As we age, many of us will experience arthritis, especially with people living longer.
Some of us develop it earlier than others due to the type of activities we do every day, either through our jobs or through our hobbies. Regardless of how we develop arthritis, we can attempt to slow the progression or prevent further damage to our joints.
When I treat people with arthritis, I educate them in modifying how they perform their daily activities and also in changing methods of doing the activities. We discuss altering their daily schedule — alternating heavy and light activities throughout the day and/or week with rest periods in between. Also, limiting the amount of time performing the activity is encouraged.
People are instructed to perform arm and hand exercises daily to prevent stiffness and relieve strain on joints. An example of changing the method of doing activities may be if the normal way is to do the activity standing or kneeling, such as with gardening, you may want to consider sitting on a stool or using long-handled equipment.
As an occupational therapist, I tend to focus more on the upper extremities. Thus, the area of emphasis I probably discuss the most is joint protection techniques for the shoulders, wrists and fingers/thumbs.
The easiest thing a person can do to preserve the small joints of the fingers is to use enlarged-handled utensils/tools to prevent a tight grasp. Many items are commercially available such as large-diameter pens or kitchen utensils, i.e. vegetable peelers, spatulas. However, you can also place cylindrical foam (available in hardware/home improvement stores) around handles of various tools to achieve the same result. Other items available include under cabinet jar openers, which allow people to use both hands to twist the jar; installing lever-type door handles or purchasing an adapted lever handle to fit over knobs.
In addition to using adaptive devices, a person can modify the technique they use to perform a task. An example would be maintaining a neutral position of the wrist (keeping the fingers/thumb in alignment with the forearm), which can prevent stress on joints that could lead to deformities and cause the fingers to sway in the direction away from the thumb side. For example, when turning a door knob, turn toward the thumb side (toward the left with the right hand, toward the right for the left hand).
Another example in which the position of the wrist is compromised is when using a regular knife. For those people with severe arthritic deformities and/or those people who find themselves in the kitchen much of the time and cutting foods, I often recommend a right-angled knife with a larger diameter handle. Instead of relying primarily on the index and thumb to stabilize the knife along with a tight grasp, the right-angled knife allows a person to position the wrist in neutral and maintain a looser grasp. Other techniques to use include carrying groceries in arms vs. grasping handles or using purses with shoulder strap vs. clutching in hand.
Arthritis does not have to limit a person's ability to participate in their daily activities. The progression of arthritis may be slowed and its effects minimized. With some planning and modifications to activities, people can limit the stress on their joints while still enjoying the independence of cooking for themselves or performing a hobby such as gardening.
Julie Allen, OTR/L, is an occupational therapist with Capital Region Medical Center.