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Upper Body Strength

New to the group - Hi!
Have had RA for about 2 years - MTX 20mg/week + Plaquenil + various "alternatives" too (Omega 3, Curcumin, flax seed oil, Vit D3...) - I'd consider it reasonably steady-state - stiffness and some pain still there but not getting worse.

Had a visit with Dr this week - I mentioned that the standard questions we all have to answer before our appts don't cover weakness in the metacarpophalangeal joints (where your fingers meet your palm). I have good strength in my arms and don't have a major issue with opening large-mouth jars because I can use my whole hand and fingers - I am dexterous enough to not have a problem buttoning or tying. Where I have a problem is small turning strength like opening a small lid water bottle or turning the key in my car or holding a plate or a frying pan... Now here's my issue - Doc basically blew off my concern and said that I need exercise to improve my upper body strength. I tried to discuss and say my arms and shoulders are strong and that isn't the issue I'm having - it isn't even a weakness in my wrist but is just the specific motion where there is weight on the side of my pointer finger. She nearly cut me off and said that if I have stronger arms it would solve the problem.

Frankly, I don't get the connection - am I missing something?


  1. Thanks so much for reaching out with your question! I'm glad you found our online community.

    I agree that it if you are able to perform other activities with your upper body without much trouble that this could be more specific than a need to "improve upper body strength." Have you ever considered seeing an Occupational Therapist? OTs are able to determine specific exercises that can optimize mobility and use of function. Here is an article about occupational therapy:

    If you are feeling that your doctor is not adequately concerned about your symptoms and/or not providing you with enough information, it could be worth seeking a second opinion. Here is an article with some tips about finding a good rheumatologist: Depending on where you live and how many rheumatologists are in your area, this may or may not be a viable option. However, having a doctor you feel you can trust and who is concerned about your symptoms goes a long way in developing confidence in your treatment plan. Furthermore, I notice you didn't mention a biologic drug being part of your medical regimen. Perhaps this is something you and your doctor have discussed and decided not to try at this point. However, if that conversation has not been had it is worth discussing the pros and cons of biologics for your individual case, as for some people biologics further reduce disease activity than DMARDs like Plaquenil or Methotrexate alone. You can read about biologics here:

    Please do continue reaching out anytime you have a question, concern, or experience you'd like to share. For your own safety we are not able to offer medical advice, however it can sometimes be helpful to have our feelings and perspectives validated. In your case, I definitely think you should trust your gut and continue trying to pursue finding answers for your hand weakness, perhaps through consulting another rheumatologist and/or an occupational therapist.

    Wishing you all the best,

    1. Hi MES20874. In my opinion, your Rheumatologist didn't really listen to you. If you are stiff all day, I wouldn't call your RA well controlled. I used to have trouble with water bottles, car keys and carrying plates, but I found a Rheumatologist who would listen to me and was willing to treat me aggressively. I can do all of those things now... except the occasional water bottle still stymies me, but not often.
      I'm on Plaquenil, just got off MTX as a precaution for something else, and am on Xeljanz. I am concerned how my RA will be when the MTX gets out of my system because it did quite a bit of good, but my doc wants to run some tests before letting me go back on it. I have been on Xeljanz for about 2 years. I was functional without it, but in pain and had limitations. When I got on the Xeljanz, I started to be able to open my own water bottles and my SED rate went down. I agree with Tamara that maybe it is time to ask your doctor about a biologic. If she is not receptive, ask why you aren't a good candidate. There could be a valid reason, or it could just be out of her comfort zone. Ask what percentage of her patients she puts on biologics. That will tell you a lot. If that number is low or she says she really doesn't use them except in extreme cases, you might need to look for another doctor. If it makes you feel any better, I am not still with my first Rheumatologist or my second. Neither thought there was anything much wrong with me because my joints didn't appear red, hot or swollen. The third one looked at the bloodwork and listened to me. Finding him changed my life.
      Don't be afraid to advocate for yourself.
      Good luck!

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