I "know someone" who has arthritis and because they are young most people never think of it when approaching them with a handshake. Sometimes a gentle squeeze is enough to bring tears. They are also private about their medical condition, but shouldn't be subject to pain or that awkward discomfort after declining a handshake from someone. Especially in a professional setting. Anyone have suggestions on how to do this in a less offensive manner?


9 Answers 9


suggestions on how to do this is a less offensive manner?

There is nothing offensive about declining a handshake because of a medical condition. Just politely decline saying you have a sore hand if you don't want to go into nitty gritty details.

  • 81
    The key is practicing the sentence. You don't need to think of a new phrase every time. Stick with a simple phrase like "Thank you. I have a sore wrist and can't shake your hand right now." Practice it until it is routine, so that it comes off as pre-meditated and well-thought-out instead of looking like you're trying to make up a lame excuse.
    – Nelson
    Commented Feb 11, 2019 at 9:38
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    @Nelson Using "right now" would leave most people thinking that it's a condition that will go away, and it would be alright to shake hands the next time you see them.
    – krillgar
    Commented Feb 11, 2019 at 13:40
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    Perfect example of "practicing and thinking it through" :) Revise when necessary and simply repeat the same sentence over until it is automatic.
    – Nelson
    Commented Feb 11, 2019 at 14:01
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    @krillgar And there's nothing wrong with repeating the "right now" answer every time. People will probably realise that it's a long-term "right now", which should still avoid offence. Commented Feb 11, 2019 at 16:21
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    I'd say I have a bunk wrist, and leave it at that. If they pry, then it's just "a bad wrist", and things are expected when you get older. Nobody needs to know you have a medical condition further than "it hurts", so stick with it.
    – Anoplexian
    Commented Feb 11, 2019 at 16:52

I'm going through this myself and straight up say that I can't shake hands because it's sore. If asked I don't mind saying it's because it's a form of arthritis. There's more of us out there than you might think - I actually work with a couple of people in the same boat.

If he's not already done so, he should see a rheumatologist as there's some great medication out there.

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    Some offer their other hand at the same time, to satisfy "custom" make others feel "welcome" or comfortable...
    – Solar Mike
    Commented Feb 11, 2019 at 5:31
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    @SolarMike True. I had that happen to me, but it is pretty rare. May be 1-2 times a year in the 25 years that I have a medical condition (not arthritis, but still painful enough a firm handshake is to be avoided at all costs).
    – Tonny
    Commented Feb 11, 2019 at 15:03
  • That is the approach I have been using for 25 years now. Usually works pretty well.
    – Tonny
    Commented Feb 11, 2019 at 15:04

This happened to me in college. I had an autoimmune thing going on while I was trying to get a job and was at job fairs constantly. It was an arthritic reaction that I was going though.

I wrapped my right hand in an ace wrap, and then carried a folder of resumes in my left. This deterred most people from shaking my hand because it was injured. If they asked about the nature of the damage, I explained it, but most didn't want to get into too much detail.

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    I was about to suggest a wrist brace. I think it would be less work putting it on and taking it off, plus it would likely be functional. Commented Feb 12, 2019 at 20:16

I'm sorry, I'd like to shake your hand but I'm dealing with a medical thing that makes it rather painful. But I'm very pleased to meet you.

That's your basic script. Explain why you can't shake hands with whatever words feel right to you, then add another short phrase to make it clear you're glad to see them. Other phrases you could use are:

  • I'm sorry, handshakes can be painful for me
  • It's nothing major but a handshake is very discomforting for me
  • I have an issue with my hands that makes shaking hands difficult

You can do the same things when you've already met someone before, simply adding a "I'm not sure if I mentioned it when we met" and closing with a "nice to see you again".

If this is a departure from your previous behaviour where you would just grin and bear it, it can be good to alert any co-workers or people you run into again. Say something like:

I have a medical condition with my hands that's under control but which has made it sometimes painful to shake hands so I'm going to avoid doing so in future.


Decades ago, this came up in a Dear Abby or Ann Landers column. The advice given was to extend your hand palm up with the fingers slightly curled. The other person should then just give a finger squeeze. (Palm down, fingers curled and fingers squeeze fingers. I think this was considered "the old lady handshake." Polite people knew that this was a signal to be gentle. This knowledge may have died out, but I encounter people who still do this.

Maybe the modern version is fist bumping. I think there is enough pandemic awareness now that if someone extends their hand and you respond with a closed fist, then they think you're being germ-careful and will bump back. The thought that you have a cold will probably pass through their minds, but it won't stay there long.

  • +1 for fist-bumping. I'm careful to do that instead of shaking hands whenever I have an illness, for hygiene reasons — everyone accepts that in the right spirit, even though I'm from a culture where it's far from common. I hope it becomes more so!
    – gidds
    Commented Feb 11, 2019 at 11:19
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    Sorry - fist bumping seems far too informal. Are you going to fist bump your new potential client?
    – Sarima
    Commented Feb 11, 2019 at 13:43
  • @Joshpbarron Most handshaking I do is informal. Frankly, I've always hated the tradition, but have put up with it for obvious reasons. Handshakes and neckties have to be two of the most random and bizarre cultural quirks ever invented.
    – B. Goddard
    Commented Feb 11, 2019 at 13:46
  • Handshakes, so I've heard, were a form of showing you didn't have a concealed weapon in your hand.
    – user62890
    Commented Feb 11, 2019 at 19:27
  • And neckties are one of the oldest garments still worn by humans, thought to have been used to remove food from the face after meals for tens of millenia. I see no mention of this in wikipedia, but I've had it mentioned to me by a prehistory buff.
    – dotancohen
    Commented Feb 12, 2019 at 15:46

I face a somewhat similar issue - while I don't have arthritis, I've had enough hand and wrist injuries to make this problematic.

I can't remember exactly where I saw this, but I remember reading somewhere that Bill Clinton had a method for preventing people from squeezing when he had to shake a lot of hands. You can try something similar.

I've tried a few different methods myself - e.g. 2-handed hand shaking. Sometimes, gripping slightly around the knuckles can prevent them from squeezing too hard, too. There are actually plenty of articles available demonstrating various other techniques for accomplishing this (or at least protecting your hand to some degree), such as this one. I'd encourage you to look up a few of them and find one that works for you.


The usual practice in places I have worked has been to offer the forearm or elbow to be shaken.

Now I have worked in chemistry and in engineering and it is common for hands to be covered in gloves which are frequently contaminated (and this probably applies in other industries where hands must not be touched, such as food preparation) but it does seem to be common enough where I work to be understood, even without any explanation (though the fact that the person offering the arm usually has their hands visibly in an unshakeable condition helps with understanding.) It is often (but by no means always) accompanied by a spoken apology for being unable to shake hands.

There is usually some brief touch of the offered part of the arm by the person with the free hand, so the physical gesture of hand to arm contact is completed without any need to de-glove.

If you work in an office environment, you could probably offer your arm like this (while apologising for being unable to shake hands as people in an office environment are perhaps less likely to understand the gesture.) It's up to you do decide if you want to explain, for example that your hands "hurt today" or enter into more detail about having arthritis.

There is no reason to be ashamed of a medical condition, but I do appreciate that you don't want to be referring to it all the time as I imagine it would be quite tedious for you.


I'm not entirely sure I understand why honesty is not the best policy here:

Sorry, I'd like to shake your hand, but I have an arthritic condition. I don't mean to be rude, but I can't shake your hand.

This should be good enough for pretty much anyone. Medical conditions can't be helped, and shouldn't be seen as rude by anyone reasonable. Trying to dodge or lie your way around the problem (e.g. "I am working through a (unnamed) medical condition", "I have a cold", "I prefer to fistbump") just comes off as lame. Just say it flat out: I have arthritis. I can't shake your hand. End of story.


Wear a finger guard or wrist guard. When people come to shake hands, show the guard/bandage and say you hurt it while "insert random excuse here: ranging from household errands to playing sports"

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    I am not a big fan of this approach. Lying, especially with as much of an effort as using a fake bandage, breaks integrity and can easily lead to distrust. Even if you are a good liar, the person on the other side might sense something is odd or maybe you even subconsciously communicate your discomfort about lying. This is not a good start for a new encounter. Commented Feb 11, 2019 at 9:33
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    The guards can also cause more pain. They're not for arthritis at all. Having the joint bound in bandages will cause more problems.
    – Nelson
    Commented Feb 11, 2019 at 9:39
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    Great idea - for the first week. Afterwards there'll be some confusion how incredibly unlucky/clumsy the person has to be to always be hurt (which gets dubious after about a month) - sounds like a great way to get the rumour mill going.
    – Voo
    Commented Feb 11, 2019 at 9:41
  • you should not wear such things unless there's a medical indication for them, and for arthritis they are, if anything, contra-indicated. I have arthritis myself (in a foot) and especially during an attack anything pressing down on the afflicted area causes unbearable pain (and that includes even such things as socks, let alone shoes).
    – jwenting
    Commented Feb 11, 2019 at 10:28
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    There is no need to give an excuse. Whenever someone sees that, they tend to be careful. (My girlfriend has rheumatism and uses a wrist brace for exactly this reason).
    – Davidmh
    Commented Feb 11, 2019 at 13:38

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