Each hand has 14 finger joints, and each of these acts like a small hinge. Because the joints are small, they are operated by muscles in the forearm that control the joints by an intricate system of small slings for the tendon leaders. The small size and complicated arrangements mean that any inflammation or damage to the joint is likely to result in some stiffness and lost motion, as even a small scar or adhesion will limit motion. So you shouldn't expect that a problem with a small finger joint will resolve completely. Even after healing is complete, some leftover stiffness and occasional twinges of discomfort are likely. Unrealistically high expectations lead to feelings that you did something wrong or that the doctor was no good. In fact, almost all of us have a few fingers that have been injured and remain a bit crooked or stiff. The hand functions very well with these minor deformities; fingers need not open fully or close completely to be perfectly functional.
Osteoarthritis frequently causes knobby swelling of the most distant (end) joints of the fingers and also swelling of the middle joints. It can also cause problems at the base of the thumb. If we live long enough, all of us get these knobby swellings. They cause most of the changed appearance that we associate with the aging hand. For the most part, they cause relatively little pain or stiffness and don't need specific treatment other than exercise.
Listen to the pain message and avoid activities that cause or aggravate pain. Rest the finger joints so that they can heal, but use gentle stretching exercises to keep them limber and maintain motion. The key to managing finger problems is to use common sense.
With a bit of ingenuity you can find a less stressful way to do almost any activity that puts stress on the joints. Since everyone's activities are a bit different, you will have to invent some of these new ways yourself. Here are a few tips to get you going:
A big handle can be gripped with less strain than a small handle, so wrapping pens, knives, and other similar objects with tape or putting a sponge rubber handle over the original handle can help you grip items. Lift smaller loads. Make more trips. Plan ahead rather than blundering through an activity. Let others open the car door for you. Use a gripper for opening tough jar lids or stop buying products that come in hard-to-open jars. When opening a tough lid, apply friction pressure on the top of the lid with your palm and twist with your whole hand, not your grip. Cultivate ingenious friends who are handy at making little gadgets to help you. Organize your kitchen, workshop, study, and bedroom so that heavy objects are not too high or too low.
Stretch the joints gently twice a day to maintain motion. Straighten the hand out against the tabletop. Make a fist and then cock the wrist to increase the stretch. Use one hand to move each finger of the other hand from full flexion to straight out. Don't force, but stretch just to the edge of discomfort. If the motion of a joint is normal, one repetition is enough, but if the motion is limited, do up to ten repetitions. Warming the hands in warm water before stretching may help you get more motion.
Don't use strong pain medicines; they mask the pain so that you may overdo an activity or an exercise. Be sure that you take prescribed medication for inflammation just as instructed. Good hand function is important, and you want to pay close attention to treatment.
By Raymond Geok Seng Lee
