I have been trying physio to improve the range of movement in my right hand. I have painful PIP knuckle pads for 5 years and my "hook" type grip is affected. We have tried soaking, massaging and binding my hand in a clenched position several times a day. I expected it to be painfull but it is seems to be making things alot worse. Im very disappointed as i hoped to slow the progression. Movement usually improves my range and gets must worse after resting. I tried for 4 weeks is this long enough? I have also tried ultrasound and accupuncture with no improvement at best! Phsyio has no more suggestions! Im not a candidate for surgery but have had US guided cortisone injections to Ledderhose node on right foot 4 months ago with noticable improvement.
Could this also work on my knuckle pads? Am 36, female with stong DC family history.
Does anyone have any suggestions or phsyio experience for this problem?

Fiona, to me "gets must worse after resting" does not sound like knuckle pads. I would rather think of rheuma or some sort of arthrosis. That being the case exercising would cause pain and not do much good. Only a doctor can tell.