How to deal with arthritis when you work with your hands?
December 4, 2015 7:32 AM   Subscribe

I started having pain in my right index finger awhile back and there was also swelling at the top joint so I thought that perhaps I had dislocated my finger. I went to a hand specialist in Manhattan and after a brief look at the x-ray informed my that I had arthritis in that finger. I work with my hands every day. What can I do?

He said there was nothing I could do about it, and later if it got too bad I could consider cortisone shots but that was about it. I felt like he was in a hurry and not very interested in discussing it further.

The problem is that I am a sculptor and I spend hours filing, sculpting, carving, etc. sometime doing small detail work. The pain is getting to be unbearable. What can I do?

So my questions are:

If you have any experience with this- is it possible the Dr. did not give me good advice, and that there is actually some kind of treatment to pursue?

Do you have any advice on pain management? Treating inflammation? Should I be taking a daily aspirin?

Am I making it worse by continuing to work with my hands? I don't feel like I have many options but I'd like to know if that is just going to destroy my fingers down the line.

Thanks in advance for any insight. I'm feeling quite depressed about this and especially because I was left feeling like this was just the beginning of total degeneration of my hands. I'm not young but not that old either (45).
posted by catrae to Health & Fitness (18 answers total) 13 users marked this as a favorite
Best answer: I take a daily prescription NSAID called Etodolac that helps a lot with the arthritis in my hands and elsewhere. Bonus: it also almost completely eliminates my previously crippling menstrual cramps.

Additionally, I wear these compression gloves when I have to do a lot of work with my hands (e.g., data entry, crafts, etc.) and there is a noticeable difference after a day of working with the gloves on vs. a day of working without them.

Cold makes my arthritis worse, so I will often warm my hands up in a sinkful of hot water when I wake up or if they start to ache.

These mitigation techniques seem to be helping -- a couple of years ago my arthritis was so bad that I often woke up unable to curl my fingers into a fist or grip anything! Now my hands still hurt, but the pain is usually bearable and they seem to be ~80-90% functional. So while it is a degenerative disease, it can significantly slowed down and sometimes partially reversed.

I'm assuming that the doctor's diagnosis was specifically osteoarthritis and not rheumatoid or psoriatic arthritis, given that the pain is in one finger and not your whole body. But if you start to have whole-body pain and fatigue, get tested for the other two (blood test for rheumatoid and bone scan for psoriatic) because there are special drugs for those types that can make a huge difference.
posted by Jacqueline at 7:54 AM on December 4, 2015 [6 favorites]

Best answer: I think you need to go back to the specialist or find another specialist who you like better (since it sounds like this one didn't have a great bedside manner). The specialist may be able to refer you to someone (physical therapy or occupational therapy) who can help you manage this condition the best way possible, and find work-arounds for performing specific types of tasks.

The more proactive you are, the better you can stave of the damage. But the best way or ways to be proactive are going to depend on what type of arthritis you have, and it'll be best to work with a specialist on managing that. There are a wide variety of medications (both anti-inflammatories and, for the rheumatoid versions, various other sorts), tools, and techniques that may be able to help you here. But you need to find the right ones, and you'll find them a lot quicker working with experts.

I say this as someone who has/had family members who work with their hands and have had various types of arthritis (rheumatoid and osteo). It's definitely hard, but it's worth trying to find strategies to manage it better.
posted by pie ninja at 8:03 AM on December 4, 2015

Best answer: Also, regarding your profession as a sculptor, perhaps you could experiment with newer technologies like laser cutting, 3D printing, etc.? Then you could create with a mouse and keyboard and let the machines do the physically demanding work that would otherwise thrash your hands.

There are also probably ergonomic versions of your hand tools or modifications that will make your current set of tools more ergonomic. There must be forums, mailing lists, etc. for professional sculptors to talk with each other. I'd post a variant of your question there, too, but with more specifics about the tools you currently use and a request for recommendations of arthritis-friendly alternatives.
posted by Jacqueline at 8:05 AM on December 4, 2015

Best answer: There are many over-the-counter anti-inflammatories that are specifically designed to help with arthritis management. One that is quite effective is Alleve or its generic equivalent. You just take one every day - or two, depending on the package directions and keep taking them for several weeks, or whenever you have a flare up. It normally takes a few days to have an effect.

You can also try to reduce all over inflammation in your body by improving your diet, if it is full of salt and grease and refined carbohydrates. A diet high in sugar usually causes inflammation and makes arthritis worse.

The thing to remember about arthritis is that it comes and goes getting worse and getting better. You are probably in your worst ever flare up right now, but can treat the problem to make it go away again. Arthritis is often extremely manageable. when tackled promptly.
posted by Jane the Brown at 8:08 AM on December 4, 2015

Best answer: I'm also going to send this question to my uncle, who is a public artist and has had rheumatoid arthritis for years. He mostly does big installation pieces so experience might not be directly relevant to your work but he'll probably have some ergonomic tips you'd find helpful.
posted by Jacqueline at 8:11 AM on December 4, 2015

Best answer: My (70+ year old) mother does pottery and she has arthritis in her hands--mostly she manages pain with Aleve and stiffness with keeping her hands warm . She noticed improvement after she started taking a chondroitin supplement. Research on efficacy is mixed but it does seem to slow progression of osteoarthritis.
posted by crush-onastick at 8:14 AM on December 4, 2015 [1 favorite]

Best answer: You haven't said if your arthritis is rheumatoid or ostheo. With rheumatoid it can be controlled with drugs so the arthritis is inactive, though it can take a long time to work out which drugs specifically work for you. If ostheo they can inject gel into some joints to lubricate them, though I'm not sure about fingers, specifically. Whether ostheo or rheumatoid, they can inject the joint with cortizone which is a painful injection but provides some weeks of relief. It is not a permanent fix and is just intended to provide relief while you wait for actual solutions (like drugs) to kick in.

You may be making it worse by continuing to work with your hands while the arthritis is active. You really should talk to your rheumatologist or get a new one if you the one you have isn't willing to explain things to you.
posted by If only I had a penguin... at 8:18 AM on December 4, 2015 [1 favorite]

Best answer: Oh yeah, and get a wax bath.
posted by If only I had a penguin... at 8:19 AM on December 4, 2015 [1 favorite]

Best answer: It is now the winter, colder fingertips are more numb, so in your work you might just be slightly beyond what your fingertip tolerates. Often the first sign of physical wear is at the extremities. So take vitamin B12, D, calcium, get enough water, glucosamine with chondroitin and MSM. Then be mindful when you work. We tend to ignore pain if it is interefering with pleasant work. You now have to do the opposite, and use this hand, but pay close attention to what is hurting it and decrease pressure to the area. One thing I did when I realized my wrists were hurting, I started doing easy pushups so I was weight bearing in that area to increase calcium uptake to those bones. It worked, the pain went away. I work in the arts too and it is important to enjoy the doing of art.
posted by Oyéah at 8:42 AM on December 4, 2015 [1 favorite]

Best answer: If you don't like the idea of taking pills every day, there are known anti-inflammatory foods (and known inflamatories, and Jane the Brown mentioned). My mom is a quilter with arthritis in her hands, and an allergy to asprin and pretty much all NSAIDs. She identified tart cherries as being her anti-inflamatory of choice, and now every morning at breakfast she counts out 25 dried cherries from her stash (when I lived in Michigan, I would mail her 6-lb boxes of local dried cherries!). Says she can feel the difference when she skips a day.
posted by aimedwander at 8:55 AM on December 4, 2015

Best answer: Look into altering handles of the tools you use. I like painting miniatures (think 1" high fully detailed figures) but have osteo in a couple of knuckles. I found using sculpy to make the handles of my favourite brushes fatter & shaped for comfort helped. I found something with a little give more comfortable & easier to hold without having to use a death grip like you do with smooth surfaced tools.
posted by wwax at 9:07 AM on December 4, 2015 [2 favorites]

Best answer: You really need to find out what kind of arthritis it is, as that can really really influence the sort of advice that will work for you.

I have Juvenile Rheumatoid, it started in my hands. It is treated very differently in the long term than osteo or other forms of arthritis. Also, if it is in your hands, and rheumatoid, you need to be very careful that it does not become psoriatic arthritis.

I'd also be very interested to know how he could know JUST looking at an x-ray, since my rheumatologist can't even do that, and she's been practicing for longer than I've been alive. MANY types of joint damage can look like "arthritis". Go see a proper rheumatologist, or a different ortho specialist. Don't go see a sports med guy, in my opinion (my two cents from having lots of weird hand problems).
posted by strixus at 9:46 AM on December 4, 2015 [2 favorites]

Best answer: There are physicians and physical/occupational therapists who specialize in treating the hands. Ask around other artists doing handwork (weavers, string-players, mosaicists) for a recommendation. The key in arthritis is to keep your joints moving and warm. My arthritic (all types) friends swear by immersing oneself in heat (wax baths, warm-water exercise, keeping your neck covered, etc.) Sweat is better than pain. Best wishes!
posted by Jesse the K at 10:44 AM on December 4, 2015

Best answer: for what it's worth, I had increasing stiffness i my fingers every morning until I started taking Omega-3 (fish oil) supplements. I'll plug the actual brand I use -- Nordic Naturals -- because at least one other brand didn't work. (I came around to trying this after going down a "perimenopausal symptoms" rabbit hole, but it might well work for you too, and it's one of the few supplements shown to have other good effects on your health as well.)
posted by acm at 1:01 PM on December 4, 2015

Best answer: You need to find an expert in the field. My aunt is a weaver, and has terrible problems both with her hands, back and knees (all necessary when weaving), and while she does have assistents doing some of the work, she has also been helped by specialists in pain management. She is not where you are, so I can't give you adresses. Only the knowledge that someone out there can help you.
posted by mumimor at 1:20 PM on December 4, 2015

Response by poster: I marked all of these answers as best because they are all very helpful. Thank you all!
posted by catrae at 9:59 PM on December 4, 2015

Are you sure he/she was a hand specialist? Problems like yours are exactly the reason we exist (I'm a hand surgeon). It is weird to me that you were told there is nothing to do- there's always something to do! Get a second opinion- you can even PM me your x-rays if you want I can get back you you.
posted by karlos at 6:05 PM on December 5, 2015 [2 favorites]

From my uncle:
First thing to do is determine if it’s Rheumatoid or Osteoarthritis. A simple blood test will turn up the RA marker if it’s present. If that’s the case, if she has RA, there are some amazing drug therapies available - the biologics as they’re called. Linda is basically night / day after her monthly infusion and the meds kick in.

This artist needs to make an appt with a dr and ask to be tested for RA. There are numerous drug therapies so she’ll need to work with her docs to find the right combo.

I’ve become immune to the super biologics so now rely on some of the more standby chemo therapies, pain meds, and muscle strengthening. For my hand I have one of those hard rubber squeeze balls to build muscles that can lighten the load on the joints. Figure this could help if she has osteoarthritis.

Your suggestions of looking into tech support / new tools is absolutely worth her look-see. I know of artists who are modeling in 3D, printing 3D in stainless steel or cutting dense foam then using those pieces as molds for cast bronze and iron. She can also flame spray an assortment of metals. Of course if she’s carving wood none of this helps, maybe. Just remember that when Matisse could no longer hold a paint brush he had them tapped to his hand. If a person has to do it they have to do it and we always find a way.
posted by Jacqueline at 8:36 PM on December 8, 2015 [1 favorite]

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