handshakeDear Ms. Meniscus,

I’m a professional man in my forties who has rheumatoid arthritis. I am not able to shake hands because of the pain. Any suggestions on what to say to people when they hold out a hand for me to shake? I don’t want to insult them.


Dearest Brian:

As a social custom, the handshake dates back thousands of years—in the Acropolis Museum in Athens, there’s a depiction of Athena and Hera shaking hands in the 5th century BC.  For today, at least, you raise an important question for many, many people.

Whether one has pain from RA or any number of conditions such as:  psoriatic arthritis, osteoarthritis, erosive osteoarthritis, fibromyalgia, dermatomyositis, lupus, Raynaud’s, gout, scleroderma, eczema or burns, shaking hands is best avoided because it is too painful. There are many people who simply don’t wish to shake hands for any number of reasons, however, having a plan for handling “the moment” will keep things moving smoothly.

You need to decide whether or not you wish to disclose your RA. Many people prefer to keep their medical information private when dealing in the business world. And keep in mind that not every culture uses the handshake as a form of greeting. But before we get sidetracked by the myriad ways human beings greet each other around the world; you have options to consider before your next business meeting.

There are quite a number of acceptable alternatives to the handshake: you can offer your hand with the palm facing downwards (this results in a less intense handshake), offer your left hand, offer to do the fist bump, or gently grasp the person’s forearm while explaining that you do not or cannot shake hands, while stating: I’m very pleased to meet you.”  It is important that you maintain eye contact and offer a friendly smile.

Before long, you’ll have a system down that comes naturally and puts you and your colleagues at ease, and you’ll be sparing yourself unnecessary suffering. See below for further reading on the subject. Madame wishes you joy and ease in future greetings.