and take a walk with a friend on a nice day!
- Prioritize essential tasks during peak energy times of the day.
- Alternate heavy and light tasks to minimize hand fatigue.
- Sit versus stand; push versus pull; pace tasks and plan ahead.
Gentle Exercises for Strength & Motion
Maintaining movement is essential, but only when done safely. OTs teach dynamic stabilization and range-of-motion exercises and can customize a program for you to work on at home. Consistency is key. Exercises are typically low-resistance and pain-free, tailored to each person’s comfort level and condition.
When to See an Occupational Therapist
If you’re experiencing persistent hand pain, decreased function, or notice visible joint changes, a certified hand therapist (CHT) can:
- Assess joint mechanics and pain triggers
- Fabricate or recommend orthotics
- Provide individualized education and training in joint protection techniques
- Help you preserve independence
Osteoarthritis in the hands doesn’t have to mean giving up your favorite activities. With the right tools, strategies, and support, you can keep doing what you love: on your own terms, but with habit changes.
Ease the ache, protect your joints, and stay engaged with things you need to do and want to do.
Need an Occupational Therapist in Evanston, IL? Click the link for my practice serving clients in Chicago and the North Shore.
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