How Can I Improve My Grip Strength With Rheumatoid Arthritis?

Here are five exercises that reduce muscle stiffness and improve pain due to rheumatoid arthritis (RA):

1. Tug of war: Hold a thick sheet of paper or an envelope between your left thumb and index finger. Try to pull the envelope or card, resisting the pull with the left thumb and index finger. Repeat with the other hand.
2. Walk your fingers: With your right hand on the surface of the table and your palm facing downward, pretend to walk the fingers of the left hand over the back of the right palm. Repeat with another side. Do this in a set of five walks.
3. Finger curls: Roll your fingers slowly from the tips until you can touch your palms. Make a loose fist by crossing your thumbs in the front. Slowly open the hand. Repeat in five sets with each hand.
4. Finger lifts: Keep your left hand flat on a table such that the palm faces the table and your fingers are wide apart. Now lift your thumb as high as you can. Hold. Put it down. Repeat for each finger and both hands.
5. Making a “C”: Make a C with your fingers as if you’re holding a can or bottle. Slowly return your hand to the starting position. Repeat.

The most important tips to deal with musculoskeletal weakness that accompanies RA include:

• Compliance to medications
• Physiotherapy and exercises under professional supervision to be started right at diagnosis
• Stress management
• Weight management

Other interventions to improve muscle stiffness include medication, practicing yoga postures, swimming, and water therapy, as well as balance exercises that strengthen your core muscles.

Three tips to deal with stiff and painful joints during a rheumatoid flare include:

1. Rest and work pauses: Respect your pain and give your joints rest as required.
   • Try to use adaptive tools and support the adjoining joints with pillows or a firm surface such as a table while working.
   • Make sure your workplace is ergonomically sound. Use wrist, ankle, and knee support if you have to work in a standing position.
   • Try to protect your finger joints from strain by avoiding prolonged gripping or twisting motions.
   • Slide objects rather than lifting them.
   • Take a pause every 30 minutes and avoid sitting or working in cramped spaces.
2. Use good body mechanics: Learn to position yourself correctly to minimize the stress on your joints. Ask your physiotherapist for advice here.
   • Carry heavy objects close to your chest, using your forearm to support the weight.
   • Use a purse or good backpack to carry stuff rather than carry them in your hand.
   • Use abdominal muscles to roll over in bed.
   • Avoid twisting and awkward positions, such as reaching for objects in the back seat of a car from the front seat.
   • Make sure your hands are supported while driving. Make sure you have good back support.
3. Avoid complete cessation of activity: Completely avoiding any movement will increase joint stiffness and cause your muscles to become weaker. Keep stretching at work and make sure the joints stay mobile.

Because rheumatoid arthritis (RA) has multiple etiologies including genetics and environmental triggers, various factors may trigger your RA. These factors differ from person to person even in the same family.

The most common aggravators in RA include:

• Minor infections such as seasonal flu or stomach flu: These may dysregulate your immune response and cause the activated white cells to attack your joint and muscle tissues.
• Stressful events (physical exertion and emotional stress): These cause a proinflammatory state in the body through the release of chemical messengers in response to stress.
• Smoking: Smokers are known to have frequent relapses and symptom initiation at a younger age.
• Change in medication: Introducing a new medication or changing the dose of an existing RA drug may trigger your symptoms.
• Low estrogen levels (during menopause): Estrogen–progesterone interplay has a complex role in RA development. Hence, conditions such as pregnancy, lactation, and oral contraceptives often affect the symptom intensity and frequency.
• Thyroid hormone imbalances: These disturb the pain perception in the body and cause muscle stiffness and pain to get worse.
• Poor gum health: A bacterium called Aggregatibacter acitnomycetemcomitans is known to cause soft tissue damage by attacking the body's immune cells.

Processed food and excess sugar intake, red meat, and dairy are all known to cause symptom exacerbation.

Rheumatoid arthritis (RA) generally starts in your 30s. The disease has a variable course with symptom-free periods followed by an acute onset of symptoms. The frequency of flare-ups depends on your genetics, body weight, exercise schedule, diet habits, and stressful periods. A flare-up may last anywhere from a day to a few weeks.

Affected individuals describe symptoms of RA flare-ups as follows:

• A sudden sharp increase in joint pain
• Increased joint stiffness, especially on getting up in the mornings
• Joint swelling, particularly in small joints (fingers and toes)
• Systemic symptoms such as fever, fatigue, and body ache
• Flu-like symptoms may be seen in some

Laboratory blood tests show elevated C-reactive protein and erythrocyte sedimentation rate.

Here are 10 red flags that your rheumatoid arthritis may be getting worse:

1. Frequent flare-ups are getting more difficult to manage.
2. Flare-ups are accompanied by systemic symptoms such as breathing problems or kidney problems such as passing frothy urine.
3. Flare-ups last for months despite starting immediate treatment.
4. You find rheumatoid nodules (bumps under your skin) around joints (especially your elbows).
5. High titers of Rh factor in blood, high erythrocyte sedimentation rate levels, and high C-reactive protein.
6. X-rays show progressive joint damage such as cysts in the bones, erosion, and joint swelling.
7. Joint stiffness does not abate anymore despite the resolution of other symptoms.
8. Joints start to appear twisted or deformed.
9. You fall sick quite often (due to virus or flu infections).
10. Physical therapy does not help with joint pain and stiffness.