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30/Jul/2020

….your hands!

Did you know that each of your hands has 27 bones, 27 joints, 34 muscles, and over 100 ligaments and tendons?

They really are amazing, complex and delicate structures. And we often take them for granted – until something happens – we hit our thumb with a hammer, we slam a finger in a drawer or we develop a musculoskeletal condition 😣.

Many conditions such as osteoarthritis and rheumatoid arthritis cause pain, swelling and sometimes disfigurement in hands. Other conditions such as Raynaud’s phenomenon and carpal tunnel syndrome can make your hands painful, and can cause pins and needles, as well as numbness.

For many people who have hand conditions, the colder months can make it worse. Your joints may ache more because of the cold, the constant hand washing can make your skin dry and the use of hand sanitiser (which often has a cooling effect) makes it feel like your fingers are about to drop off 😒.

But there are things you can do to decrease hand pain, deal with the cold and COVID, and make everyday activities easier.

Look after your hands. Inspect them for things such as swelling, nail and skin changes and any changes to the joint shape or direction of fingers and/or thumbs. By being aware of our hands and any changes that occur, you can seek advice sooner and prevent things from getting worse..

Wash and dry your hands regularly and thoroughly. Just as washing with soap and water for at least 20 seconds is necessary to help prevent the spread of germs (including SARS-CoV-2), drying your hands thoroughly is also important. Germs love moisture and thrive in moist places. Drying your hands reduces your chances of spreading or picking up germs when you touch things with damp or wet hands.

Apply a moisturising hand cream regularly to keep your skin healthy and nourished. With our more frequent hand washing and use of hand sanitiser, it’s easy for our hands to become dry and cracked. Cracked skin is an opening for germs to get in and potentially cause an infection. And if you have a condition such as scleroderma or psoriatic arthritis, skin care is an important part of your overall management plan. You may need to use a medicated skin cream, rather than an over-the-counter product. Talk with your doctor or pharmacist for more info.

Use assistive devices if your hands are painful and stiff. They can help if you have difficulty gripping or holding everyday items. Assistive devices such as jar openers, book holders, tap turners, button hook and zipper aids and easy grip utensils can make tasks easier by reducing joint stress and eliminating tight grasps. You may need to speak with an occupational therapist about what equipment is best suited to you. Also check out our online shop. We have some products available to help you with your everyday activities.

See a hand therapist if you have hand/wrist pain or a condition that affects your hands, especially if it’s causing you issues with your day to day activities. Hand therapists are occupational therapists or physiotherapists that have undergone advanced training to become experts in the assessment, diagnosis and treatment of upper limb problems (shoulder to hand). They can provide advice on joint protection and energy conservation (e.g. splints) as well as recommendations for adaptive devices/equipment to improve hand function.

Splints and other supports may be an option. They can give support to a painful joint by providing mild compression, warmth and/or joint protection. There are two main types of hand or wrist splints – resting splints and working splints. The choice of splint will depend on your condition and your current needs. Splints need to fit your hand comfortably and correctly, so speak with a hand therapist about what’s best for you and how often you should wear them.

Exercise your hands, as well as the rest of your body. Regular hand exercises can reduce stiffness and support your joints by keeping your muscles strong. If you’re considering hand exercises, it’s best to get advice from a hand therapist or other specialist as to which exercises are most suitable for you. Exercises should be mild and should not cause you additional pain when you’re doing them. See our Hand information sheet for some basic range of motion exercises.

Wear gloves in the cold weather, especially if you have Raynaud’s phenomenon. Hand warmers are also helpful. If you’re going to the shops for supplies and you have to use hand sanitiser before you enter, be aware that many of them have a cooling effect. This can really aggravate your condition. Having a couple of hand warmers in your pockets can help. You can get disposable hand warmers, or reusable ones. Just remember if you use the reusable ones to thoroughly wash the fabric pouch it’s contained in between uses. They can easily become contaminated, and hygiene is everything during this pandemic.

Also wear gloves when you’re gardening, washing dishes or doing any tasks that have the potential for your hands to get dirty or damaged.

Medications may provide some temporary pain relief, depending on the underlying condition causing the problem in your hand/s. Your doctor may suggest analgesics (pain relievers like paracetamol) as well as nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen. A cortisone injection is generally not recommended for osteoarthritis of the hand, but may be used for rheumatoid arthritis or acute attacks of gout. In conditions such as rheumatoid arthritis you may also be taking disease modifying anti-rheumatic drugs (DMARDs). It’s important to take these medications as prescribed by your doctor.

With conditions such as Raynaud’s, if simple measures like keeping your hands warm hasn’t helped, you may need to be prescribed medications that widen your blood vessels and improve circulation. Talk with your doctor for more info.

Making life easier on your hands

Sometimes simply changing the way you do everyday tasks can reduce pain and protect your joints. You can make life easier on your hands by considering the following:

Listen to your body – pain can serve as a warning sign that your joints are being overworked. Try to find a balance between activity and rest by pacing yourself. Take regular breaks when completing tasks and try not to overdo it on a good day. You might like to try heat or cold packs to help relieve pain. Some people also like to soak their hands in warm water or wrap their hands around a warm mug of tea.

Try to avoid using a tight grip for long periods. For example:

  • use foam or sponge to increase the grip size of handles on cutlery, pens and other hand held devices
  • use assistive devices with thick rubber grip handles (e.g. key turners, jar openers)
  • use rubber squares and gloves to help improve grip
  • consider lever handles around your home to minimise any twisting forces (e.g. mixer taps in bathrooms/kitchens).

Avoid repetitive movements. For example:

  • prolonged typing, pruning and power tool usage particularly those that vibrate
  • when gardening ensure your tools are sharpened and well maintained for ease of use
  • if you can’t avoid these repetitive movements, make sure you take regular breaks.

Try to use your body’s larger joints and muscles when you can. For example:

  • use your forearms to carry bags instead of your hands
  • when carrying items hold them closer to your body
  • when lifting heavier items squat and use your thigh muscles.

Spread the load – try to spread the load of an object over more than one joint. For example:

  • when picking up objects use two hands
  • slide sheets and swivel pads can help move items with less strain
  • divide shopping into smaller bags and try using a backpack and/or trolley.

Find an alternative. For example:

  • buy pre-cut meat and vegetables instead of trying to cut them up yourself
  • use electrical items instead of manual (e.g. can openers and graters)
  • look for items that are easier to use (e.g. push on pegs)
  • keep a pair of scissors handy to open packaging.

Rethink personal care/hygiene – for people with decreased hand function or fine motor skills, everyday tasks such as showering and toileting can be quite challenging. To make things easier you could use:

  • a bidet to help with cleaning difficult to reach areas
  • baby wipes/moist towelettes instead of toilet paper (but remember that they’re not flushable)
  • toilet paper tongs/aids to help with grip
  • soap dispensers instead of a bar of soap
  • items to make dressing easier e.g. sock sliders, elastic shoe laces, button hole hooks/zip pullers, front fastening bras as well as dressing aids for coats and cardigans o shoes with velcro fasteners instead of laces.

Our hands are complicated and important and we depend on them more than we realise. Painful hands can often be managed with simple self-care strategies, however if your hands are causing you a lot of grief, and affecting your day to day functioning, talk with your doctor for information and support.

Contact our free national Help Line

If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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30/Jul/2020

Guest blogger Phil Cole

Hi I’m Phil Cole. I’m 47 years old and have a young family. Ziggy is just over a year old now and my long suffering partner Marie is an amazing mother 💖. She always carries on despite the extra stresses my condition brings to our lives.

My musculoskeletal situation is complicated…

I officially have psoriatic arthritis, an autoimmune inflammatory condition similar to rheumatoid arthritis. It affects all of my joints and organs.

But recently I’ve been under the care of an immunologist investigating rare immune diseases, in conjunction with my endocrinologist and many other ‘ologists’.

I’m prone to infections and am mostly always sick with something. The only good thing about this lockdown is I haven’t been out much and been exposed to germs – so I’ve haven’t caught as much as I normally do. Sometimes these infections can last months 😑.

But the jury’s out on what I have, unfortunately. We know it’s immune-related, we know it’s inflammatory, that’s it so far. I’ve probably had it in some form for most of my adult life, but it’s over the last ten years that its really gotten worse. I also have some added complications due to my Army Service – bad knees and other injuries that don’t help.

Day to day life

Like other people living with a chronic condition, it affects my day to day life. And it’s gotten progressively worse each year.

Chronic pain and exhaustion are the most debilitating factors. I have some mobility issues that flare and have had to give up activities I loved – like kite surfing and skiing.

To be truthful every day is some version of the same struggle. Frustration is the hardest thing. It’s like I’m stuck in a sick Groundhog Day (remember that movie with Bill Murray?). There’s no improvement over all. In fact it’s been heading the other way 😑.

My condition affects my future plans to some degree, but overall we try to plan and live as if I will improve someday, as any plans are not just for me.

Coping strategies

In the past my coping strategies weren’t great. It involved a lot of self-medication and isolation.

But I’m really happy to say that all changed after I attended a pain clinic nearly two years ago.
Since then I’ve been off all my opioids and I have more of a framework to help deal with the pain and bad flare ups.

Having the right mindset is really important. For me it’s knowing I can at least run the clock out on this flare up – just get up every morning and keep going. There’s others far worse than me out there suffering.

Regular walking and stretching, mindfulness, hot chips with grated cheese and baked beans helps too 😋

This is all a work in progress – trying to stick to a schedule with all the above isn’t always easy with a one year old terrorist hiding your car keys!

I wish people knew…

When it comes to my condition I wish people knew that a lot of the worst symptoms are invisible to anyone outside of your immediate family. And that’s because they have to live with it too.

Chronic pain isn’t like normal pain, just as exhaustion isn’t the same as being tired. There’s literally no break from it, no return to normal life.

Both of these things are impossible to convey to others. In fact I don’t, or try not to these days.

It’s not anyone’s fault at all. These things are subjective to a great extent and the nature of the degeneration and symptoms are largely hidden from view.

Some annoying/frustrating things I hear about my condition

This will probably ring true for most people living with a musculoskeletal condition, but it can be annoying when people say “you look well”. I know it’s not their fault, they often don’t know any better. But I did have an ‘ologist’ say exactly that to me last week – now they should know better.

Then there’s the usual stuff – “it improves in good weather” or “I’m tired too” or “have you tried X?” or “my aunty tried X and now she’s better”. Most times it turns out that X is a pseudoscience.

This all comes from a good place so it’s not that annoying really. It’s just that it always happens 😑.

So I now try to look at it as more info to consider. One day someone might have just the right idea or advice, so I’ve decided the best thing to do is listen and then apply some critical thinking to the claim.

Some tips and advice I’d like to share with others

Hands down the best thing I ever did to manage my condition was attend a pain clinic. It taught me how to live with chronic pain and even reduce it, as well as how to get off all the drugs I was taking to manage it.

Some other things I’ve learned along the way:

Own it – don’t rely on others to fix you. You may be lucky and your pain goes away or your condition gets better, but realistically, this is unlikely to happen. So own it.

You have to keep on top of all your specialists. The current model is your GP manages all of your specialists, but in my experience this only exists on paper. That’s why you need to be on top of it all. And try to stay up to date as far as the research and current consensus is for your condition. If, for example, ‘eating oranges cures psoriatic arthritis’ then that will show in the consensus. Until then, it’s just speculation, not fact.

It can be hard to keep on top of it all, but do your best. Keep an open mind, but not so open your brain falls out 😁

Learn and practice critical thinking methodologies and have a basic understanding of the scientific method. These are not just catchphrases but a learned skill. You can use these real step-by-step methods to evaluate potential treatments, drugs, research your condition and challenge specialists – at the very least it will save you time filtering the interweb.

Be the custodian of ALL your medical records. Get a copy of every single test and scan you have. Consider keeping them organised online using a cloud drive like Google Drive or Dropbox so you can access them in real time at any of your appointments. Some pathology centres will email the results to you. So it can’t hurt to ask.

If you know how, transcribe all your results into a master spreadsheet. You can see patterns over time. This has been instrumental in my diagnosis and realisation that what’s going on with me is more complicated than a ‘normal’ rheumatological condition.

Other tips:

  • Learn the medical lingo.
  • Try to eat well.
  • Get referred to a chronic pain clinic.
  • Learn about sleep hygiene – or the habits and everyday practices that help you sleep well. This includes things like exercise, having a nighttime routine, turning off screens etc. This is so important!
  • Don’t ever give up, especially trying to find a diagnosis.

I’m participating in Walk in July for MSK

It’s a great excuse to see how I go on a longer walk than I’m used to. It’s also my chance to help out a great organisation and generally rib the CEO Rob Anderson along the way (or get him to buy me a coffee at least!).

Final words

I think most people living with musculoskeletal conditions have the same struggles. Generally there’s only so much you can do to slow the progression of the condition and limit the pain, exhaustion and mobility issues.

At its core it’s a big, lifelong mental battle. It can be very isolating dealing with that every day, you have to try and come to terms with the fact that your life has changed forever and there’s no cure…yet.

So you must adapt, and seek out the positives…you’ll find there’s many if you look for them 🙂

Believe me, I know it’s not always easy to do. There’ll be some dark days ahead – that’s why acceptance is so important.

Things that your old self loved to do may no longer be an option – try and find new stuff to replace that old stuff.

In the end you may find your life becomes much more simplified in many ways, and that’s a really good thing 😊.

Contact our free national Help Line

If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore




Musculoskeletal Australia (or MSK) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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