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Make Needlework Less Painful

Try these finger-friendly tips to keep creating despite hand arthritis.

By Mary Anne Dunkin | Updated Nov. 15, 2023

For many people, needlework is an enjoyable activity that brings the satisfaction of making one-of-a-kind creations that are beautiful and functional. But if arthritis affects your hands, activities like knitting, crocheting, quilting and embroidery also brings pain. 

While needlework can cause some pain, it is generally not detrimental for people with arthritis in their hands, says Debbie Amini, director of professional development at the American Occupational Therapy Association (AOTA). 

“In fact, it can actually be an excellent method for maintaining movement and strength and increasing personal satisfaction and mental well-being through participation in a meaningful activity,” she says. However, if needlework causes pain or you have significant deformities in your hands it is important to pay attention to your tools and techniques. 

Before beginning any activity, Amini and occupational therapist Teresa Dufeny, practice manager for advanced certification at AOTA, recommend setting up your workstation for success. Have often-used items within easy reach, keep space organized and have an adjustable seat that supports your back and legs and allows positioning of your arms and support for elbows as needed, they advise.

“If your hands are generally stiff and cool, gentle warming with paraffin dips or hand warmers may help to improve mobility and comfort prior to beginning an activity,” Amini says. “However, if joints are red and inflamed, heat should be avoided, and time spent with the activity should be limited.”

While working, take joint breaks often, especially with activities requiring repetitive movement or those that require little movement for long periods of time. “[Try] standing, walking, or stretching all joints while seated, for three to five minutes every 30 to 45 minutes. Use larger joints for movement and stability where possible,” Dufeny says.

Listen to your body. Pain is not normal so try to avoid it, they say. If a particular position creates pain, try a new position. For individual forms of needlework, try the following tips: 

Embroidery/cross stitch
  • When doing counted cross stitch, choose a lower gauge fabric – meaning it has more space between stitches — to making moving the needle easier. 
  • Use the right tools — a hoop holder to free your non-dominant hand, which can then assist with needle movements (pulling needle through fabric); a needle threader to thread the floss; and a rubber thimble to add traction and reduce the force needed to pinch the needle. 
  • Consider punch-needle embroidery, which allows for better positioning of the hand and forearm and use of larger joints. The punch needle can be enlarged by wrapping with medical tape or duct tape.
Knitting
  • Try alternatives to metal needles, such as birch or bamboo needles, which are lightweight and warmer to the touch.
  • Stick with wool or wool blend yarns. Wool is elastic and more forgiving than cotton and other fibers, which makes it easier to manipulate.
  • Knit flat on a circular needle. Even if you don’t need to make a tube, the circular shape allows the weight of the sweater to fall in your lap, not off your wrist.
Crocheting
  • Try hooks with rubberized grips. 
  • If standard hooks cause pain or excessive pinching of your hands or fingers, try building up the handles with tape. 
  • Use a yarn tension ring to ensure best stitch tension.
Quilting
  • Consider using a sewing machine versus hand quilting for piecing and quilting.
  • Use electric scissors, spring-loaded scissors or rotary cutters. Scissors must be sharp and fit your hand.
  • Try working on smaller projects of “quilt as you go” to avoid having to manage a large quilt.
  • Consider sending the quilt to a long-arm quilting service for finishing.
If you experience problems, consider working with an occupational therapist who may have additional ideas, such as splinting to help you create without pain.

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