Hand disorders and conditions
Understanding and treating your pain
Hand conditions
Osteoarthritis of the hand
What is hand osteoarthritis?
Hand osteoarthritis is a common degenerative condition that can cause pain, stiffness, and loss of function. It results from the breakdown of the cartilage in the joints, leading to direct bone contact and limiting movement.
What are the causes of hand osteoarthritis?
- Natural wear: Aging is one of the primary causes.
- Genetic factors: Osteoarthritis can be hereditary.
- Joint trauma: Previous fractures or sprains increase the risk.
- Overuse: Repetitive movements, especially in certain professions or activities, can promote its development.
What are the symptoms?
- Persistent joint pain, worsened by the use of the hand.
- Stiffness, especially in the morning or after a period of inactivity.
- Loss of strength and difficulty grasping or handling objects.
- Joint deformity with the appearance of nodules.
- Swelling and a feeling of warmth in the affected joints.
Management and treatments
Medical approach
- Anti-inflammatory medications to relieve pain and reduce inflammation.
- Corticosteroid injections in case of severe pain.
- Surgery in advanced cases where pain and loss of function are disabling.
Hand therapy and rehabilitation
- Orthotics and splints: They help stabilize the joints and reduce pain.
- Therapeutic exercises: Maintain mobility and strengthen the hand muscles.
- Heat application: Relieves stiffness and reduces pain.
- Adaptation of daily movements: Use of assistive devices to reduce stress on the joints.
What is the role of the hand therapist in recovery?
A hand therapist can offer personalized solutions to preserve autonomy and improve the quality of life for patients with hand arthritis.
Overuse injuries in musicians
What are the overuse injuries related to musical practice?
Musicians are particularly prone to musculoskeletal disorders due to repetitive movements and restrictive postures imposed by their instruments. These conditions may include pain, numbness, muscle fatigue, and a decrease in dexterity.
What are the symptoms of overuse injuries?
The symptoms vary depending on the instrument and the musician’s habits. They typically present as pain in the hands, wrists, arms, shoulders, and neck. Some experience pain only while playing, while others may suffer even at rest. Weakness, stiffness, and tingling sensations may also be present.
What are the causes of these injuries?
Musician overuse injuries are often caused by repeated movements over long periods, improper posture, and lack of warm-up or recovery. The adjustment of the instrument and playing environment can also influence the onset of symptoms.
What are the treatments for overuse injuries in musicians?
Treatment involves adjusting playing habits and correcting postures. Specific exercises to improve flexibility, strength, and coordination may be recommended. Sometimes, a temporary reduction in playing time is necessary to prevent symptom worsening.
What is the role of the hand therapist in recovery?
A hand therapist assesses the posture, muscle tensions, and movements of the musician to identify risk factors. They develop a personalized rehabilitation program aimed at improving playing ergonomics, strengthening the involved muscles, and preventing relapses. Adjustments to the instrument or workstation may be suggested to reduce physical strain and ensure a safe return to musical practice.
Hand fractures
What is a hand fracture?
A fracture refers to a break in a bone, which can range from a small crack to a complete break that pierces the skin (open fracture). The hand contains 19 bones distributed among the fingers, thumb, and palm. Any break affecting these bones is classified as a hand fracture.
What are the symptoms?
- Throbbing, intense pain in the hand
- Swelling and the appearance of bruising
- Visible deformity of the finger or hand
- Difficulty or inability to move the fractured finger and adjacent fingers
- Numbness if the nerves near the fracture are affected
What are the causes and risk factors?
- Direct trauma (e.g. fall, sports injury, violent impact)
- Work-related accidents involving impact to the hand
- An impact strong enough to break the bone, sometimes associated with damage to nearby structures
What are the treatments?
Diagnosis and initial management
- An X-ray is performed to confirm the fracture and guide management
- Three types of treatments are commonly used depending on the severity of the fracture
Possible treatments
- Immobilization and protection: using a splint or cast to stabilize the fracture and promote healing.
- Closed reduction: medical manipulation to realign the bone fragments without surgery.
- Open reduction and fixation: in case of an unstable fracture, surgery with the placement of pins, screws, or plates may be necessary to ensure stability.
What is the role of the hand therapist in recovery?
A hand therapist plays a crucial role in the rehabilitation of fractures. They can design a custom splint to immobilize the hand and promote proper bone healing. Since fingers tend to stiffen quickly after a fracture, the therapist teaches specific exercises to maintain flexibility and prevent stiffness. After the immobilization is removed, therapy aims to gradually restore the range of motion, strength, and function of the hand to enable an optimal return to daily and professional activities.
Joint hypermobility and Ehlers-Danlos syndrome (EDS)
What is joint hypermobility?
Joint hypermobility is characterized by excessive range of motion in the joints, exceeding normal limits. It can be due to laxity in the connective tissues, often of genetic origin, as seen in conditions like Ehlers-Danlos syndrome (EDS). Connective tissue plays a crucial role in maintaining the structure and support of the joints.
What is Ehlers-Danlos syndrome (EDS)?
Ehlers-Danlos syndrome is a connective tissue disorder that leads to generalized joint hypermobility. This condition can make the joints more unstable and fragile, increasing the risk of sprains, dislocations, and chronic pain. An EDS diagnosis is typically made using a clinical test and, in some cases, genetic analysis.
What are the symptoms of joint hypermobility and EDS?
People with joint hypermobility or EDS may experience:
- Joint and muscle pain
- Fatigue and muscle weakness
- Joint instability with a risk of subluxations or dislocations
- Difficulty controlling movements and maintaining good posture
These symptoms can interfere with daily activities and often require tailored management.
What are the treatments for joint hypermobility and EDS?
There is no curative treatment for these conditions, but appropriate management can help reduce pain and improve joint stability. Treatments include muscle strengthening exercises, learning proper postures, and, in some cases, the use of splints to support the joints.
What is the role of the hand therapist in recovery?
A hand therapist supports patients by teaching strategies to reduce strain on their joints. They may recommend splints to stabilize the wrists and fingers, as well as a personalized exercise program aimed at strengthening muscles and improving endurance. The goal is to optimize hand function and minimize pain associated with hypermobility.
Hand infections
What is a hand infection?
Hand infections can result from a minor injury, such as a cut or scrape, allowing bacteria to enter the skin and underlying tissues. These infections can affect various structures, including nails, tendons, joints, and soft tissues, and may lead to serious complications if not treated promptly.
What are the symptoms of a hand infection?
Hand infections typically present with redness, swelling, pain, a sensation of heat, and sometimes the presence of pus. Some types of infections cause stiffness in the fingers or increased pain when attempting to move them. Without treatment, they can lead to loss of mobility and damage to deeper structures such as nerves and bones.
What are the causes of hand infections?
Infections can be caused by untreated cuts, human or animal bites, insect stings, or splinters of wood or glass remaining under the skin. An infection can also occur after surgery or due to an underlying condition such as diabetes, which increases susceptibility to infections.
What are the treatments for hand infections?
Treatment depends on the severity of the infection. Mild infections can be managed with antibiotics and appropriate wound care. In more advanced cases, surgery may be required to drain the infection and remove damaged tissue. Post-treatment rehabilitation is often necessary to restore optimal hand function.
What is the role of the hand therapist in recovery?
A hand therapist plays a key role in the healing process by providing appropriate care such as dressing changes, mobilization exercises to prevent stiffness, and the fabrication of splints to protect the affected joints. Their goal is to help the patient regain strength, mobility, and functionality in the hand after an infection.
Flexor tendon injury
What is a flexor tendon injury?
Flexor tendons are strong structures that connect the muscles of the forearm to the bones of the fingers and thumb, allowing them to bend. These tendons are essential for performing daily tasks such as grabbing an object, buttoning a shirt, or opening a jar. An injury to these tendons can lead to partial or total loss of movement in the affected fingers.
How do flexor tendon injuries occur and what are the symptoms?
Flexor tendon injuries typically occur due to a cut on the palm side of the hand, trauma during sports activities, or certain conditions like arthritis that can weaken the tendons. The most common symptoms include pain, swelling, increased sensitivity, and the inability to bend the affected finger.
What are the treatments for flexor tendon injuries?
Injuries affecting these tendons are serious and do not heal spontaneously. Surgery is necessary to reconnect the severed or ruptured tendons. The surgeon evaluates each tendon individually to determine the extent of the damage.
What is the role of the hand therapist in recovery?
After surgery, a hand therapist plays a key role in rehabilitation. They create a custom splint to protect the hand and guide the patient through a controlled exercise program to promote healing without compromising the repair. The goal of therapy is to prevent the formation of adhesions that limit movement while ensuring optimal recovery. Collaboration between the surgeon, therapist, and patient is essential to restore full hand function.
Extensor tendon injuries
Role and Importance of Extensor Tendons
Connected to the muscles of the forearm, the extensor tendons are located on the back (dorsal) side of the hand and allow it to open. They become particularly visible when the fingers are in forced extension. These tendons play an essential role in many everyday movements, such as releasing an object or performing the “thumbs up” gesture.
Causes of extensor tendon injuries
Extensor tendon injuries can occur as a result of a cut with a sharp object or direct impact, such as trauma sustained during a sports activity. Other causes include fractures, crush injuries, or certain degenerative conditions, such as arthritis, which gradually weaken these structures essential for hand mobility.
Therapeutic options for tendon injury
In case of suspected extensor tendon injury, it is essential to consult a healthcare professional promptly to avoid complications such as reduced finger or thumb extension, which could compromise hand functionality. The choice of treatment depends on various factors, including the severity and location of the injury. Some injuries may be managed with temporary immobilization using a custom splint, promoting tendon healing. However, more severe injuries may require surgical intervention to restore tendon continuity and regain hand mobility. After a medical evaluation, a specialist will direct the patient to a hand surgeon or a specialized therapist to maximize recovery and prevent potential functional impairments.
The contribution of the hand therapist
A hand therapist provides tailored care for extensor tendon injuries, whether treated conservatively or post-surgically. A personalized rehabilitation program may include the design of a custom orthosis as well as exercises aimed at restoring joint range of motion and hand function. Collaboration between the patient, therapist, and doctor is essential to optimize recovery and ensure a successful return to daily activities.
Dupuytren's disease
What is Dupuytren's disease?
Dupuytren’s disease, also known as Dupuytren’s contracture, is a condition of the hand that causes the progressive thickening and tightening of the palmar fascia, the tissue layer beneath the skin. This condition leads to a gradual flexion of the fingers, pulling them toward the palm, making it difficult to fully open the hand. It typically affects the ring and little fingers, but can involve other fingers as well.
What are the symptoms of Dupuytren's disease?
The initial signs include the appearance of nodules or thickening under the skin of the palm. Over time, these formations can evolve into fibrous cords, limiting the extension of the fingers and making certain everyday tasks more difficult, such as sliding the hand into a pocket or holding objects. The progression of the disease varies from person to person and can take several months or even years.
What are the causes of Dupuytren's disease?
The exact cause of this condition remains unknown, although genetic and environmental factors are suspected. It is more common in older men, and factors such as smoking, diabetes, and a family history increase the risk of developing the disease.
What are the treatments for Dupuytren's disease?
The diagnosis is primarily based on a clinical examination. In the early stages, medical follow-up is recommended to monitor the progression of the nodules. If the contracture becomes disabling, surgical intervention may be considered to remove the thickened tissues and restore better finger mobility.
What is the role of the hand therapist in treatment?
After surgery, a hand therapist plays a key role in recovery. They may design a custom orthosis to keep the fingers extended, offer a tailored exercise program to improve mobility and strengthen the hand, and implement scar management techniques. Their support helps optimize recovery and assists the patient in regaining optimal hand function.
Raynaud's disease
What is Raynaud's disease?
Raynaud’s disease is a circulatory disorder characterized by an excessive response of the blood vessels to temperature changes and stress. When the fingers, toes, or other parts of the body such as the nose or ears are exposed to cold, the blood vessels constrict excessively, leading to changes in skin color and pain.
What are the symptoms of Raynaud's disease?
Symptoms include discoloration of the fingers, turning white and then blue when exposed to cold, followed by redness as they warm up. This transition may be accompanied by pain, tingling, and a feeling of stiffness. Some people also experience muscle fatigue or increased sensitivity to cold temperatures.
What causes Raynaud's disease?
There are two forms of the disease:
- Primary Raynaud's, which occurs without an identified cause.
- Secondary Raynaud's, often associated with autoimmune diseases such as scleroderma or lupus, or with repeated hand trauma.
Other risk factors include smoking, stress, and prolonged exposure to vibrations (such as from power tools).
What are the treatments for Raynaud's disease?
The treatment mainly aims to manage symptoms and prevent episodes. It is recommended to protect the hands from the cold by wearing gloves, avoid nicotine and caffeine, which promote vasoconstriction, and, in some cases, take medications to improve blood circulation.
What is the role of the hand therapist in recovery?
A hand therapist helps identify the triggers of the disease and offers strategies to minimize their impact. They can advise on the choice of gloves and other thermal protections, recommend exercises to improve circulation, and help adapt daily activities to reduce the frequency and intensity of episodes. Education on lifestyle adjustments is also essential for better managing the disease on a daily basis.
Hand edema
What is hand edema?
Hand edema refers to swelling caused by an excessive accumulation of fluid in the tissues. This phenomenon can be a sign of inflammation in the joints or soft tissues of the hand. Swelling may appear suddenly after trauma, such as a fracture, or develop gradually over a long period, particularly in cases of arthritis.
What are the symptoms of hand edema?
Signs of edema include an increase in hand size, tight or shiny skin, a feeling of heaviness, and, in some cases, pain or joint stiffness. Pressing on the skin may leave a temporary indentation (pitting sign). Some patients experience discomfort or a sensation of pressure in the hand.
What are the causes of hand edema?
Swelling in the hand can be caused by several factors: trauma (sprain, fracture), infection, inflammatory diseases such as arthritis, or repetitive stress on the joints. A cast or bandage that is too tight can also cause edema. In some cases, chronic edema may indicate a circulatory or lymphatic disorder.
What are the treatments for hand edema?
A medical examination is recommended to identify the cause of the edema. Treatment varies depending on the origin of the swelling and may include rest, elevating the arm, applying cold compresses, taking anti-inflammatory medications or antibiotics in case of infection. Temporary immobilization may be prescribed if necessary.
What is the role of the hand therapist in recovery?
A hand therapist supports families by providing tailored exercises to loosen the tendon and prevent the worsening of the blockage. After any potential surgical intervention, they may design an orthosis to maintain thumb extension and encourage functional recovery through engaging activities and exercises for the child.
Scleroderma
What is scleroderma?
Scleroderma is a rare autoimmune disease that causes abnormal hardening and thickening of connective tissues. It can affect the skin, joints, blood vessels, as well as some internal organs. This condition results from excessive collagen production, which disrupts the flexibility and proper functioning of tissues.
What are the symptoms of scleroderma?
The symptoms vary depending on the form of the disease. In its localized form, scleroderma primarily affects the skin, causing thickened and rigid patches. In its systemic form, it can affect internal organs, leading to respiratory, digestive, or cardiac complications. Some of the most common symptoms include:
- Hardening and tightening of the skin, particularly on the fingers and hands.
- Joint and muscle pain
- Increased sensitivity to cold and bluish discoloration of the fingers (Raynaud's phenomenon)
- Fatigue and shortness of breath
- Digestive issues
What are the causes of scleroderma?
The exact cause of scleroderma remains unknown, but it is considered an autoimmune disease, where the immune system attacks the body’s own tissues. Genetic and environmental factors may play a role in its onset.
What are the treatments for scleroderma?
There is no cure for scleroderma, but various approaches can help alleviate symptoms and slow its progression. Treatments may include:
- Medications to improve blood circulation and limit vascular complications
- Anti-inflammatory treatments to relieve joint pain
- Physical therapy and occupational therapy to preserve joint mobility and prevent muscle contractures
- Fatigue and shortness of breath
- Digestive issues
What is the role of the hand therapist in recovery?
A hand therapist can help maintain the flexibility and mobility of the fingers and hands affected by scleroderma. They may offer stretching exercises, massage techniques to improve blood circulation, and splints to prevent joint deformities. The goal is to preserve the patient’s autonomy in their daily activities as much as possible.
Complex Regional Pain Syndrome (CRPS)
What is complex regional pain syndrome?
Complex regional pain syndrome (CRPS) is a chronic condition characterized by persistent pain, usually affecting a hand, arm, foot, or leg. This condition often results from trauma or surgery and involves a malfunction of the nervous system, leading to symptoms that are disproportionate to the initial injury.
What are the symptoms of complex regional pain syndrome?
People with CRPS experience intense and constant pain, often described as a burning or tingling sensation. Other symptoms may include swelling, changes in skin temperature and color, hypersensitivity to touch, joint stiffness, and circulatory problems. In some cases, muscle atrophy and reduced mobility may develop.
What are the causes of complex regional pain syndrome?
CRPS typically occurs after an injury, fracture, surgery, or prolonged immobilization. It is associated with a dysfunction of the sympathetic nervous system, which regulates the inflammatory response and blood circulation. Some patients develop this syndrome without an apparent cause, making its diagnosis and management more challenging.
What are the treatments for complex regional pain syndrome?
The treatment of CRPS relies on a multidisciplinary approach involving medicine, occupational therapy, physical therapy, and sometimes psychotherapy. Early intervention is crucial to limit the progression of the syndrome and improve the patient’s quality of life.
What is the role of the therapist in recovery?
The hand therapist plays a crucial role in the management of CRPS by providing progressive exercises to restore mobility and function of the affected hand or limb. They implement desensitization techniques to reduce hypersensitivity and promote a return to appropriate activity. Psychological support may also be recommended to help manage chronic pain and the emotional impact of the condition.
Conditions of the fingers
Amputation of a finger
What is a finger amputation?
Amputation of a finger refers to the partial or total loss of a finger from the hand, resulting from trauma, a severe infection, or a disease affecting the tissues. Depending on the extent of the injury, the amputation may involve only the tip of the finger or extend to the joint or base of the finger.
What are the impacts of a finger amputation?
The consequences vary depending on the affected finger and the level of amputation. Losing a finger can lead to decreased grip strength, impaired dexterity, and difficulty performing certain daily tasks. Residual pain, hypersensitivity, or the sensation of a “phantom limb” may also be experienced.
What are the causes of finger amputations?
Amputations are typically caused by workplace accidents (machines, sharp tools), household injuries (knives, doors), or trauma related to sports activities. Certain diseases, such as severe infections or vascular disorders, may also require medical amputation.
What are the treatments and solutions after an amputation?
After an amputation, management includes wound healing, pain and hypersensitivity management, as well as adapting to the new capabilities of the hand. A prosthesis may be considered to improve functionality. Rehabilitation plays a key role in learning to compensate for the loss of the finger and optimizing the use of the remaining hand.
What is the role of the hand therapist in recovery?
A hand therapist helps the patient regain autonomy by working on strength, flexibility, and sensitivity of the hand. They provide tailored exercises to compensate for functional loss and teach techniques to adapt daily movements. If a prosthesis is used, they also guide the learning process of its use.
Arthritis at the base of the thumb
What is arthritis at the base of the thumb?
Arthritis at the base of the thumb, also known as rhizarthrosis, CMC arthritis, or trapeziometacarpal arthritis, occurs when the joint space between the bones narrows. This condition is common because the thumb joint is heavily used in everyday movements, leading to gradual wear of the cartilage, which acts as a shock absorber.
Causes of thumb arthritis
Several factors can contribute to the development of this condition:
- Genetic factors: A family predisposition may increase the risks.
- Overuse and repetitive movements: Repetitive actions such as pinching and thumb rotation can contribute to its development.
- History of trauma: Fractures or dislocations of the thumb joint can accelerate cartilage wear.
Symptoms to watch for
People with symptomatic CMC arthritis typically experience:
- Pain at rest and/or when using the thumb, especially when grasping objects, pinching, opening a jar, or turning a door handle.
- Swelling and tenderness at the joint.
- Reduced range of motion and weakened thumb strength.
- In advanced cases, joint deformity may be observed.
Treatment options
The management of this arthritis relies on both non-surgical and surgical approaches:
- Conservative treatments
Adapting daily activities to reduce strain on the joint is recommended. Additionally, a splint helps stabilize the joint and limit painful movements. The use of anti-inflammatory medications and/or injections (cortisone, viscosupplementation) are also part of the conservative treatment.
- Surgery
If conservative treatment is insufficient and pain becomes disabling, affecting hand function, surgical intervention may be recommended to restore mobility and relieve pain.
The role of the hand therapist
The hand therapist helps the patient by providing:
- Custom-made or prescribed orthosis tailored to the patient's needs.
- Advice on techniques and assistive devices to minimize pain and preserve thumb function.
- Targeted exercises to improve the strength and stability of the joint.
- Post-operative follow-up to optimize recovery after potential surgery.
By consulting a specialized therapist, patients can benefit from a personalized approach aimed at relieving their pain and regaining better autonomy in their daily activities.
Boutonnière deformity
What is a boutonnière deformity?
A boutonnière deformity is an injury to the proximal interphalangeal joint (PIP) that prevents its extension, while causing hyperextension of the distal interphalangeal joint (DIP). This misalignment results from damage to the extensor tendon on the dorsal side of the finger, known as the “central slip.”
What are the symptoms?
The initial signs include difficulty straightening the PIP joint, although the movement can be performed with the help of the other hand. The affected area may be swollen and painful. If left untreated, this deformity can become permanent, making certain daily tasks difficult, such as writing, buttoning clothes, or slipping the hand into a pocket.
What are the causes of boutonnière deformities?
This injury can occur after a dislocation of the PIP joint, a cut to the extensor tendon, or be associated with inflammatory diseases such as rheumatoid arthritis. An injury that seems like a simple “locked finger” can actually be an underlying tendon injury that leads to a boutonnière deformity if not treated promptly.
What are the treatments?
A precise diagnosis by a doctor is essential to determine the appropriate treatment. For a recent injury that does not require surgery, immobilization with a splint made by a hand therapist is generally recommended to maintain finger alignment and promote tendon healing. In cases where the deformity results from an untreated injury, significant tendon damage, or an inflammatory condition, surgical intervention may be considered.
What is the role of the hand therapist in recovery?
The hand therapist plays a key role in recovery. They fabricate a custom splint to immobilize the affected joint in an optimal position. They also teach techniques to reduce inflammation and guide the patient through an exercise program aimed at rebalancing motor forces and regaining optimal finger function. In post-surgical cases, the therapist provides a tailored plan to protect the repair, prevent joint stiffness and tendon adhesions, and restore mobility.
Mallet finger
What is a mallet finger?
The mallet finger is a common injury characterized by the inability to straighten the tip of the finger. It is caused by damage to the extensor tendon located at the last phalanx. This injury typically occurs after a direct impact on the tip of the finger, such as from a ball hit, or during daily activities when a finger is suddenly forced into flexion.
What are the symptoms?
The characteristic signs of a mallet finger include:
- A drooping of the fingertip, with an inability to actively straighten it.
- Pain, swelling, and sometimes redness at the distal joint.
- A risk of stiffness in the other joints of the finger if the injury is not treated promptly.
How to treat a mallet finger?
Treatment involves immobilizing the joint in an extended position for a period of 6 to 8 weeks. This immobilization is essential to allow the tendon to heal. It is crucial to keep the finger straight at all times to ensure optimal healing.
In rare cases, if the injury is associated with a fracture or if healing is unsatisfactory, surgery may be considered to stabilize the joint and restore finger function.
The expertise of the hand therapist
A hand therapy specialist plays a crucial role in the management of a mallet finger. Their intervention helps to:
- Design a custom splint to immobilize the finger in the correct position.
- Provide specific advice to avoid improper movements during the healing process.
- Supervise the gradual return of movement to prevent any recurrence.
- Ensure optimal recovery of mobility and finger function after immobilization.
Trigger finger
What is trigger finger?
Trigger finger, or stenosing tenosynovitis, is an inflammation of the flexor tendons located on the palm side of the hand. These tendons allow the fingers and thumb to flex. When they become inflamed, their sliding through the synovial sheath becomes difficult, causing the finger to get stuck in a flexed position before suddenly unlocking.
Symptoms
- Pain and the appearance of a nodule in the palm of the hand
- Finger locking in flexion, followed by a sudden release
- Progressive stiffness of the finger, especially in the morning
- A cracking sensation during flexion and extension movements
Causes and risk factors
- Repetitive movements requiring a strong grip (e.g., hand tools, musical instruments)
- Medical conditions such as diabetes and arthritis
- History of trauma or microtrauma in the palm area
- No identified cause in some cases
Treatment options
Conservative Approach (Non-Surgical)
- Medication: Anti-inflammatory drugs to reduce pain and inflammation
- Custom Splint: Keeps the finger in extension to limit tendon irritation
- Cortisone Injection: Helps reduce inflammation and relieve symptoms
- Physical and Occupational Therapy: Specific exercises to prevent stiffness and restore mobility
Surgical Approach (as a last resort)
- Indicated in cases of persistent symptoms despite conservative treatments
- An intervention aimed at releasing the tendon sheath to allow smooth gliding
The role of the hand therapist
A specialized therapist can help with:
- Design a custom splint to reduce tendon irritation
- Propose ergonomic adjustments to limit excessive strain
- Teach mobilization and stretching exercises to ensure proper tendon healing
- Guide rehabilitation after a possible surgical intervention
With appropriate care, most patients regain optimal function without the need for surgery. Personalized follow-up helps maximize recovery and prevent relapses.
Injuries to the fingertips
What is a fingertip injury?
Fingertip injuries are common and range in severity, from superficial cuts to more severe damage, including fractures, partial amputations, and injuries to nerves and blood vessels.
What are the symptoms of a fingertip injury?
These injuries can cause bleeding, bruising, swelling, and intense pain due to the high concentration of nerve endings in this area. Numbness or finger deformity may also occur, and some injuries may become infected if not treated properly.
What are the causes of fingertip injuries?
Common causes include domestic, occupational, or sports-related accidents. Getting a finger caught in a door, cutting yourself while cooking, or experiencing a direct impact during sports activities are frequent scenarios. The longer fingers are usually the most affected, as they are more exposed.
What are the treatments for fingertip injuries?
A doctor should examine the injury to determine the appropriate treatment. Depending on the severity, wound care, immobilization with a splint, or surgical intervention may be necessary to prevent complications and preserve finger functionality.
What is the role of the hand therapist in recovery?
The hand therapist helps protect the injured area with a custom splint, promotes healing, and prevents complications such as joint stiffness or loss of sensation or hypersensitivity. They also provide exercises aimed at restoring mobility, strength, and functionality of the finger, ensuring optimal recovery.
Ulnar collateral ligament injury of the thumb
What is an ulnar collateral ligament (UCL) injury of the thumb?
The ulnar collateral ligament (UCL) of the thumb is a crucial structure located at the metacarpophalangeal joint. It plays a key role in stabilizing the thumb during gripping and pinching movements. An injury to this ligament, known as “skier’s thumb,” can range from a mild sprain to a complete rupture.
What are the symptoms of an ulnar collateral ligament (UCL) injury of the thumb?
Symptoms include pain and swelling at the thumb’s middle joint, often accompanied by bruising and stiffness. A loss of grip strength and difficulty performing simple tasks such as holding a glass or writing may also be observed. Joint instability may be felt in cases of ligament rupture.
What are the causes of ulnar collateral ligament (UCL) injuries of the thumb?
These injuries typically occur during a fall where the thumb is suddenly pulled outward, such as when a skier falls while holding a pole. They can also be caused by sports-related trauma (football, cycling, soccer) or direct impact on the thumb.
What are the treatments for ulnar collateral ligament (UCL) injuries of the thumb?
The diagnosis is based on a clinical examination, supplemented by X-rays to rule out a fracture. In the case of a sprain, immobilization with a splint is prescribed to allow healing. For a complete ligament rupture, surgery may be necessary to restore joint stability.
What is the role of the hand therapist in recovery?
A hand therapist plays a key role in rehabilitation. They create a custom splint to immobilize the thumb and promote healing. They also offer progressive exercises to strengthen the hand and improve thumb function after recovery. In post-surgical cases, the therapist guides the patient through a tailored rehabilitation program to regain strength and mobility while preventing long-term complications.
Dislocation of the fingers
What is a finger dislocation?
A finger dislocation is a common injury that occurs when the bones of the finger are displaced from their normal position at a joint. This dislocation can affect any joint in the finger, but it is most common at the proximal interphalangeal joint (PIP). Depending on the direction of the displacement, different types of dislocations are identified: dorsal, palmar, or lateral. A dislocation can also be accompanied by a fracture or ligament damage.
What are the symptoms of a finger dislocation?
Symptoms include a visible deformity of the finger, intense pain, swelling, and bruising. Finger mobility may be reduced or impossible, and some dislocations may be accompanied by numbness or tingling, indicating possible nerve damage. In some cases, the skin may be injured.
What are the causes of finger dislocations?
Finger dislocations often occur as a result of direct trauma, such as a blow during sports (e.g., a ball striking the finger forcefully), a fall, or excessive twisting of the finger.
What are the treatments for finger dislocations?
A clinical examination and X-rays help confirm the diagnosis and rule out any associated fractures. The reduction of the dislocation (realignment of the joint) is usually performed by a healthcare professional. Temporary immobilization with a splint or bandage may be necessary to promote healing. In cases of complex or unstable dislocations, surgery may be considered.
What is the role of the hand therapist in recovery?
A hand therapist plays a crucial role in rehabilitation after a dislocation. They can design a custom splint to protect the joint and guide the patient through a progressive exercise program to restore mobility, strength, and finger function. Proper care helps prevent joint stiffness and ensures an optimal return to daily and professional activities.
Injury to the palmar plate of the finger
What is a palmar plate injury?
The palmar plate is a ligament located on the inner side of the finger that provides stability to the proximal interphalangeal (PIP) joint. This ligament prevents excessive hyperextension of the finger. An injury to the palmar plate can range from a simple sprain to a complete rupture or bone avulsion.
What are the symptoms of a palmar plate ligament injury?
Symptoms include pain, swelling, and bruising around the PIP joint. Stiffness or reduced mobility of the finger may also be present, and in cases of dislocation, the joint may appear misaligned.
What causes palmar plate ligament injuries?
These injuries typically occur due to a sudden hyperextension of the finger, often caused by a direct blow, a fall, or an impact during sports activities such as catching a ball. They can also result from a dislocation of the PIP joint.
What are the treatments for volar plate ligament injuries?
The diagnosis is typically confirmed through a clinical examination and X-rays. Most injuries can be treated non-surgically with temporary finger immobilization using a splint, followed by gradual exercises. In cases of severe instability or an associated fracture, surgical intervention may be required.
What is the role of the hand therapist in recovery?
A hand therapist plays a crucial role in recovery. They can design a custom orthosis to protect the joint while guiding the patient through an exercise program aimed at reducing stiffness, restoring mobility, and strengthening finger function. Tailored rehabilitation helps optimize healing and prevent long-term complications.
Pediatric trigger thumb
What is pediatric trigger thumb?
Trigger thumb is a condition where the flexor tendon of the thumb (flexor pollicis longus – FPL) gets stuck as it passes through a pulley at the base of the finger. This restriction prevents full extension of the thumb, creating a mechanical blockage known as “catching.”
What are the symptoms of pediatric trigger thumb?
Children with this condition have a thumb held in a flexed position, sometimes associated with a small bump (nodule) at the base of the finger. Although this may limit the ability to grasp and manipulate objects finely, the pain is usually mild. The condition can be detected as early as 4 to 6 months of age but often becomes more noticeable between 1 and 2 years old.
What are the causes of pediatric trigger thumb?
The exact cause of this condition remains unknown. Unlike the adult form, it is generally not related to trauma or overuse.
What are the treatments for pediatric trigger thumb?
The treatment depends on the severity and duration of the condition. In less advanced cases, a specific splint may be prescribed to help with thumb extension. Stretching exercises taught to parents by a hand therapist may also be recommended. If the thumb remains permanently locked, surgery to release the tendon may be considered.
What is the role of the hand therapist in recovery?
A hand therapist supports families by providing tailored exercises to loosen the tendon and prevent worsening of the blockage. After any potential surgical intervention, they can design a splint to maintain the thumb’s extension and promote functional recovery through engaging games and activities for the child.
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