Hand therapy is a type of rehabilitation performed by an occupational or physical therapist for patients that have conditions affecting the hands and upper extremities. Therapy is very important. Hand therapy helps patients return to their productive lifestyles. Therapy often starts with an initial evaluation. This will help the therapist learn what symptoms you have and what your goals are. They will review the prescription and treatment you have already started. The therapist will then perform a detailed exam. This will establish your baseline function. Then they will create a plan with goals and a timeline. This plan will help reach your desired function.

Hand therapy will include different treatments with the therapist. It will also include assignments to complete at home. It is helpful to keep up with therapy. Skipping sessions can result in your function moving backwards, and it may make it harder to move forward. Lack of effort will prolong or prevent recovery.

Hand therapy patients may have been affected by an accident, trauma or arthritis, or may have undergone surgery. There are many problems that therapy can help. Therapists can:

• 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 learn to be functional

Therapists can help patients adapt to their new function. They can suggest new ways to do things. They can provide helpful tools to replace lost function. Some common problems that therapists help include fractures, tendon repairs, arthritis, stiff hands or fingers, trigger fingers, tennis elbow, carpal tunnel, and weakness after a stroke.

What does hand therapy provide?

Hand therapy can provide the following:

• Treatments without an operation
• Help with recent or long-lasting pain
• Help to reduce painful feelings from nerve problems
• Learning to feel again after a nerve injury (sensory re-education)
• Learning home exercise programs to help with movement and strength
• Custom-made splints to protect an injured bone, tendon, or ligament, or surgical repair. Splints may help prevent or improve stiffness (Figure 1).
• Learning to complete everyday activities with special tools
• Help getting back to work, sports, or hobbies
• Help with a patient’s recovery after surgery. This may include assistance with helping wounds heal, preventing infection, scar treatment and reducing swelling.

How do therapists help improve function?

Exercises. These may include active hand and finger exercises where the patient uses their own muscle strength. Passive exercises are when the patient or therapist pushes a stiff joint to move without the patient using their own tendons/muscles.

Strengthening. This may include use of putty of different firmness, grippers, weights, TheraBands and other aides.

Scar treatment. Friction massage, taping, use of silicone putty/sleeves/sheets

Edema control. Use of external compression garments and wraps, retrograde massage, elevation, and active motion

Pain control. Somethings that may help pain include fluidotherapy, ionotophoresis, therapeutic ultrasound, desensitization, mirror therapy, and guided imagery.

Coordination of return to work

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

Ergonomics involves analyzing and improving design of the workplace to be more safe and efficient. Work hardening is a special type of therapy. It is designed to simulate the work environment. In a low-stress way, the therapist will gradually help increase strength and endurance to safely return to work.

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