Patient Education

Hand Therapy

Examples of hand therapy splints including static resting splint and outrigger splint
Figure 1. Custom-made splints may protect an injured bone, tendon, ligament, or surgical repair and may help prevent or improve stiffness.

Hand therapy is a type of rehabilitation performed by an occupational or physical therapist for patients who have conditions affecting the hands and upper extremities. Therapy is very important because it helps patients return to their productive lifestyles.

Hand therapy often starts with an initial evaluation. This helps the therapist learn what symptoms you have, what your goals are, and what treatment has already started. The therapist then performs a detailed exam to establish your baseline function and creates a plan with goals and a timeline to help reach your desired function.

Hand therapy includes different treatments with the therapist and assignments to complete at home. Keeping up with therapy is important. Skipping sessions can cause function to move backward and may make it harder to move forward. Lack of effort can prolong or prevent recovery.

Conditions Hand Therapy Can Help

Hand therapy patients may have been affected by an accident, trauma, arthritis, or surgery. Therapists can help with many problems, including fractures, tendon repairs, arthritis, stiff hands or fingers, trigger fingers, tennis elbow, carpal tunnel syndrome, and weakness after a stroke.

  • Monitor and treat wounds
  • Soften scars
  • Reduce adhesions between skin and tendons
  • Help nerves glide, tendons slide, and joints move
  • Reduce swelling
  • Decrease pain
  • Teach patients with amputations of the fingers, hands, or arms how to be functional

Therapists can also help patients adapt to new function, suggest new ways to do daily tasks, and provide helpful tools to replace lost function.

What Does Hand Therapy Provide?

  1. Treatments without an operation
  2. Help with recent or long-lasting pain
  3. Help reducing painful feelings from nerve problems
  4. Learning to feel again after a nerve injury, also called sensory re-education
  5. Home exercise programs to help with movement and strength
  6. Custom-made splints to protect an injured bone, tendon, ligament, or surgical repair and to help prevent or improve stiffness
  7. Learning to complete everyday activities with special tools
  8. Help getting back to work, sports, or hobbies
  9. Support after surgery, including wound healing, infection prevention, scar treatment, and reducing swelling

How Do Therapists Help Improve Function?

Exercises Active exercises use your own muscle strength. Passive exercises involve the patient or therapist moving a stiff joint without the patient using their own tendons or muscles.
Strengthening Strengthening may include putty of different firmness, grippers, weights, TheraBands, and other aids.
Scar treatment Scar care may include friction massage, taping, silicone putty, sleeves, or sheets.
Edema control Swelling control may include compression garments and wraps, retrograde massage, elevation, and active motion.
Pain control Options may include fluidotherapy, iontophoresis, therapeutic ultrasound, desensitization, mirror therapy, and guided imagery.

Coordination of Return to Work

Hand therapists can talk with employers about preventing problems for workers with hand or arm symptoms. They may recommend changes at your workplace or suggest different ways of doing your job to help support a healthy and safe work environment.

Ergonomics involves analyzing and improving the design of the workplace to make it safer and more efficient. Work hardening is a special type of therapy designed to simulate the work environment. In a low-stress way, the therapist gradually helps increase strength and endurance to support a safe return to work.

At the end of care, a therapist may perform a functional capacity examination. This is a detailed report that includes many activities you can and cannot perform.

How Do I Find a Hand Therapist?

Search for a hand therapist in your area at the official website of the American Society of Hand Therapists: www.asht.org.