All About Hand Therapy

“Working with a knowledgeable hand therapist can make the difference between success and failure in complex hand surgical cases. The therapist extends the continuum of our care, as well as functioning as coach and trainer for our patients.” – Marybeth Ezaki, MD, Past President, American Society for Surgery of the Hand

What is Hand Therapy? 

Hand therapy is the art and science of evaluating and treating injuries and conditions of the upper extremity such as the shoulder, arm, elbow injuries, forearm, wrist and hand injuries. 

It uses a number of therapeutic interventions and occupational therapy to help return a person to their highest level of function. It evolved from the need for a specialist with the knowledge and experience required to manage the challenging recovery of complex hand and upper extremity injuries.

Who is a Hand Therapist? 

A hand therapist is an occupational therapist (OT) or physical therapist (PT) who, through advanced continuing education, clinical experience and integration of knowledge in anatomy, physiology and kinesiology, has become proficient in treatment of pathological upper extremity conditions resulting from trauma, disease, congenital or acquired deformity.

Hand therapists bridge the gap from medical management of upper extremity conditions to successful recovery, allowing individuals to function normally in their daily lives. They work closely with hand surgeons to ensure maximal outcomes for patients. 

Who is a suitable for hand therapy? 

Patients who are candidates for hand therapy may have been affected by an accident or trauma leaving them with wounds, scars, burns, injured tendons or nerves, fractures, or even amputations of the hand and upper limb. 

Others include patients who suffer from the effects of conditions such as carpal tunnel syndrome, tennis elbow and trigger fingers, as well as from such chronic problems as arthritis or a neurologic condition (i.e., stroke).

What does Hand Therapy Provide? 

Hand therapists provide a variety of nonoperative interventions, preventative care and post-surgical rehabilitation. 

These include: 

  • Preventative, non-operative treatment 
  • Management of acute or chronic pain 
  • Desensitization following nerve injury or trauma 
  • Sensory re-education after nerve injury 
  • Design and implementation of home exercise programs to increase motion, dexterity, and/or strength
  • Splint fabrication for prevention or correction of injury 
  • Training in the performance of daily life skills through adapted methods and equipment 
  • Conditioning prior to returning to work 
  • Education on joint protection and energy conservation 
  • Recommendations for adaptive equipment or devices to improve function.

Post operative rehabilitation may include: 

  • Management of open or sutured wounds (prevention of infection and assistance in healing) 
  • Control of hypertrophic (raised and/or swollen) or hypersensitive scars 
  • Reduction of swelling 
  • Fabrication of custom orthoses to protect surgery or increase movement 
  • Instruction in home exercise program 

Your hand therapist may consult with various industries establishing preventive programs for workers with upper extremity symptoms. Hand therapists recommend modifications of workstations and alternative work methods to help ensure healthy workstyles of all employees.

The above material has been modified from content available at the American Society for Surgery of the Hand (ASSH) website. It is copyrighted by ASSH and its use is permitted for members.

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