Modifying activities can help people with arthritis continue their favorite leisure-time activities.
Reviewed By Brunilda Nazario
When stiff, painful, swollen joints interfere with your ability to do the handicrafts and other hobbies you enjoy, arthritis experts say, don't give up.
"Regardless of the cause of arthritis, it's extremely important to keep going and maintain range of motion so your hands don't get stiff," says hand specialist James Carlton, MD, of Mercy Medical Center in Baltimore. "It's rare that attempts to manage pain are so unsuccessful that people have to give up what they want to do. That's not to say there aren't limits. A virtuoso pianist can continue to play but not at the same level as before."
Pain isn't the only limitation. Problems with strength, grip, and range of motion are important factors also. But if you're willing to modify your activities and learn to use adaptive devices, experts say the benefits are worth it.
Benefits of Leisure Activities
The CDC recently reported that 70 million Americans -- that's almost one in three -- have arthritis and/or chronic joint symptoms, up from 43 million in 1997. So you're not alone.
"Therapeutic benefits of hobbies depend on how the arthritis affects a person's hands and wrists," says Jill Noakre Luck, director of occupational therapy at the University of Pittsburgh Medical Center. "Almost any activity has a component of range-of-motion exercise." Nevertheless, she advises people not to substitute activity for a specific exercise program that addresses their unique mobility and strengthening needs, but to use them together to improve overall health and function.
Another benefit is that certain activities may provide relief if your arthritis responds to heat or cold, says Shannon Mescher, vice president of programs and services at the Arthritis Foundation. For example, if you like gardening, you can choose to weed or water in the warm sun or work cool soil with your hands.
One of the few studies addressing leisure activities and hand osteoarthritis involved four people playing the piano in 20-minute sessions, four times a week, over a four-week period. The University of Kansas researchers found improvement in finger pinch and range of motion; three participants showed significant improvement in finger velocity, strength, and dexterity; and two reported less discomfort after playing.
Staying active has value beyond meeting physical needs. "Because people who have arthritis are likely to experience depression, becoming involved or continuing hobbies is important for well-being," Mescher says.
Modify, Don't Eliminate, Favorite Activities
Luck says too often people give up cherished activities they could continue if they'd make some modifications. She recalls doing an informal survey of people hospitalized for arthritis, and of those who said they once enjoyed gardening as a hobby, two-thirds said they'd given it up because of arthritis. "It was striking to me the number that gave it up even though it had been of great value to them," Luck says. "Maybe they've lost strength, range of motion, or some function, but despite changes, how can we help them preserve this enjoyable activity and focus not on what they've lost but on helping them use their current abilities?"
Gardening. Luck recommends choosing garden tools with enlarged handles that don't require such a tight, strong grasp, or elongated handles that use larger muscle groups in the arm, not just the hand. Also, make tasks easier and save energy by using a tool caddy on wheels and a metal frame to hold your weed bag. You may not feel like tilling a half-acre, but you can still derive the pleasure of growing things in container or raised-bed gardens. You'll find more gardening tips at the American Occupational Therapy Association web site, www.aota.org.
Cooking. Whether you regard cooking as a hobby or necessity, you'll enjoy it more with some modifications that reduce wear and tear on your hands:
- Buy foods packaged in sealed pouches that you can cut open with scissors.
- Buy prepackaged chopped onions and jars of minced garlic instead of chopping.
- Replace heavy, hard-to-handle cookware and dishes with user-friendly versions.
- Set your cookbook on a holder.
- Save energy by laying out all ingredients before you begin, like the TV chefs.
- Let your grinder, chopper, or food processor take over many tasks you used to do by hand.
- Look for cookbooks that offer simplified methods, such as using a slow cooker, to prepare the foods you love.
Sewing and needlecrafts. Sewing and needlecrafts pose their own set of problems. "Pinching activities, such as using scissors, hurt a lot if you have degenerative arthritis at the base of the thumb, which almost everyone gets," Carlton says. He suggests using adaptive scissors that are spring loaded like grass shears.
If holding a needle is difficult, you can still work on sewing projects. Let your sewing machine do most of the work, and use products such as iron-on hem tapes and fabric glues to minimize the need for hand stitching. Cross-stitch, embroidery, and knitting become more manageable with holders for embroidery hoops and knitting needles that clamp to a table.
Working with small crochet hooks and knitting needles is a challenge. "Some people who knit take pink foam hair curlers that have a hole through the center and put them on their knitting needles," Mescher says. Also try to vary projects. If your hands tire making a baby sweater, switch to a bulky scarf that uses thick yarn and big needles and hooks, or do macrame, which doesn't require tools. If you must give up a favorite craft, ask the clerk at your craft store to recommend alternatives.
Get a Grip With Adaptive Devices
"The general rule for choosing adaptive aids is to look for things that are as big as possible -- big, fat pens, pens with foam over the top and kitchen utensils with big handles," Carlton says. Some of the best adaptive devices are ones you rig up at home. Most people with arthritis have trouble with gripping or pinching tasks, so the Arthritis Foundation suggests wrapping tape or bubble wrap around handles of pens, tools, utensils, knitting needles, etc.
Fortunately, more and more commercial products are becoming available to help you enjoy your favorite activities. The Arthritis Foundation provides a list and description of products they've awarded the Ease-of-Use commendation. The foundation also recommends products in the North Coast Medical Functional Solutions catalog. In addition, many stores carry tools and kitchen utensils with enlarged grips. One popular line is OXO Good Grips. Also, check with your craft store. Even if they don't carry what you need, they can probably direct you to a source.
If your favorite activities cause pain, there are ways to minimize it. "Do the activity immediately after you take your pain medication or at a time of day when you feel better," Mescher says. She also suggests using a heat treatment before the activity and taking frequent breaks to stretch your hands and fingers.
Luck says to avoid prolonged grip and pinch tasks and twisting motions that push your joints out of the plane of normal movement. Also, use tools to reduce stress on joints; for example, don't use your thumb to push a thumbtack.
If an activity such as knitting becomes painful, Carlton suggests adjusting dosage of your analgesics. "Patients can make the decision to escalate their treatment so they can engage in activities and be pain free," he says. "They should ask themselves if the activity is important enough to increase the medication.
"Our first choice is to treat the patient sufficiently so they can engage in the activities they want, even escalating medications as a way to take care of pain. Eliminating desirable activities in order to be comfortable is a second choice."
Published Feb. 2, 2004.
SOURCES: Journal of Music Therapy, Summer 2001. James Carlton, MD, Mercy Medical Center, Baltimore. Jill Noakre Luck, director of occupational therapy, University of Pittsburgh Medical Center. Shannon Mescher, vice president, programs and services, Arthritis Foundation. American Occupational Therapy Association. Arthritis Foundation. North Coast Medical Functional Solutions.
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