Hello, I wonder if anyone here can help. My husband has Rheumatoid Arthritis and Osteoarthritis. He loves fixing things, but is finding it harder to do fine movement and often gets strong shooting pain.
He is on tocilxumab infusions. He has had steroid injection before but it sent his diabetes (type 2) haywire. Since he had a liver infection last autumn he has been left with liver damage (fibrosis) which limits what drug treatment he can have. He is wondering about a local steroid injection to help manage the wrist / hand pain.
I am trying to help him cope with the frustrations of ongoing limitations. He has never had a hobby as such, but I was wondering if clay therapy would be possible? We went on a holiday years ago and there was a free event making head models from clay and he had a go and the result was impressive!
However, not having RA myself I have no idea if this would be a good idea or cause more frustration? Has anyone found activities or non-medical treatment which has helped with hand pain and limitations?
Many thanks.
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strongmouse
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Hi strongmouse, does your husband have ’working splints’ ? I find these help with my wrist and hand pain when doing things that are going to take a toll on my wrists. Gives support and stops them moving in ways that cause extra pain. I have had to stop a lot of diy/maintenance but these allow me to do some still. It’s eliminating the worst tasks and getting someone else to do them. It’s hard when you have to stop doing things you love.
Do you wear them all the time or just when doing certain jobs? Did you buy these yourself or were they fitted / prescribe by a therapist? My husband is quite a big man. I had suggested he try compression supports, but I know they are more useful for osteorthritis. Sorry to bombard you with questions!
Originally I was given them by the hospital physio but I’ve since bought my own as they are made in different materials so I usually have those above or neoprene ones. Complete Care shop is a good place for aids and don’t forget you can get zero rate vat on aids. They do a few sizes and tell you how to measure for them. Recently my RA nurse gave me some but they were a bad fit and a horrible material so I won’t get any more of those. The metal bar in them is straight across the wrist and I bend them more to fit my wrist shape as I have near fusion but they’re not straight so I need to get the right angle.
I don’t wear them all the time but for anything that requires repetitive actions I do ie painting. They’re also good if you’ve been overdoing it to support your hands after. Could he speak to his rheumy nurse about getting some to try?
Compression gloves are good for swelling but they don’t give the support that splints do. I hope this is of help. The photo shows the splint bar as it comes (bottom)and how I bend mine (top)
Splint metal bars removed from the splint, showing the bend in them
I was given wrist splints by the rheumy OT (and compression gloves) and wear the splint when I'm doing anything which makes my wrist hurt but not all the time. I wear it for Aquafit too.
Hello. If possible, see if your husband can be referred to a hand therapist. They work within physiotherapy departments but, in my experience, they are excellent at tailoring your therapy to particular activities. The first thing they will do is find out what you can't do that you want to do - they're used to working with people like musicians who can no longer play their instruments. For me, it was using fine printmaking tools. I would think clay therapy was perfect as one of the first things they do is build your hand strength with a special putty of varying resistances. Having a creative outlet is so important for good mental health.
Another option I can't speak to from personal experience, is the Men In Sheds movement. Worth looking into as it's social and practical - I would have thought ideal for someone who likes fixing things and although it's not physically therapeutic I'm sure there'd be no judgement of someone who had a particular physical limitation.
Something that has helped me when my normal medication isn't working well enough is prescription-strength co-codamol. Most GPs won't prescribe it for routine use, but my GP allows me 100 every so often if I stretch them out. If my hands are bad and I know I'm going to need them to be less stiff and painful for a particular task, I take two or three. I sometimes take ibuprofen at the same time although I've been advised against it. Please note that I'm totally unqualified to give medical advice - I'm just saying what I do (and I probably incline on the somewhat reckless 'live today' side). I've had trouble finding treatments that keeps my symptoms under control, so I need to have a small hoard of quick-fixes for difficult patches! When I can do without this I'll be very happy.
I strongly recommend asking his rheumatologist for a referral to Occupational Therapists especially one that specialises in hands. They may be able to give him some aids and will definitely have ones he can try to see what works before shelling out yourselves.
When I first started with RA, my right arm ( I am right handed ) became virtually useless due to a ruptured tendon. I couldn’t even hold a tooth brush ! After about a year with support from the RA specialists and physio my arm slowly returned to normal, and now it’s almost as it was before I got RA, the gripping power of my rh hand is still weak. I was a very active person before all this started, so it was a bit depressing. I started to paint and joined a local gallery which gives you the opportunity to exhibit and sell your work. I’ve recently taken up woodworking again and am enjoying it, though I don’t have the energy and stamina I used to have.
The reason I’m writing is to say that any activity that helps a person express their creativity is worthwhile. I hope that your husbands health improves and he finds something that will help him with his problems.
Many thanks Chris_O for sharing. It can be depressing and challenging when activity ability diminishes. Good that you were able to recover from the ruptured tendon. I want to encourage my husband to try something different which he might be able to keep doing even when his RA flares. I enjoy painting myself. Well done for trying woodworking again. It is so important to keep active in whatever way you can.
I agree with Kitty, that it is worth trying the hand splints. I got some from my musculoskeletal dept, they provided 2 different manufacturers. The left one is the same as the one Kitty has shown, the right is similar but different material and black and not comfortable.
Please do not do as Aporiac suggests taking 2-3 cocodamol. Each cocodamol has 500mg paracetamol and should be a max of 2, but given he has fibrosis of the liver may not be advised at all.
I had a severe stroke 4yr ago and had an ongoing weakness in my left hand. I purchased some of the therapy putty, which was good at regaining strength. I still use it occasionally as the weakness returns if I stop. The clay hobby sounds ideal. I would request a referral to an occupational therapist or hand therapist to get an assessment and issue of necessary equipment.
I also use compression gloves, which dies ease my pains when my hands are inflamed. Doesn’t make them PAI free but reduces the discomfort considerably. Hope you find something that allows him to continue what he enjoys 🤗
Hi Strongmouse, Since having been off my RA medication for long periods (because of treatment for something else than RA), I have more damage in my hands and inflamed tendons. My exercise regime to help consists of spreading my fingers and then forming a fist very slowly or brining he fingertips together as if pinching something. I do this many times a day when I don't use my hands. Also kneading my bread dough by hand and using a form of non-sticky plasticine for kneading is great. Over the months this has helped a lot, strengthened gave me more flexibility and reduced the pain. It hurts, but it's worth the effort.
If working with clay inspires him then he get the valuable added bonus that creativity and learning a new skill bring. I wish you both all the best.
Sorry to hear of your difficulties. It is challenging when having several health conditions. Thanks for sharing what you've found helpful. It does seem to be the case that exercise helps in RA.
Yes, exercise definitely helps and is part of my daily routine. I would never have been in remission without it. Doesn't have to be strenuous. Stretching, Qigong, Tai Chi and walking are my staple fare. Good luck.
The OA in my fingers & thumbs is more of an issue than RD now, no cartilage & some with bone spurs. Whilst not as supportive or restrictive as wrist splints I find compression gloves help when doing things, gardening & such. If correctly fitted they give what I consider gentle support but the greater benefit is the warmth they give, helpful to keep the joints moving with less pain. They're great to wear under gloves in winter too, keeping hands toasty warm. Unfortunately they do little for my grip but I have a variety of aids to help with that.
Has he had an assessment for specific pain meds at all? Aside from general pain relief I mean. It could be that he'd benefit from topical relief, but his GP would possibly be the first step to discuss that. I find that diclofenac gel 2.32% can give immediate if not long lasting relief on finger joints but curcumin cream can be helpful for some. I am also prescribed an NSAID, even so my GP relies on me to use the gel appropriately, though it may be a one or the other case for some.
Your husband may find a referral to Occupational Therapy the best place to start, so he can be assessed for his immediate needs. I found mine to be very helpful, supplying me with wrist splints & exercises initially, before the OA really got a hold.
Thanks for the ideas on hand exercises and compression gloves, and the encouragement. I think getting the right fit will be crucial. He is speaking to his GP this afternoon. Unfortunately he can't take aspirin or NSAIDs because of an allergy reaction. A referral to an OT or Physio sounds as though it would be a good idea. OT's are in short supply round here!
I would second Mens Shed. Some of them focus on gardening but many of them and the original ones were workshops.
I would also second asking for a referral to a hand specialise in the physio department. I have found them much more useful than a general pysio
Compression gloves though... recent research has found that they aren't particularly helpful, other than to keep hands warm. So it doesn't matter whether they are normal gloves or compression gloves.
Personally, I find compression gloves are more painful because they press on the joints so are pressing tissue into osteophytes, or compression swollen joint capsules. I do a lot of knitting which is good exercise for the hands and it also results in warm gloves and hand warmers!
It does seem that the overlap of Rheumatoid Arthritis and Osteoarthritis works differently for individuals. Getting a referral to someone to help seems like a good idea.
Does has anyone have any experience of a steroid injection into the joint at the base of the thumb? I've heard it can be painful, but that it helps over a long period? He is wondering about asking the RA nurse about this, but thought he'd wait to see what his latest blood results are (taken today).
Hi, I had a steroid injection in the base of my thumb 3 years ago now. The actual injection wasn't too bad, but I had a cotisone flare after it which lasted 48 hours- during this time I so wished I hadn't had the injection and was taking every painkiller I could! But then, it subsided and I actually have had long term relief and not needed another injection, Sometimes it is very painful but I have worked out what compression gloves and wrist supports help and use them as soon as it starts up and usually it settles again. My thumb and wrist are slightly unstable so they need redjusting regularly. When these times occur, I make sure I wear the wrist supports all through the night every night to get the best result. When it is settled again I go without for a while because I dont like the restriction but they do really help. We are all different though, as as your hubby is going to do, best ask the RA nurse.
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