Definition & Overview

Hand physiotherapy is a special branch of physical therapy that specialises in the diagnosis, treatment, and long-term rehabilitation of the hand in cases of injuries and illnesses. Its goals are to restore the normal movement and function of the hand as well as reduce the patient’s risk of recurrences.

In general, physiotherapy involves a combination of different approaches, ranging from physical hand exercises to acupuncture, to achieve treatment goals.

Since the hand plays an important role in normal day-to-day movements, hand and wrist injuries and illnesses can be debilitating and affect the quality of life, making hand physiotherapy highly important.

Who Should Undergo and Expected Results

Patients suffering from injuries and illnesses that may affect the movement and function of the hands qualify for this procedure. These injuries and illnesses include:

  • Osteoarthritis
  • Trigger finger
  • Ganglia
  • Rheumatoid arthritis
  • Tendinitis
  • Tenosynovitis
  • De Quervain's syndrome
  • Raynaud syndrome
  • Congenital defects and deformities, such as finger clubbing
  • Nerve compression syndromes, such as carpal, radial, and cubital tunnel syndromes
  • Infections, such as hand abscess, herpetic whitlow, and tendon sheath infections
  • Skier’s thumb injury and other injuries to the ligaments of the hands
  • Mallet finger and other injuries to the tendons of the hands
  • Hand and wrist sprains or injuries to the joints of the hands and wrists
  • Strains or pulled muscles in the hands and wrists
  • Wrist fracture or broken bones
  • Wrist dislocations
  • Crushing injuries
  • Repetitive stress or overuse injuries
  • Animal bites
    Injuries that affect the hands more commonly affect people who:

  • Are older, due to their weaker bones and reduced muscle mass

  • Have an increased risk of accidental falls due to vision or balance problems
  • Engage in contact sports, such as wrestling, soccer, and football
  • Engage in sports such as gymnastics that require the hands and arms to bear much weight
  • Engage in sports that require hand-controlled equipment such as tennis racquets and lacrosse sticks
    Although minor hand and wrist injuries can heal without treatment and may require only self-care and home remedies, more severe injuries need to be treated and rehabilitated to avoid long-lasting pain and permanent damage or disability.

During and after hand physiotherapy, the patient can expect to experience:

  • An improvement in pain symptoms
  • Reduced swelling
  • Wound and scar management
  • Improved mobility of the hands and wrists
  • Muscle strengthening
  • Restored function of the hands

How is the Procedure Performed?

Hand physiotherapy treatment programs are performed and facilitated only by trained professional physiotherapists specialising in hand and wrist injuries. They usually work in physical therapy/rehabilitation clinics, hospitals, community health centres, and as privately employed physiotherapists working as part of sports teams and charitable organisations.

During a hand physiotherapy consultation, the therapist will examine the patient’s hand and wrist to determine the extent of the injury or effects of the illness. After this, a treatment program customised to the patient’s case or condition will be designed. This treatment program will encompass various treatment techniques, such as:

  • Hand and wrist exercises – Regular exercises help to gradually improve the strength and movement of the hand and wrist following an illness or injury.
  • Manual therapy – In manual therapy, the therapist massages the hands and wrists to improve blood and fluid circulation, relieve pain and stiffness, and promote nerve and muscle relaxation.
  • Acupuncture – In acupuncture, the therapist inserts very fine needles into specific points of the body to release pressure and relieve pain.
  • Hydrotherapy or aquatic therapy – This refers to exercises that are performed in warm, shallow water, as water is known to have a relaxing effect on the muscles and joints.
  • Compression therapy – This is known to be very helpful in reducing swelling
  • Mobility aids – If necessary, the treatment program may involve the use of splints and straps. Aside from improving mobility and promoting healing, hand and finger splints also provide much-needed protection during the recovery period.
  • Remodeling techniques – These are performed when there are wounds and scars involved

The therapist will also educate the patient on proper hand and wrist ergonomics to speed up healing and prevent future injuries from occurring.

Possible Risks and Complications

The use of different techniques to treat hand and wrist injuries help patients achieve healing and full rehabilitation while minimising the use of medications. As most of the techniques used are non-surgical, physiotherapy treatments are safe and relatively free from risks.

Perhaps the biggest risk is when the treatment fails to restore a patient’s hand movement and function to normal. This risk is higher among patients who suffer from crushing injuries and chronic degenerative diseases affecting the hands.

References:

  • Richmond N. (2013). “Hand injuries can become complicated problems.” Journal of Emergency Medical Services. http://www.jems.com/articles/print/volume-38/issue-8/patient-care/hand-injuries-can-become-complicated-pro.html

  • Logan AJ., Makwana N., Mason G., Dias J. (2004). “Acute hand and wrist injuries in experienced rock climbers.” Br J Sports Med 2004;38:545-548. http://bjsm.bmj.com/content/38/5/545.full

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