Hand Therapy for Rheumatoid Arthritis

Certified Hand Therapist Cindy Glaenzer helps patients with rheumatoid arthritis improve hand function.


What is rheumatoid arthritis?

Rheumatoid arthritis is a systemic disease, and it attacks joints. It's autoimmune, which is why they can use the biologics for treatment. In the hand especially, rheumatoid arthritis destroys the big knuckles, the MP joints. The extensor tendons slide off to the side, and they get bad on their deviation of their fingers. They also have that same destruction on their wrist joint, so the wrist is going one way and the fingers are going the other way. It makes it very difficult to function. A lot of people can't extend their fingers at all, which doesn't really allow you to grasp many things and doesn't give you much strength.

What's the difference between rheumatoid arthritis and osteoarthritis?

Osteoarthritis is a wear-and-tear arthritis. If you were a gymnast and have arthritis in your back from all the flexibility things that you did 20 or 30 years ago, now when you're trying to do something, you might have some more stiffness because you did wear-and-tear activities to that specific joint. Knees are a big one. Hips are a big one too.

How have treatments have changed?

When I first started in hand therapy, they were doing joint replacements on all of the knuckles on rheumatoid arthritis patients. Now with the invention of the biologic medicines, they've stopped and arrested that disease much sooner so people don't progress on to the terrible deformities that they once had. Plus it's also gotten much better as far as the surgical techniques. The joints and the bones are stabilized so much better and so much quicker that we can minimize the amount of time that we spend with people, which is better for them and better for the economy as far as healthcare dollars being spent. We get to see more people because we are treating them quicker. There's much less pain involved and much more stable joints, and they can get back to what they need to do quicker.