Therapy helps clients get grip on arthritis

Molly Ball

Monday, Dec. 19, 2005 | 8:27 a.m.

Try to imagine life without the use of your hands.

If you had an itch, you couldn't scratch it. If you wanted to remember something, you couldn't write it down. If you wanted to leave the room, you couldn't turn the doorknob. And let's not even talk about using the bathroom.

"It's degrading for an individual," said Audrey Lloyd-Davies, a certified hand therapist. "You don't want somebody feeding you and cleaning you. People who can't use their hands get grumpy, and they start to turn away from life."

Lloyd-Davies devotes part of her practice to working with arthritis sufferers, massaging their hands and teaching them strategies to save their joints. She says it is the Las Vegas Valley's first arthritis hand therapy program.

"I'd rather not have surgery if I can do something to avoid it," said Colleen Hansen, a 56-year-old Las Vegan who developed osteoarthritis when a hand injury from a workplace fall wasn't treated properly.

Lloyd-Davies was using an ultrasound wand to massage hot paraffin wax into Hansen's limp, pink hand. The sound waves from the wand push the wax deeper into the skin.

Hansen's long fingernails were elegantly French manicured. But before she met Lloyd-Davies, her situation wasn't pretty.

"It was constant pain," she said. "It would wake me up at night." Working as a hairdresser, she couldn't grip a curling iron, and it was difficult to grasp a pen to write.

Arthritis, a condition of the weakening of the joints that can have several different causes, is not curable. Doctors treat it with medication that eases the pain, but the medicines do nothing to slow the disease's progress or keep the joints from becoming gnarled and unusable.

As the disease advances, surgery may be necessary to relieve the unbearable pain, either transplanting a tendon to cushion the joint or replacing the joint with an artificial one.

Lloyd-Davies' therapy aims to slow down arthritis and preserve the hands' function so they do not get to that point.

In addition to massaging their hands to keep the joints flexible, she teaches patients to use a wide variety of odd-looking accessories. After about six sessions, patients do not need to keep seeing Lloyd-Davies -- they know how to do the therapy, use the accessories and adapt their lifestyles to weak joints.

"A lot of what I do is education," Lloyd-Davies said. "I want to give them a strong home program that they can follow themselves."

Hansen has a paraffin bath at home in which she soaks her hand. The wax's moisture and warmth are soothing -- cold is painful for arthritics. Coating the hand with wax, wrapping it and then peeling the wax off after about 15 minutes can relieve pain for several hours. She also uses a cooling menthol salve called "Biofreeze" that can soothe hands for four hours.

Hansen sleeps with a special brace on her hand. It wraps around the base of her thumb to keep the joint aligned. Thickening or broken ligaments can pull fingers in one direction, sometimes even causing the extensor tendons that run down the back of the hand to slip off the knuckles. Keeping the hand in the correct position helps prevent this.

Lloyd-Davies' props also include a variety of different splints, which similarly keep fingers and hands correctly aligned. Donut-shaped cloth sacks filled with special moisture-producing beads can be chilled in the freezer or heated in the microwave, then placed around the hand or wrist. A simple plastic device can open bottles and jars of all sizes to avoid putting stress on the wrist joints.

About 10 percent of Lloyd-Davies' patients are arthritis sufferers, she said. She sees about 100 patients a week for a variety of hand problems, which also include fractures and repetitive stress injuries.

"I really have an interest in arthritis," said Lloyd-Davies, who became a hand therapist when the field was in its infancy 30 years ago. Through her programs, sufferers "feel better and have more use of their hands, which makes them very happy."

Hansen said her pain has decreased since starting the therapy, and everyday tasks, like using a curling iron, have become possible again. She also has made changes in her lifestyle, like buying thick-barreled pens with gripping pads that make it easier to write.

One of the main causes of arthritis is simple wear and tear. Our hands are made up of 26 bones connected by a delicate lattice of ligaments that make the wrists and fingers twist in every direction. Every motion, Lloyd-Davies said, is "a complex choreography."

Because we use our hands in almost every part of our lives, they are heavily stressed, so they are one of the most common parts of the body to be affected by arthritis.

Lloyd-Davies said there are a few things ordinary people can do to avoid stressing delicate hand joints.

Women who carry heavy purses should sling the straps over their forearms rather than their wrists or fingers, she said. And people getting up from a seat should put their hands flat on the armrest rather than making a fist and putting pressure on their knuckles.

As Lloyd-Davies rubbed lotion into Hansen's hand, she said, "The soft tissue massage feels good, but I also take her through the full range of motion."

She told Hansen not to grip things too tightly or use a finger-strengthening squeeze ball. "You're not going for strength, you're going for range of motion," she said.

"I'm going for pain-free," Hansen answered.