Hand Osteoarthritis: Therapy, Exercise, and Nutrition
Updated: Oct 1
Hand osteoarthritis (OA) is a common condition that can cause pain, stiffness, weakness, and difficulty with everyday activities. But osteoarthritis does not necessarily mean that pain and loss of function will continually worsen. There is often much that can be done to manage symptoms, maintain mobility, and keep the hands active.
Effective management usually involves more than one approach. Exercise, education, activity modification, and strategies for managing pain form the foundation of care. Depending on the individual, manual therapy and other interventions may also be incorporated to help address pain, mobility, and function.
In this article, we explore what happens in hand osteoarthritis, how it can affect the joints and surrounding tissues, and practical strategies for managing it, including manual therapy, mobility and strengthening exercises, and nutritional and lifestyle considerations.
The goal is not to promise a cure or reverse osteoarthritis, but to help you keep your hands moving, functioning, and doing the things that matter to you.
Article Index:
Understanding Hand Osteoarthritis
Hand osteoarthritis (OA) is more complex than simple “wear and tear.” It involves changes throughout the joint, including the cartilage, bone, synovium (the tissue lining the joint), ligaments, and other surrounding tissues.
Cartilage normally provides a smooth, low-friction surface that helps joints move efficiently. In osteoarthritis, the balance between maintaining and breaking down this tissue becomes disrupted. Cartilage can gradually thin and lose some of its normal structure, while the underlying bone may also change. Over time, some joints develop bony enlargements known as osteophytes, along with changes in joint shape and mobility.
Chondrocytes: The Living Cells Within Cartilage
Cartilage is not simply an inert cushion. It contains specialized cells called chondrocytes, which help maintain and repair the cartilage matrix.
In osteoarthritis, the behaviour of these cells changes. Chondrocytes may increase the production of enzymes, including matrix metalloproteinases (MMPs), that contribute to the breakdown of collagen and other components of cartilage. At the same time, the joint's ability to maintain and repair its normal cartilage structure becomes less effective.
This helps explain why osteoarthritis is better understood as an active biological process involving the entire joint, rather than simply cartilage wearing away with age.
Inflammation and Hand Osteoarthritis
Inflammation can also play an important role in osteoarthritis. The synovium and other tissues within the joint can produce inflammatory mediators that contribute to pain and changes in joint tissues. In some people, this inflammatory activity may be more prominent during periods when symptoms increase.
However, osteoarthritis is not simply an inflammatory disease. Mechanical loading, previous injury, genetics, age-related changes, joint anatomy, metabolic factors, and biological processes can all contribute to its development and progression.
This is also why management should look beyond the cartilage alone. Movement, exercise, maintaining general health, avoiding smoking, and addressing modifiable risk factors can all be part of a broader strategy for living well with osteoarthritis.
Manual Therapy and Exercise for Hand OA
Exercise is an important part of managing hand osteoarthritis. Mobility exercises can help maintain joint movement, while strengthening exercises can improve hand strength, function, and the ability to perform everyday activities. The type and intensity of exercise should be adapted to the individual, particularly when joints are painful or symptoms fluctuate.
Manual therapy may also be incorporated as part of a broader treatment and rehabilitation program. Techniques such as joint mobilization and soft-tissue therapy may help reduce pain and improve mobility for some people, particularly when stiffness or restricted movement is present.
Manual therapy and exercise serve different but complementary roles. Manual therapy may provide short-term improvements in pain or mobility, while exercise helps the individual actively develop and maintain strength, movement, and function over time.
The goal is not simply to treat the arthritic joint itself, but to help the hands remain mobile, strong, and capable of performing the activities that matter in everyday life.
Manual Therapy Demonstration
The following videos demonstrate manual therapy procedures used within Motion Specific Release (MSR) when working with wrist and hand conditions. Depending on the individual, manual therapy may be incorporated alongside exercise and other strategies to help address pain, restricted mobility, and limitations in function.
These procedures should be selected according to the individual's examination findings and should be considered part of a broader approach to managing hand osteoarthritis rather than a treatment for the underlying disease process.
Manual Therapy for Hand and Wrist Osteoarthritis
In this video, Dr. Brian Abelson demonstrates MSR manual therapy procedures used when addressing pain and restricted mobility in the hands and wrists. The techniques include joint and soft-tissue approaches that may be incorporated into a broader program of exercise and rehabilitation when clinically appropriate.
Fascial Expansion: MSR Wrist & Hand Protocol
This video demonstrates how fascial expansion techniques are incorporated into the MSR approach for wrist and hand conditions. The procedure draws upon concepts from fascial anatomy and kinetic-chain relationships, along with selected principles and points traditionally used in acupuncture and Traditional Chinese Medicine, including PC7, LU9, TH4, TH5, LI4, LI5, and SI4.\
Within MSR, these techniques may be combined with joint mobilization or manipulation, myofascial techniques, and functional exercise according to the individual's examination findings. The goal is to address pain, mobility, and function as part of a broader rehabilitation program.
Article Index
Osteoarthritis Exercises
Exercise is an important part of managing hand osteoarthritis. Regular movement can help maintain joint mobility, while strengthening exercises can improve hand strength, stability, coordination, and the ability to perform everyday activities.
Manual therapy may sometimes be used alongside exercise to help address pain or restricted mobility. However, exercise provides the active component of rehabilitation, helping individuals maintain movement, build strength, and continue using their hands with confidence.
Exercises should be adapted to the individual and progressed according to symptoms, ability, and functional goals. The objective is not simply to exercise the hands, but to keep them capable of performing the activities that matter in everyday life.
Demonstration Videos
Hands and Thumb - Self-Myofascial Release
This video demonstrates self-myofascial techniques for the hands, fingers, and thumbs using gentle compression, rolling, and pin-and-stretch movements. These techniques can be used to address soft-tissue discomfort and restricted movement as part of a broader mobility and exercise program.
Hand Mobility Exercises - Bharatnatyam Inspired
In this video, Kamali Abelson, who is trained in classical Indian dance (Bharatanatyam), demonstrates three hand exercises designed to encourage mobility, coordination, and neuromuscular control.
The exercises are inspired by the expressive hand movements and gestures used in Bharatanatyam, where mudras and other movements of the hands are an important part of communication and storytelling.
Nutrition, Lifestyle, and Hand Osteoarthritis
There is no specific diet proven to cure hand osteoarthritis or reverse the structural changes that occur within an osteoarthritic joint. However, nutrition remains an important part of overall health, and emerging research suggests that broader dietary patterns may influence pain, inflammation, metabolic health, and physical function in people with osteoarthritis. Much of this research involves osteoarthritis generally rather than the hands specifically, so the evidence should be interpreted cautiously.
Rather than focusing on individual “anti-inflammatory” foods, a practical approach is to emphasize an overall healthy dietary pattern:
Eat a variety of vegetables and fruits: These provide fiber, vitamins, minerals, and numerous plant compounds important for general health.
Include healthy sources of fat: Fish, nuts, seeds, olive oil, and other minimally processed foods can provide unsaturated fats, including omega-3 fatty acids.
Consume adequate protein: Protein supports the maintenance of muscle and other tissues and becomes increasingly important as we age.
Choose high-fiber foods: Vegetables, fruits, legumes, and whole grains support cardiovascular, metabolic, and digestive health.
Limit highly processed foods: Diets dominated by highly processed foods, refined carbohydrates, and excessive saturated fat generally provide poorer overall nutritional quality.
Maintain good metabolic health: Regular physical activity, adequate sleep, a nutritious diet, and maintaining an appropriate body weight support overall health and may also be relevant to osteoarthritis.
Avoid smoking: Smoking negatively affects many aspects of musculoskeletal and general health.
Diet should therefore be viewed as one part of a broader approach to living well with osteoarthritis, alongside exercise, appropriate medical care, maintaining physical activity, good sleep, and other healthy lifestyle behaviours.
An Integrated Approach to Hand Osteoarthritis
Hand osteoarthritis is more than a change in the cartilage alone. Pain and loss of function can also be influenced by joint mobility, muscle strength, coordination, sensitivity, previous injury, and the demands placed on the hands during work, recreation, and everyday activities. Effective management should therefore consider both the affected joints and how the hands are functioning as a whole.
Thorough Assessment: A clinical examination can help determine which joints and surrounding tissues are contributing to symptoms, assess mobility, strength, function, and neurological findings, and identify features that may require further investigation or referral. It is also important to distinguish osteoarthritis from other conditions that can produce hand pain and stiffness.
Individualized Treatment: Treatment should be guided by the individual's symptoms, examination findings, functional limitations, and goals. Within MSR, manual therapy may include joint mobilization or manipulation, myofascial and fascial techniques, and other approaches when clinically appropriate. These interventions are used as part of a broader management strategy rather than as a treatment for the underlying osteoarthritis itself.
Exercise and Self-Management: Mobility and strengthening exercises can help maintain movement, improve strength and support everyday hand function. Education, activity modification, and practical strategies for managing symptoms can also help people remain active and continue using their hands confidently.
Lifestyle and General Health: Physical activity, good nutrition, adequate sleep, avoiding smoking, and maintaining overall health are important for healthy aging and may also influence how people experience and manage osteoarthritis.
Regular Reassessment: Osteoarthritis and its symptoms can change over time. Pain, mobility, strength, function, and progress toward individual goals should be reassessed throughout care. If symptoms change significantly or are not responding as expected, the diagnosis and management plan should be reconsidered, with further investigation or referral when appropriate.
Ultimately, the goal is not to promise a cure for hand osteoarthritis. It is to reduce symptoms where possible, maintain or improve function, and help people continue using their hands confidently in the activities that matter to them.
References
Buck AN, Vincent HK, Newman CB, et al. Evidence-Based Dietary Practices to Improve Osteoarthritis Symptoms: An Umbrella Review. Nutrients. 2023;15(13):3050.
Glyn-Jones S, Palmer AJR, Agricola R, et al. Osteoarthritis. The Lancet. 2015;386(9991):376-387.
Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK, Felson DT. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Annals of the Rheumatic Diseases. 2011;70(9):1581-1586.
Huang L, Zhang ZY, Gao M, Wang XQ, Duan XQ, Liu ZL. The effectiveness of exercise-based rehabilitation in people with hand osteoarthritis: a systematic review with meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2024;54(7):457-467.
Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. The Lancet. 2019;393(10182):1745-1759.
Kloppenburg M, Kroon FPB, Blanco FJ, et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Annals of the Rheumatic Diseases. 2019;78(1):16-24.
Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research. 2020;72(2):149-162.
Kroon FPB, Carmona L, Schoones JW, Kloppenburg M. Efficacy and safety of non-pharmacological, pharmacological and surgical treatment for hand osteoarthritis: a systematic literature review informing the 2018 update of the EULAR recommendations for the management of hand osteoarthritis. RMD Open. 2018;4(2):e000734.
Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis and Cartilage. 2013;21(9):1145-1153.
Zhang W, Doherty M, Leeb BF, et al. EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT. Annals of the Rheumatic Diseases. 2009;68(1):8-17.
Disclaimer:
The information provided on this website, including articles, videos, exercises, and other educational materials, is intended for general educational purposes and should not be considered a substitute for individualized assessment, diagnosis, or treatment by a qualified healthcare professional.
Musculoskeletal conditions vary considerably from person to person. An exercise, treatment, or technique that is appropriate for one person may not be appropriate for another. If you have pain, neurological symptoms, an injury, or concerns about your health, consult an appropriately qualified healthcare professional.
MSR manual treatment procedures intended for healthcare practitioners should only be performed by professionals with the appropriate training, qualifications, and scope of practice. Members of the public should not attempt professional manual treatment procedures based solely on information presented on this website.
Use of this website does not establish a healthcare provider-patient relationship. Please refer to our Terms of Use and full website disclaimer for additional information.
DR. BRIAN ABELSON, DC. - The Author
Dr. Brian Abelson is a chiropractor, author, and educator with more than 30 years of clinical experience in musculoskeletal care, rehabilitation, and sports performance. His educational work focuses on musculoskeletal conditions, human movement, sports biomechanics, and evidence-informed approaches to treatment and rehabilitation.
He is the developer of Motion Specific Release (MSR) and Clinical Director of Kinetic Health in Calgary, Alberta, Canada.
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