Arthritis First Aid For Hands

Transcript

Welcome And Why Arthritis Hurts

SPEAKER_00 0:01

Welcome back to the Hand to Shoulder Solution where pain meets its match. I'm your host, Carl Petito. I'm an occupational therapist and a board-certified hand therapist. I specialize in the rehabilitation of orthopedic conditions that affect the fingertips through the shoulder. So today let's talk about arthritis, stiffness, and pain. What can you do at home? Now, in the clinic, it's really important that we evaluate exactly what is going on and what is optimal for you. But let's talk about it's almost some first aid things, just some simple things that you can do at home to feel a little bit better. And really should always be evaluated by your healthcare professional.

What Not To Do First

SPEAKER_00 0:41

So let's talk about the risk in hand. There's a couple of things to not do. And arthritis, with inflammation expands, because itis means inflammation, arthritom means joint. So there's two types of arthritis. There's the osteoarthritis, which is from wear and tear, and our bodies are designed optimally to last perfectly for about 40 years. Then after the age of 40, wearing steroids starts to occur in some people more than others, but that's the osteoarthritis. The rheumatoid arthritis can start at any age. And that is when your immune system attacks your joint surfaces, and your immune system thinks that uh the joint surfaces, like the cartilage, for example, is a foreign body and tries to get rid of it. So let's talk about osteoarthritis. Basically, any inflammation and pain, you know, here's a few things you can do at home. So, a couple of things to avoid first, which arguably are more important than what to do. So, here's what not to do. Don't continuously move. I have patients come in and they're telling me about their symptoms, and while they're talking to me, they're just their hands are on their lap, and they're there's kind of always doing this. Because inflammation expands, it takes up space within the joints and makes the joints feel tight. So the trap is that it feels great when you're moving, but then now you stop and wow, now the inflammation increased, and now it feels more tight. So then you remember it felt great when I was moving, so I'm just gonna keep it, keep it moving. But that just it causes, you know, rubbing, rub, rub, rubbing, rubbing on the joint surfaces, aggravating, aggravating, aggravating, making the inflammation uh really increase. Another thing is too much heat. So heat always feels good when it's on because it increases blood flow, it's it expands and loosens up everything, but it guess what? It also expands the inflammation. So when that inflammation is expanded, now you get out of the heat, and now it's you get a big inflammatory uh response. And then you're naturally remember it felt great when the heat is on, you go back to the heat, and it just it's a vicious cycle, increases the inflammation. And guess what? It also increases the pain and increases the stiffness. So because it hurts more, you move a little bit less, and because they move a little bit less, now the tissues tighten up and the tendons and the muscles, and things aren't just aren't moving normally, and they get really tight. So, what can we do?

Fast Cold Therapy For Swelling

SPEAKER_00 3:08

So, at home, use either get a get a uh old pitcher or uh uh Tupperware or something, fill it full of water, keep it in the refrigerator, and talking we're talking about wrist and and hand and finger arthritis. So you can take it out and just lay your wrist and hand in it. See that bone that juts up right there on the back side of the wrist. I would go up to about that point, okay? That's the ulnar head, and I would go up to up to that point, and that gets the whole the carpels that form the carpal tunnel that gets all these joints, and there's 24 contact surfaces in the wrist we talked about before, 15 bones that are involved. It's a lot going on there. So I would lay that in the cold water only until deeply cold, 10 to 20 seconds. And right when it's deeply cold, you're done. And that's more effective than an ice pack for 10 minutes. Or you can just stick it under the cold running faucet, fingertips up to the on their head, up to that bone right there, back and forth, get it deeply cold, done. I have some patients come in and their wrist and hand is just huge and inflamed and red and just angry. And I'll I will tell them you go home today, you stick it under the cold running faucet every hour for the rest of the day. And they're you know, but and their pain is eight out of ten. And then with I'll have them come back in a couple days and they'll say, Wow, you know what? Just after a few hours, my pain went down to two. And well, it the cold shrunk down their inflammation and put took the pain along with it. So that could you know that should be done ideally, like maybe late morning, lunchtime, after dinner, before bed, and then you kind of get a feel for you know what's what's the best.

When Heat Helps Instead Of Hurts

SPEAKER_00 4:44

Now, in the morning, that's when your inflammation is at its lowest point because you've been resting all night, you've been sleeping all night long, and it's not moving, the inflammation will be at its lowest point. So you can use heat without the fear of expanding the inflammation and irritation. What's the benefit of heat? We're gonna open up the blood vessels, bring more blood, which means more nutrients and oxygen to the tissues, to the joint surfaces, healthier joint surfaces, and that that helps to make you feel better. And you that's when it's safe to use the heat, so you don't have that inflammatory response. Now, in the morning, the inflammation is low, but guess what? The stiffness is high, it's really tight and stiff in the morning, but that's okay. With most of my patients, they'll tell me why I get up in the morning, it's just all tight. I just forced it to keep moving. That's aggravational to think about it. So in the morning, I tell people to just let it loosen up on its own. You use a low electric heating pad on the lowest setting, low to medium, even uh medium low, for 15 minutes around the wrist and hand. Or if you take your shower in the morning, it warms up in the shower. Normal shower temperature, don't make it extra hot. I've had people make it extra hot and say, boy, I you should see me. I'm ready. I get that good and hot, and they're proud of it. It's just gonna increase your inflammation. So normal heat in the morning, warm it up, let the fingers loosen naturally as you get into your day. You're using your hand after an hour or a couple hours, it's gonna be nice and loose without the aggravational forcefulness. So don't force anything.

Skip Rubbing Use A Gentle Hug

SPEAKER_00 6:18

All right, another thing. Here we go. You ready? When something gets sore, it's natural to want to rub it. And and I'll patients come in on their first day with me, they're sitting there, they're talking to me, and they're wringing their hands and they're rubbing the wrist. And it's skin and bone here. It's it's and you're on the the arthritis is inflammation of the joint. So arthritis joint, it just means inflammation. And deep pressure makes it feel good, but boy, that rubbing it just aggravates us. And when you're done rubbing, now it hurts worse. But what can you do instead of rubbing? Give it a little hug. You can just lay your hand on it and just don't grip it hard, but just give it a little hug. And that neutral warmth from the other hand, and that just that uh little light pressure is very soothing without the rubbing.

Thumb And Wrist Traction Basics

SPEAKER_00 7:02

All right, now traction. What's joint traction? So traction is lightly separating the joints, pulling the joint surfaces away from each other that effuses or sucks in, it creates some negative pressure. So when you separate the joints, it it pulls in some nice nutrient-rich fluids into the joint space. So one of the most common areas of arthritis is the base of the thumb. And a good way to, you know, if it hurts when you do it, don't do it, okay? So you can try this. A lot most people I'll do that to them, and I'll just lightly pull on the thumb and they go, Oh, they feel so good. You can just see the relief in their face. Now, as with anything else, we can't do it all the time. You can't just make it a habit and just kind of always do it. The hands are handy, they're right there. We can't just do it all the time, okay? So just I had people do this three repetitions three times a day. They hold it for like three seconds, three, three, and three. So let's so let me show it to you. So if you if on the opposite hand, let's pretend my my right base of my right thumb is really sore, okay? I'm gonna use my opposite hand and stick my index finger up, okay? So I'm gonna lay my index finger on the back of the hand where I'm gonna do the traction. So I'm gonna lay my index finger on the back of the hand, and then I'm gonna grab the thumb. So it's like that, okay? And then I'm gonna bring my wrist and hand right in front of my stomach, and I'm gonna hold my shoulder um muscle just so I don't pull my whole arm, but I'm gonna relax my my hand and wrist. It has to be totally relaxed. It takes some practice. So you hold it right here. I'm holding my shoulder, I'm relaxing my wrist and hand, and I'm just gonna pull slightly so that way I feel a little bit of separation here on the base of my thumb. So I'm hold it like this. I got my thumb, okay? And just one and two and three. Then I relax, I let it go. And again, one and two and three. But if this hurts you, don't do it, okay? It's not everybody's, you know, this is a crookie cutter, it's not every same thing for everybody. It's a little first aid thing. This could, you know, it's okay to do one and two and three and relax. Three seconds, three repetitions, three times a day. Uh, next one, let's do some traction to the wrist. So you can grab the back of your wrist and see that that bone we talked about when we were doing the cold running water, you kind of go up to that big bone right there that juts up. You can go just below that, toward your fingers, just below that, and put your long finger right here, and then just grab your wrist. Now you're not gonna grab the livid heck out of the wrist, you're not gonna grab real hard. You're just gonna just just hold it, okay? And then you're gonna bring it up by your stomach, it's totally relaxed again, and you're gonna pull gently until you feel a light separation. One and two and three, and relax. We're separating it like an eighth of an inch, not much at all. Again, one and two and three and relax. But also, but remember if this hurts, just don't do it. But this is something that really helps a lot of people. Three seconds, three repetitions, three

Rebuilding Your Fist And Grip

SPEAKER_00 10:18

times a day. Now, let's say your wrist and hand are really stiff. So let's talk about the fist. You know, progressively, because of the inflammation and pain, it uh people start moving a little bit less, and then because they move less, and now it gets stiff, and then the joints themselves get stiff, and then the the we lose our flexibility of the tendons that connect the muscle of the bone, and things start to go in the wrong direction. All right. So with making a fist, if you go, let's say you can only go that far, use the opposite hand to go on the back. Let's we're gonna do each finger individually, and they're all connected in the back. So if you try to keep them out of the way so you can reach it better, you're defeating the purpose because they're all connected in the back. So they all have to go down as a team. Okay, so they go down as a team, very important. They go down as a team. You put the opposite hand behind the finger because that keeps the big knuckle bent to 90 degrees. Okay, now I'm gonna push on the top of the finger, and now I'm bending the middle knuckle. I got the big knuckle in the middle knuckle, and then now I'm gonna slide down on the tip, and I'm just gonna hold that for 10 seconds, and then now when I let go after 10 seconds, I'm gonna hold it there with my muscles. That gets the rest of the team going all in the same direction, even easier. And now I'm gonna go to the next one and push that down and then get down on the tip, and then and so forth, and 10 seconds each finger, what's that? 40 seconds. So this doesn't take long, and then after a while, my fist will go from here down to here, down to here. Might take three or four weeks, may take six weeks, but you can get your fist back, you can get your grip back. The thumb, the thumb, look on your if you have a if the other hand isn't affected very much. Where does yours go? Most full thumb flexion goes to the base of the little finger. So if you follow your little finger down, and then there's the bottom right there, should go there. So you if it doesn't go there, just aim for that spot. So you have one finger on the back of your thumb, and then another one up here on the tip of the thumbnail, and you can start stretching that down. I like to rest it right right on my leg. Then you can push that down and hold that stretch. So again, no pain, it should just pull, it should just be a stretching, a pulling. So no pain. Okay, you're gonna hold that for 10 or 20 seconds. Then when you're done, active hold. So now you hold it there. One, two, three, relax. That retrains your muscles to pull down to the end of your flexibility as you as you get more flexible, and then eventually, guess what? You'll get it down there, and it'll start moving all the way again. But it might take four weeks, six weeks. The wrist.

Forearm Turning And Wrist Stretches

SPEAKER_00 12:51

Let's talk about let's talk about the forearm turning a palm up and palm down. So if it won't turn palm down, and and you're finding yourself you have to move your shoulder in order to grab something and palm down. If you tuck your elbow into your side and you turn it palm down, it won't go anymore. You can reach over the top. Oh, now this time above that bony knob, okay, and you can grab yourself underneath, okay, and then use the heel of your palm to turn it palm down. So you just turn it until you feel it pulling. Okay, that's pulling. I'm gonna hold that for 10 or 20 seconds. Now I'm gonna hold that position line like oh, one, two, three, and relax. Now the opposite is true. To turn it palm up, you can get what's called like a clamp grip and get rid in here again toward the elbow above that, above that bony knob right there, okay. And you get it like this, elbows tucked in, elbows tucked into your side, and you're gonna turn it palm up like this 20, 10 or 20 seconds in the end. One, two, three. Now, wrist, when the wrist is stiff, it doesn't want to bend toward the palm or toward the back of the hand. You can use your knee as a fulcrum. I I tell people to lean the tip of their elbow right into your their thigh, have it forward enough so the knee isn't in the way, and then you can bring it down and push on the back of the wrist until you feel a light stretch. Fingers are free, okay? Fingers are free. You're pushing on the back of the hand until you feel a light pull here. You hold that light stretch, just a stretch, not pain, okay? 20 seconds, all right. And then you can relax it, do it again for 20 seconds, and then you can flip it over, and then fingers are still open. Pom to pom and bring it down. You can stretch that 20 seconds, a couple of repetitions. Now, let's say you won't turn all the way, palm up, won't turn all the way palm down. That's okay. To go back this way toward the back of your hand, you can go on the inside of your knee and push that back like that, and then you can go on the outside of your knee to go toward your palm in the opposite direction. Now, if you're listening to this driving down the road, be sure to watch the video so you can see the demonstrations and share this with other people who are dealing with our arthritis problems. Um, so you can use your knee as a fulcrum, you can go over the edge of a table. It also, if if the if the wrist is bending far enough, you can even bend the elbow all the way and push it down like this. You flip it over, push it down like this. What a lot of people will do is actually free hand like this up in the air. A lot of people will resist and not really realize that they're resisting the stretch and they're arm wrestling themselves in this way, resisting the stretch. When you use a fulcrum, it's not it's easier to relax and then you don't arm wrestle yourself. But a great way to prevent your arm wrestling yourself or resisting your stretch is have it as you move it on its own, the direction you want it to go, you keep help moving on its own, just come in and help with this one, and they're all going in the same direction. Then when you flip it over, you're pulling it down on its own, and then you come in and help, and they're both going in the same

Clinic Options And Next Steps

SPEAKER_00 15:52

direction. All right, so there's some stretches, there's some things to do, things not to do. Uh, this is very detail-oriented. Make sure you get into the clinic, like and subscribe to the channel, share this with other people. Look, I so many people have arthritis. I'm repeating these things in the clinic all day long. I really want these videos to get out, get them out to a lot of people. I hope they're helpful. I know they're helpful. Um, I'm getting a lot of great feedback, and especially in the clinic when people come in. Um, and in the clinic, I'm doing things for them in the clinic that they can't do for themselves at home, like joint mobilization and cold laser treatment, other things. And it's not a lot of visits. It's you know, one visit a week for maybe like two or three weeks, and then there you go. Now you know how to manage your personal condition on your own. If you need anything, give me a call. That's really how we handle it with our arthritis. Um, sometimes some uh little joint stabilization techniques like kinesio tape and maybe some special types of splints for special types of arthritis that that kind of thing. So it's it's really important that it's all tailored to the patient. So the website, CarlPetito.com, check out the website, a lot of good material there. And thank you for watching the hand to shoulder solution, where we are the solution to your pain. Thank you.