Five exercises cover most stiff, painful hands: tendon glides, a gentle grip squeeze, the thumb web-space hold, finger table lifts and thumb opposition rings. Do them twice a day, ideally after five minutes in warm water. Expect better function within about three months, and expect the change in grip and movement to be larger than the change in pain.
Where the joints are painful across several fingers at once and stiffness is worst first thing, the wider picture of training with inflammatory arthritis is covered in PhysioHub’s guide to exercising with rheumatoid arthritis.
These are ranked on how much they contribute to a hand that works, weighed against how many people can do them during a painful flare. Twice a day is the standard dose, and the whole set takes under ten minutes.
| Exercise | Best for | Dose | Load on the joints |
|---|---|---|---|
| 1. Tendon glides | Morning stiffness and lost range | 5 cycles, 2–3× daily | None |
| 2. Gentle grip squeeze | Grip strength for jars, bags and taps | 10–12 gentle pulses, 2× daily | Low, adjustable |
| 3. Thumb web-space hold | Pain at the base of the thumb | 10 holds of 5 seconds | Low |
| 4. Finger table lifts | Straightening the fingers fully | 10 lifts per finger, 2× daily | None |
| 5. Thumb opposition rings | Pinch, buttons and small objects | 5 reps per finger, 2× daily | None |
Doing them after five minutes in warm water makes the range easier to reach, which is why most hand programmes suggest it.
This is a documentary review of published trial evidence rather than a programme prescribed for your hands. Around fifteen exercises commonly given for stiff and arthritic hands were considered, including the five here plus wrist flexion and extension, forearm rotation, finger abduction against a band, lateral pinch strengthening, putty rolling, individual finger extension with a rubber band, thumb flexion to the base of the little finger, and composite fist holds.
Three criteria decided the ranking: how much each contributes to everyday hand function, how well it is supported by trial evidence, and how many people can do it during a painful period.
The sources read were the SARAH trial, a UK randomised trial of 490 people with rheumatoid hand pain across 17 NHS sites, and the 2017 Cochrane review of exercise for hand osteoarthritis by Østerås and colleagues. Evidence checked in August 2026.
What could not be checked: no trial has ranked these five against each other, and the Cochrane evidence for hand osteoarthritis is graded low quality, meaning the true effect could be larger or smaller than the trials suggest. A hand with sudden severe swelling, a finger that locks in a bent position, numbness that wakes you at night, or joints that are hot and painful with a fever needs assessing rather than exercising.
Separate movement from strength. Tendon glides and finger lifts restore range and can be done every day, including during a flare. Grip and thumb work builds strength and is the part to ease off when joints are hot.
Warm the hands first. Five minutes in comfortably warm water before the session gets more range out of the same effort, which matters most first thing in the morning when hands are at their stiffest.
Aim at what the hand has stopped doing. Jar lids and taps point at grip. Buttons, coins and zips point at thumb opposition. Pain when you pinch a key points at the thumb base. Choosing by the lost task keeps the programme short.
Expect function to improve before pain does. That was the SARAH finding, and it is worth knowing in advance, because a programme that is clearly working can still leave the hands aching.
What it is
A sequence of four hand positions that moves the finger tendons through their full range: flat hand, hook fist, full fist, then straight fist.
Who it suits
Everyone with a stiff hand, including during an inflammatory flare when nothing else is comfortable.
How to do it
Start with the fingers straight. Bend only the top two joints to make a hook. Then curl into a full fist. Then straighten the knuckles while keeping the fingertips down, which makes a flat-topped fist. Return to straight. Five cycles, two to three times a day.
What the evidence supports
Each of the four positions moves the tendons a different distance through their sheaths, so the sequence covers a range that ordinary hand use does not. Tendon and joint range work of this kind is a standard component of hand therapy programmes, including the stretching half of the SARAH programme that improved hand function at 12 months.
Limits and cautions
Forcing the full fist when the knuckles are swollen achieves nothing and hurts for the rest of the day. Go to the edge of comfort and stop. Anyone with a finger that catches or locks as it straightens should have that looked at rather than working through it.
Time and effort
Two minutes, sitting anywhere, with nothing needed.
Why it made the list
It ranks first because it is the one exercise that stays available in every week of the year, and because lost range is harder to win back than lost strength.
What it is
Squeezing a soft sponge or a piece of light therapy putty in the whole hand, in gentle pulses rather than a sustained crush.
Who it suits
Anyone struggling with jars, taps, bags or a kettle, which is usually the first practical loss people notice.
How to do it
Hold a damp sponge or soft putty in the palm and squeeze to about half of your maximum, holding for two seconds, then release fully. Ten to 12 pulses, twice a day. Progress by moving to a firmer sponge or a stiffer grade of putty rather than by squeezing harder.
What the evidence supports
Grip strengthening is the strength half of the SARAH programme, which improved hand function at 12 months in 490 people with rheumatoid arthritis. The Cochrane review of hand osteoarthritis exercise pooled five studies of grip strength in 362 people and found a small to moderate improvement, on low-quality evidence.
Limits and cautions
Hard grippers and spring devices are the common mistake, particularly with thumb base arthritis, where a strong crush grip loads exactly the joint that hurts. Stop during a hot, swollen flare and return to tendon glides.
Time and effort
Two minutes, and a kitchen sponge does the job.
Why it made the list
Grip strength is the measure that tracks most closely with what a hand can actually do, and it is the one that responds to training.
What it is
Holding an open C shape between thumb and index finger against light resistance, keeping the space between them wide.
Who it suits
Anyone with pain at the base of the thumb, which is the single most common site of hand osteoarthritis and the one that interferes most with daily tasks.
How to do it
Make a wide C shape with the thumb and index finger, as though holding a mug from above. Place a soft ball or a rolled flannel inside the C and press gently inwards, keeping the web space open and the thumb joints straight rather than collapsing. Hold five seconds, ten times.
What the evidence supports
Thumb base pain is aggravated by pinching patterns that pull the thumb across the palm. Training the muscles that hold the thumb out and away supports the joint in the position it is stable in, and thumb strengthening of this kind sits in the exercise arm of the hand osteoarthritis trials pooled by Cochrane.
Limits and cautions
Letting the middle joint of the thumb buckle inwards during the hold trains the pattern you are trying to avoid. Watch the shape rather than the effort. This exercise pairs with changing how you open jars and turn keys, and neither works well alone.
Time and effort
Two minutes, with a soft ball or a rolled flannel.
Why it made the list
It targets the joint that causes the most trouble per square centimetre in the whole hand.
What it is
Resting the hand flat on a table and lifting one finger at a time, keeping the others down.
Who it suits
Anyone whose fingers no longer straighten fully, and anyone whose hand feels clumsy rather than weak.
How to do it
Hand flat, palm down, fingers straight. Lift one finger as high as it will go without the hand rocking, hold for a second, and lower. Ten lifts per finger, twice a day. Progress by holding at the top for three seconds.
What the evidence supports
Straightening the fingers is a weaker action than bending them, and it is the direction that is lost first in a hand that spends its day gripping. Working it directly is a standard part of hand therapy, though there is no trial isolating this exercise from the rest of a programme.
Limits and cautions
Rocking the whole hand to lift one finger higher is the usual fault. The height is small and that is fine. The ring finger will lag behind the others in almost everyone, which is anatomy rather than a problem.
Time and effort
Two minutes, at any table.
Why it made the list
It covers the one direction the other four exercises leave out, and it takes almost no time.
What it is
Touching the tip of the thumb to the tip of each finger in turn, making a round O shape each time.
Who it suits
Anyone struggling with buttons, coins, zips or picking up small objects.
How to do it
Touch the thumb tip to the index fingertip and make the O as round as you can, hold for two seconds, then open the hand fully before moving to the middle finger. Work down to the little finger and back. Five rounds per finger, twice a day.
What the evidence supports
Opposition is the movement that separates a human hand from a paw, and it is the one that fine tasks depend on. It is a mobility and coordination exercise rather than a strengthening one, so it belongs in the range half of a programme.
Limits and cautions
Letting the O collapse into a pinch with a flat thumb is the fault worth watching, because it is the exact position thumb base arthritis dislikes. Roundness is the point.
Time and effort
Two minutes, anywhere.
Why it made the list
It ranks last because it builds no strength, and it stays on the list because the tasks it protects are the ones people mind losing most.
| Exercise | Main target | Builds strength | Usable in a hot flare | Equipment | Everyday task it protects |
|---|---|---|---|---|---|
| Tendon glides | Finger range | No | Yes | None | Making a fist, holding a rail |
| Gentle grip squeeze | Grip strength | Yes | No, pause it | Sponge or putty | Jars, taps, carrying bags |
| Thumb web-space hold | Thumb base stability | Yes | Reduced only | Soft ball or flannel | Keys, jar lids, kettles |
| Finger table lifts | Finger straightening | Slightly | Yes | A table | Flattening the hand, typing |
| Thumb opposition rings | Pinch and coordination | No | Yes | None | Buttons, coins, zips |
Three of the five stay available during a flare, which is what keeps the routine going through the weeks when the hands are at their worst.
If your hands are hot, swollen and painful right now, do tendon glides, finger lifts and opposition rings only, and bring the grip and thumb work back as the flare settles.
If pain sits at the base of the thumb when you pinch or turn a key, the web-space hold is the priority, alongside changing how you grip lids and taps.
If jars and taps are the problem, prioritise the grip squeeze and build it slowly over eight to twelve weeks.
If the fingers feel clumsy rather than weak, tendon glides and opposition rings are the pair that matter, done little and often through the day.
If numbness or pins and needles wake you at night, this is likely a nerve rather than a joint problem. Our guide to median nerve glides covers what to do instead.
If you have inflammatory arthritis, work these around your flares rather than through them, and read our guide to exercising with rheumatoid arthritis for how the rest of the week should look.
Hand and thumb complaints arrive in a seasonal wave in the Uckfield clinic, and early autumn is one of the peaks. The gardens around Wealden get cut back between September and November, and a fortnight of secateurs, hedge trimmers and pulling roots is a large, sudden increase in gripping for a hand that was doing very little of it in August. The same pattern shows up after a few days of DIY, and it catches people who would never describe themselves as having arthritis.
What has changed in the last couple of years is how often that wave now includes the base of the thumb rather than the wrist. The clinical point is that a thumb base that hurts after gardening is rarely damaged by the gardening. It is a joint with reduced capacity meeting a fortnight of unusual load, and the fix is a mix of building the muscles that hold that joint steady and changing the tools so the thumb is not doing the crushing. A pair of ratchet secateurs changes the load more than any exercise does.
Where thumb or finger joints have been painful for months rather than weeks, our page on osteoarthritis sets out how it is assessed and what a plan usually involves.
Do hand exercises actually help arthritis?
They help function more than they help pain. The SARAH trial randomised 490 people with rheumatoid arthritis of the hands and found that a tailored strengthening and stretching programme improved hand function at 12 months by 4.4 points on the Michigan Hand Outcomes Questionnaire, with no difference in pain scores. For hand osteoarthritis, a 2017 Cochrane review found low-quality evidence of small to moderate benefits for pain, function and stiffness.
Should I exercise my hands when the joints are swollen and hot?
Move them gently, and leave the resistance work alone until the flare settles. During an inflammatory flare, tendon glides through a comfortable range keep the joints moving without loading them. Heavy putty, repeated pinching and strong gripping are the ones to pause.
Why are hand exercises easier after warm water?
Warm water raises the temperature of the tissues around the joint, which makes the capsule and tendons more extensible and reduces the stiffness people feel first thing. Five minutes in a bowl of comfortably warm water before the exercises is the simplest way to get more range out of the same session.
What is the best exercise for pain at the base of the thumb?
The thumb web-space hold. Thumb base arthritis is aggravated by pinching movements that pull the thumb across the palm, and holding an open C shape against gentle resistance works the muscles that keep the joint seated without squeezing it. Building that up alongside changing how you grip jar lids, keys and kettles is the usual combination.
How long do hand exercises take to work?
Give it 12 weeks. The SARAH programme ran for four months with six therapist sessions and daily home exercises, and the benefit was still present a year later. Hands respond slowly compared with larger joints, partly because the exercises are low load and partly because the hand is used constantly through the day.
Will squeezing a stress ball make arthritis worse?
Gentle, controlled squeezing is fine and is part of most hand programmes. Hard, sustained squeezing of a very firm ball is what irritates arthritic joints, particularly at the base of the thumb. The useful version is a soft sponge or light putty, pulsed rather than crushed.
Can hand exercises stop arthritis progressing?
No, and no exercise programme claims to. What they change is how much the hand can do and how strong the grip stays, which is what most people are actually losing. Joint changes on an X-ray and the amount of trouble a hand causes are only loosely related.
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