6 Hand Exercises for Multiple Sclerosis

Numbness or tingling in the hands, arms, and legs is often the earliest symptom of multiple sclerosis (MS), according to the National Multiple Sclerosis Society (NMSS). But symptoms affecting the hands can also include pain, muscle weakness, tremors, and problems with hand-eye coordination, says Linda Walls, an occupational therapist and consultant for the Can Do MS center in Avon, Colorado, for more than 25 years.

All of these symptoms are caused by a disruption in communication between the central nervous system (the brain and spinal cord) and the sensory nerves in the hands. When your hands are affected, everyday tasks — such as writing, typing, getting dressed, and grasping or picking up objects — can become more difficult.

Is there anything that can help? Yes. In a word, exercise. “I recommend exercise to keep muscles moving and stretched, and it also stimulates the nerves to help with sensation,” explains Walls. “The goal is maximizing range of motion and strength so you can maintain the best function of your hands and stay independent with everyday activities.”

Hand exercises when you have MS can help you maintain or improve your hand function so you're better able to perform activities that require hand strength and coordination. Plus, the exercises will help with stiffness that may develop from some muscles being tight, adds Walls.

The following hand exercises for MS can also improve your ability to grip and pinch with your hands. Perform the exercises slowly, and pay attention to how you feel. “Do the exercises to a count of 2 or 3 so your muscles have a chance to fully respond and go through the full range of motion,” advises Walls. As your range of motion and strength improve, you can add resistance to increase your hand and forearm strength.

RELATED: How to Manage Numbness, Tingling, and Other Sensory Symptoms of MS

1. Finger Flexion and Extension

The goal of finger flexion and extension exercises is to slowly increase range of motion and strength, says Walls.

How to Do It Bend the fingers of one hand toward the palm to make a fist, then straighten your fingers and stretch out your hand. Start with one set of 10 reps a day, then progress to two sets in a row (or do one set twice a day). Repeat with the other hand.

If one hand is more affected by MS symptoms than the other, you might do two sets on that hand and only one set on the stronger hand. You can also use the less affected hand to stretch the more affected hand. But be careful not to overdo it. “Hand muscles easily fatigue,” warns Walls.

To focus more on strength, hold a rolled-up washcloth or ball of therapeutic putty in your hand as you squeeze and release. Place the washcloth or putty on a tabletop, squeeze it in your hand, then push or roll it back out with your fingers. These objects will provide some resistance. Walls frequently recommends Theraputty, which is available on Amazon and often comes with some pictured exercises. “I recommend a soft to medium resistance, not a firm resistance,” says Walls. “The added benefit of using Theraputty or a washcloth is the sensory stimulation that helps with numbness.”

Hand exercises should always be done in groups, adds Walls. “I have seen too many who work on finger flexion and forget that finger extension is just as important.”

2. Finger Abduction and Adduction

Finger abduction and adduction exercises are important for improving range of motion, says Walls.

How to Do It Straighten the thumb and fingers of one hand. Spread the fingers apart and then squeeze them together. Perform three to five repetitions to start; progress to 10 to 15 reps. Repeat with the other hand.

To add resistance, place a rubber band around your fingers when they're in the closed position (it should fit snugly), and then spread them apart, pressing against the band. You can also use a small rubber band on two or three fingers at a time.

RELATED: Rehabilitation for People With Multiple Sclerosis

3. Finger Pinch

Finger pinch exercises are effective for picking up and holding small objects such as a button or a coin.

How to Do It Roll a washcloth or putty into a tube shape. Using your thumb and index finger, pinch along the tube from one end to the other. You can also just do thumb to each finger for coordination and range of motion, says Walls. To strengthen your palm, use your thumb, index finger, and third finger to pinch a washcloth or putty or a Nerf ball. Perform the exercises three to five times with each hand, working up to 10 to 15 reps. Repeat with the other hand.

After working on pinch, take a minute to fully open the hand and stretch the muscles you just worked in the opposite direction to encourage strength and range of motion, adds Walls.

4. Rice Exercises

Rice exercises are effective for general strengthening and sensory stimulation to the hand.

How to Do It Place a large bag (or two) of rice in a big bucket. Place your hands in the bucket and open and close them in these various positions:

• Palms facing each other
• Palms facing away from each other
• Palms facing your body
• Palms facing away from your body

You might also rotate your hands in a clockwise direction, and then counterclockwise, in the rice.

5. Movement Therapy, or ‘Piano Hands’

“This is a good strength and coordination exercise,” says Walls.

How to Do It Sit up tall in a chair, facing a table or desk. Place your hands, palms down, on the edge of the table (your forearms should be hanging off). Lift your fingers up and down, one at a time, as if you were playing the piano. Then move them up and down the imaginary keyboard. You might even do this to real music — play for 20 to 30 seconds of a tune to start. “This can be similar to typing on a computer keyboard,” notes Walls.

6. Dexterity Exercises

You can also try some hand physical therapy or hand occupational therapy, such as playing cards or video games, doing crafts that require dexterity, typing at your computer keyboard, or organizing your desk or kitchen drawers. Doing these exercises helps you focus your attention on developing functional movements and coordination, which will keep you engaged in everyday activities.

“Try to use your hands as much as possible for everyday tasks such as picking up coins from the table, writing a note, bathing, using lotion, dressing, and preparing a meal,” says Walls. The NMSS also recommends playing board games, building models, and functional activities like sorting nuts and bolts and organizing “junk drawers” in your home.

These activities won’t make hand pain go away, “but stretching helps get more blood flowing to your hands and can help you increase movement and manage tightness,” explains Walls.

Additional reporting by Jennifer D’Angelo Friedman.