By Alain Alvarez, MD
A patient guide from Dr. Alain Alvarez, Rheumatologist
If your hands have arthritis, you already know it’s not the big things. It’s a hundred small ones — a jar lid that won’t budge, a shirt button that takes three tries instead of one.
Every week, patients ask me the same question: “What should I actually buy?” There’s no shortage of answers online — compression gloves, splints, gadgets that promise relief in a headline. But not everything that’s popular has been tested. And a few things that have been tested didn’t hold up the way people expected.
So I went back to the research — the 2019 guideline from the American College of Rheumatology and the Arthritis Foundation, along with the clinical trials behind it — and I want to walk through it with you. Not a shopping list. An honest look at what the evidence shows.
Hand exercises and therapy putty — strong evidence
Let’s start with the one that surprises people: exercise. Not just “stay active,” but specific, structured hand exercises — and something as simple as therapy putty, a soft, stretchy dough you squeeze to build hand strength.
A review of hand exercise studies in rheumatoid arthritis (a type of arthritis where your immune system attacks your joints) found real improvements in grip strength, without making pain or disease worse. Putty-based exercise programs improved hand function and quality of life over twelve weeks.
In the UK, this idea grew into a full program called SARAH — Strengthening and Stretching for Rheumatoid Arthritis of the Hand. It’s recommended in national guidelines, and there’s now a self-guided online version.
If you take away one thing from this article, let it be this: hand exercises are the cheapest tool on this list, and they have the strongest evidence behind them.
Paraffin wax heat therapy — moderate evidence
Next: paraffin wax baths. You dip your hands in warm, melted wax, let it set, then peel it off.
It sounds almost too simple, but a review of randomized trials (studies that compare a treatment group with a control group by chance assignment) found it measurably reduced pain and improved grip and pinch strength — especially over several weeks, and especially paired with exercise.
The evidence isn’t huge — we’re talking about a handful of small trials — but it’s consistently positive, and the risk is low. Countertop units are inexpensive and easy to use at home.
I tell my patients: this is a solid, low-cost addition. It’s not a replacement for exercise, but a good partner to it.
Thumb splints — mixed evidence
Here’s where I want to be honest with you, because this one surprised even me.
Splints for the base of the thumb — the joint most affected by hand osteoarthritis (the “wear and tear” type of arthritis) — are recommended in the guidelines. Earlier trials showed they help with pain and function.
But the most rigorous trial we have — a large study of 349 people called OTTER II — found that adding a thumb splint on top of a good self-management and exercise program didn’t add extra benefit. Everyone improved. The splint group didn’t do better than the exercise-only group.
So what does that mean for you? A splint can still help you get through a flare, or a task that really aggravates your thumb. Just don’t expect it to replace the exercises above. Think of it as backup, not the main plan.
Compression gloves — weaker evidence than expected
Compression gloves are everywhere, and I understand the appeal. They’re comfortable, they’re marketed everywhere, and plenty of people swear by them.
But the largest trial we have, called A-GLOVES, tested real compression gloves against a placebo glove (a fake version made to look and feel the same, used for comparison) in over a hundred people with rheumatoid arthritis. After twelve weeks, both groups improved about the same amount. The researchers concluded that routine use could reasonably be stopped.
Here’s the interesting part, though: people in both groups still said the gloves helped them feel better — and pointed to the warmth, not the compression, as the reason.
So if you already love your gloves, keep wearing them. They’re low-risk, and warmth genuinely does help sore joints. Just know you’re paying for comfort, not for a proven mechanism.
TENS units — mixed evidence
Last one: TENS units (Transcutaneous Electrical Nerve Stimulation) — small devices that send a mild electrical pulse through your skin.
The research here is genuinely mixed. One review of TENS for rheumatoid arthritis of the hand found some short-term benefit for pain. But newer, broader reviews of TENS for nerve-related pain haven’t found a clear effect.
My honest take: it’s low-risk, and some of my patients do find relief, especially when they use it around activity, not instead of it. Just don’t expect it to be a stand-alone fix.
The daily-living toolkit
Not everything that helps has been through a randomized trial, and that’s okay. The guidelines recommend something simpler: look at what’s actually hard for you, and get a tool that removes that specific barrier. This is called joint protection, and it’s genuinely evidence-based advice, even when the individual gadget isn’t.
A few categories worth knowing:
. For jars and lids — an electric jar opener for the toughest days, or a simple rubber-grip opener for everyday use.
. In the kitchen — swivel peelers, rocking garlic presses, and utensils with built-up handles that don’t ask your fingers to curl tightly.
. For writing — an ergonomic pen, or a foam grip added to a pen you already own.
. For getting dressed — a button hook with a zipper pull. It consistently ranks as the single most useful dressing aid for arthritic hands.
. Around the house — key turners and silicone doorknob covers that turn a pinch-grip task into a whole-hand task.
One practical tip: look for the Arthritis Foundation’s “Ease of Use” seal. It means the product was actually tested by people with arthritis and reviewed with input from hand therapists (specialists who help you keep or regain use of your hands) — not just popular on a shopping site.
The take-home message
If I had to boil this down to one sentence: exercise first, comfort tools second.
Hand exercises and therapy putty have the strongest evidence. Paraffin wax is a great low-risk add-on. Splints, compression gloves, and TENS can genuinely make you feel better — just go in knowing the evidence for each is more modest than the marketing suggests. And for the everyday stuff — jars, buttons, keys — the right tool really can give you back a little independence, one task at a time.
None of this replaces a conversation with your rheumatologist or a hand therapist, especially if your hands are changing quickly, or the pain is new.
This article is for general education only. It isn’t a substitute for individualized medical advice. Please talk with your rheumatologist or hand therapist about what’s right for you.
Sources: 2019 ACR/Arthritis Foundation Hand Osteoarthritis Guideline; Bergstra et al., Clin Rheumatol 2014; Choudhry et al., Indian J Physiother Res 2024; Srikesavan et al., J Hand Ther 2025; Kim et al., J Hand Ther 2023; Buhler et al., Osteoarthritis Cartilage 2019; Adams et al. (OTTER II), Rheumatology 2021; Hammond et al. (A-GLOVES), BMC Musculoskelet Disord 2021; Brosseau et al., Cochrane Database Syst Rev 2003; ElMeligie et al., BioMed Res Int 2025; Arthritis Foundation Ease of Use Certification Program.
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