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We found out after decades of experience that wrists can quit being in fibromyalgia pain if the right leverage is used in the right place in the right way. The shower massager is off unless the valve lever is turned 90 degrees. When it is just the brass lever, this valve lever is a pain to turn. But when I add a PVC pipe to extend the leverage, it is much easier to turn. Similarly, since the original shower knob was way too hard to operate, we unscrewed it and added a free accessibility valve lever. It was just a little screwdriver with a 1/8" shaft whose end we sawed off. We stuck Epoxy into the 1/8" hole, then twisted in the sawed-off screwdriver, wiping off the Epoxy we pushed out.