How to improve your hand function

Our helpline team look at how MS can affect hand function, and the things that can help

MS can impact on hand function due to sensory impairments (loss of feeling) and the direct functional impact of multiple sclerosis (MS) activity within the central nervous system (CNS). This means that sensory information is not being sent around your body effectively. MS can also affect coordination, dexterity and grip strength too.

These symptoms are caused due to MS activity interfering with signals being sent along nerve fibres and around your body. MS causes inflammation within your CNS, which damages the axons and neurons (parts of the nerve fibre) that help transmit ‘messages’ from your brain and spinal column to the rest of your body.

It is like getting poor signal on an old mobile phone. The signal/message received may be patchy or in some cases, not work at all. When the MS activity is damaging the axons and neurons, the nerves cannot conduct messages to your brain as effectively as they should.

If hand function is affected by your MS, the symptoms may initially appear mild or of little concern, but over time this may change. This is especially the case if more damage is done to nerves affected by previous MS activity.

In some instances, where there is nerve damage the brain can be trained or taught to find new neural pathways to get messages through. Science calls the creation of these new neural pathways (now carrying the message via a ‘diversion’) ‘neuroplasticity’.

MS and my hands, what can I do?

We often get asked about self-management and ‘what can I do to help myself’?

• As explained briefly above, the right types of exercise, movement and training can help teach your brain to reroute messages. Through regular use (functional exercise) you can reaffirm new pathways and help with neuroplasticity. The Helpline team have gathered five top tips to help if hand function is a concern.
• In January 2025 Dr Gretchen Hawley delivered an information session titled ‘Building new pathways – the role of neuroplasticity and remyelination in MS’. This session which can be viewed via the portal section of our website gives practical strategies and the latest research to help improve movement and enhance strength. Dr Hawley also delivered a session all about hand therapy and exercise.
• You could try some simple hand warm-up exercises (as suggested by Cambridge University Hospitals NHS Foundation Trust). These can be done as part of your morning routine to help you get started for the day and can help kick-start sensory and tactile awareness. You could try some basic exercises that can help maintain or boost hand strength. For example, ‘finger aerobics’ and ‘finger stretches’ are exercises that are designed to warm up your hands in readiness for activity and help to build or maintain hand strength.
• You can practice squeezing using different types of grip and different types of material. Squeezing and manipulating Play-Doh is good exercise you can use your whole hand grip or individual fingers. You can squeeze, hold for a few seconds, then release.
• You can also complete a range of other more ‘natural’ home-based activities too. You can do finger and hand-based exercises and training with normal household objects, whether that is stacking coins, popping bubble wrap, turning over beer mats or playing cards, or rolling marbles between your fingers and thumbs. You can also complete hobbies and activities that use fine motor skills. This could range from model making, completing jigsaw puzzles or even Lego building.

There are a range of specialist therapeutic hand putty products on the market that have been specifically designed with hand rehabilitation in mind. Therapeutic hand putty is used by physiotherapists as a means of helping people build grip strength, help with dexterity and useful functional hand uses (such as pinching, tube and ball rolling and thumb flexes). The hand therapy department of the Chelsea and Westminster Hospital NHS Foundation Trust has written a guide to a therapy putty purchase. They mention that the hand therapy department does not recommend any single company over another and their information has been designed to provide a resource to help with a range of buying options.

For people who live with less functional use of their hands, Hand reflexology and gentle massage can be beneficial for the sense of wellbeing it can bring. In the ‘exercise from home’ handout (linked above) Naturopath Katie Ruane explains how to use hand reflexology to boost wellness. Katie explains massage techniques, suggests comfortable amounts of pressure to apply and says that hand reflexology can be a good thing to do in the evening before bed, to help aid relaxation and get better sleep.

Who else can help with my hand function?

We suggest that prior to starting any new type of hand exercise regime, you should speak to your health team. It is important to get an assessment from your neuro team as they have professionals such as a physiotherapist or occupational therapist that can help. These professionals can measure and establish a baseline (how your hands are functioning now) and can help identify and guide you over the type of hand exercise and strengthening tools that would be right for you.

If you are lucky enough to live near one of the Neuro Therapy Centre’s or specialist MS support organisations close to your community, there may be additional help there too.

How can I measure my hand function and see if there are changes?

For a long time there has been an emphasis on measuring the progression of people’s MS by the distance they can mobilise. This was certainly true when it came to the inclusion and exclusion criteria for research and clinical trials. The Think Hand Campaign was initially launched in 2016 to help raise awareness of the importance of upper limb function in MS and to develop ways of measuring and recording consistent data about hand function.

The 9-hole peg test is the ‘gold standard’ for monitoring arm and hand function in MS and was promoted heavily during the launch and roll out of the think  hand campaign. The 9-hole peg test is often used in clinical trials, for remotely monitoring a person’s ability and in Neurology clinic’s for measuring changes in hand function.

You can buy a version to use at home for £9.99 from professor Professor Giovannoni and the team at Clinic Speak. Check the link for more details,  and a short video and some Q&A’s about hand function and MS.

Are there any aids to help with hand function?

There are a range of independent living aids designed to help people with limited hand function. These can range from straps to help someone hold onto objects, to adaptive cutlery with a range of ergonomic grips. Some of the better known small aids include large grips for door keys and mouldable grips for pens and pencils.

Most mobility shops can let you know what products are available. If you prefer to buy online, it will be useful for you to know about Living Made Easy. The Living Made Easy website is owned by the Shaw Trust charity and give you buying guides written by health professionals can act as an independent catalogue of products, and can act as a comparison tool, linking you to the cheapest available product.

One particular brand stands out. Active Hands was launched by a mechanical engineering student at Warwick university who survived a spinal injury but was left with partial paralysis.

The award-winning Active Hands has lived experience at the heart of what they do and for the last 20 years have been producing a range of aids to help with exercise, hobbies, personal care, DIY, gardening and for use in the kitchen.

Active Hands products are not particularly cheap but their small item gripping aid can be used with small paint brushes and their specialist aids for fishing, kayaking can keep activity accessible.

There may be other gripping aids on the market too.

If you need any additional support and guidance, please remember that our Helpline team are here if you need us. We can be contacted by telephone on 0800 783 0518 (Monday to Friday 10am to 4pm), via our website webchat facility, WhatsApp or send us an email on info@ms-uk.org.