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You don’t realize how integral your hands are until they are injured. Pain and inflammation associated with injuries and overuse of the hand have the potential to bring your day to a grinding halt. With this in mind, occupational and physical therapists use a variety of hand treatments to reduce pain, inflammation, and sensation changes. They also promote appropriate positioning and improved motion of the hand and fingers. Some of these treatments focus on more than one symptom, making them effective options for managing these diagnoses and restoring function. In this article, I’ll review the top 5 treatment options for hand pain.
1) Electrical stimulation
Electrical stimulation, also known as e-stim, is a treatment that uses electrical charges to relieve pain and improve the flow of nerves in the local area. This can be used on carpal tunnel syndrome, cubital tunnel syndrome, tendonitis of the hand, hand or wrist fractures, and more.
These electrical charges tense (or contract) and relax your muscles with the intent to relieve any muscle tension you may be experiencing. These electrical charges are low level, meaning they will not cause any harm or electrical shock. They are typically described as feeling like light pinpricks and can be adjusted by your therapist for comfort. Some people feel almost immediate decreases in pain after receiving electrical stimulation while others may need a few sessions to see an impact.
Electrical stimulation can also be used anywhere there is pain in the body. Therapists will attach small adhesive pads to the area where you are experiencing pain. The electrical current flows through these pads to this small area of the body. If a therapist wishes to use electrical stimulation on a larger part of the body, larger pads are placed farther apart on the body to elicit this effect.
It is important to note, electrical stimulation cannot be used by individuals who have pacemakers or other electronic implants. Electrical stimulation also cannot be used over open wounds or areas which have cancerous growths.
2) Therapeutic massage
Often referred to by therapists as manual techniques, therapeutic massage can also be used to relieve pain, swelling, and nerve compression of the hand.
Therapeutic massage for swelling, called retrograde massage, utilizes a circular technique to move built-up fluid toward the heart to improve circulation and blood flow. Furthermore, other therapeutic massages can be used to loosen tense muscles to relieve pain. Scar massage is a light pressure massage used to promote skin healing while lowering sensitivity to the area.
Keep in mind, scars and recently operated areas are often highly sensitive at the start of therapy, making activities difficult.
Not to be confused with ultrasound imaging, therapeutic ultrasound is an effective way to relieve muscle tension and pain. Therapists use small, flat wands to massage ultrasound gel into the skin. Ultrasound waves from the machine send the ultrasound gel to deeper tissues below the surface of the skin.
Therapists often describe ultrasound as massage for deeper tissues of the body. Ultrasound can be done on small or large parts of the body using different size wands. An evaluation and doctor’s report allows the therapist to determine how deep the tissue injury is. Ultrasound settings can then be adjusted to target tissue at the appropriate level.
Some people report feeling a slight warming sensation while the ultrasound is being completed while others report feeling no discomfort at all. This warming sensation means ultrasound is not an appropriate treatment option (specifically for those with implants such as rods, screws, or plates). In these instances, ultrasound waves can create an internal warming effect which heats up these metal objects.
4) Strengthening programs
Increasing strength is a vital portion of any rehabilitation program. Hand injuries are no exception. An important part of regaining prior use of your hand is focusing on fine motor skills. This includes fine motor strength and coordination, which means treatment must focus on improving grip strength and finger movement.
Strengthening programs often consist of exercises or activities that use the hand in various positions for functional tasks. Putty, elastic bands, clips, and equipment with specific resistance levels assigned are all used for the purposes of strengthening weak, injured muscles. In some cases, additional exercises are given for use at home to further increase the frequency of practice.
Each exercise assigned by a therapist is intended to isolate muscles causing problems, either from weakness or overuse. With this in mind, exercises appropriate for one patient may not be appropriate for others, even if the same symptoms are present. This makes it important to follow a strengthening program prescribed by a trained professional.
Splints and braces are also used for muscle and joint healing. Collectively known as orthoses, they are commonly recommended and fit for hand injuries.
Splints hold a body part in a specific position while allowing movement from other body parts. For this reason, they are typically recommended for daytime use. For example, hand splints are fit to allow for movement and use of the fingers as needed. Splints assist with repositioning the hand and wrist to relieve pressure on compressed nerves, as seen with carpal tunnel syndrome. Splints also provide neutral positioning to prevent muscle deformity, as is the case with strokes or other brain injuries.
On the other hand, braces are purposely more restrictive. This allows them to immobilize joints and muscles for proper healing. Similarly to splints, braces are used in many parts of the body. In the upper body, braces are commonly used for elbow conditions such as tendonitis, tennis elbow, or cubital tunnel syndrome. For this reason, therapists typically recommend wearing braces during the night or while are at rest.
There are many therapeutic methods that can be used to improve symptoms related to hand injuries. Treatment methods such as these are used at the discretion of an occupational or physical therapist who has first completed a therapy evaluation.
If you feel you could benefit from any of these treatments, ask your doctor for a referral to an occupational or physical therapist. From there, these trained professionals can assist with improving your hand’s function and overall lifestyle.