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Hand

Hand Physiotherapy

 

Hand Physiotherapy

Osteoarthritis of the hand

 

Signs and Symptoms 

  • Most commonly affects the base of the thumb (the carpo-metacarpal joint) particularly in women over the age of 50.
  • Pain within the joint, weakness of pinch grip, loss of range of movement and stability of the joint, reduced function especially if the dominant hand is affected.

 

What is happening with the body? 

Osteoarthritis  is a condition where the articular cartilage (lining of the bone joint surface)  begins to diminish in size and changes to the surface of the joint occur making it irregular instead of smooth. This process can lead to swelling, pain and reduced strength of the surrounding muscles.

 

How can physiotherapy help? 
Massage, gentle mobilization, use of a splint to rest and support the joint as well as assist in function, advice on achieving a balance between rest and exercise to optimize function with minimal pain. Splints may be a neoprene or elastic thumb wrap, or a custom made thermoplastic version which offers more support for painful joints.

 

Carpal Tunnel Syndrome

 

Signs and Symptoms 

Can include tingling, pins and needles (paresthesia), numbness in the area of the hand supplied by the median nerve- mainly the tips of the thumb and first 2 fingers. If the branch of the nerve that goes to the muscle becomes affected, there will be eventual weakness in the thumb muscles, leading to weakness especially in pinch grip. The paresthesia and numbness are often worse at night.

 

What is happening with the body? 

Carpal tunnel syndrome (CTS) is caused by compression of the median nerve as it travels through the tunnel at the wrist. Predisposing factors that can lead to CTS include pregnancy, obesity, and diabetes. There is speculation that cumulative repetitive movements and prolonged use of vibration tools in work can lead to CTS, but there is no current evidence to show a direct cause.

 

How can physiotherapy help?  

Splinting using a wrist brace, mainly worn at night, exercises, therapeutic ultrasound, manual techniques to improve joint movement. Advice on computer and work station set up if relevant to your situation.   Should symptoms persist we will liase with your GP regarding an opinion from a hand surgeon as sometimes surgery is required  to release the pressure on the nerve in the carpal tunnel. Physiotherapy following surgery will help to maximise recoery.

De Quervains Syndrome

 

Signs and Symptoms 

Pain and tenderness over the two affected tendons on the thumb side of the wrist, often accompanied by palpable swelling and difficulty gripping. Common in new mothers (or grandmothers!) when nursing the baby or changing nappies.

 

What is happening with the body? 

De Quervains Syndrome is the name for a range of conditions that cause irritation or “tendinopathy” of two of the thumb tendons. It is essentially an overload of these tendons – the load placed on the tendons is greater than the ability of the muscle and tendon to cope with that load. The types of activities that overload the tendon are those that involve pinching, grasping, pushing or pulling play a part, and intensive use of a computer mouse. There may also be a hormonal impact as it is a common problem in breastfeeding and postmenopausal women.

 

How can physiotherapy help?  

Splinting the thumb and wrist to rest the tendons, massage, therapeutic ultrasound, ice or heat to reduce pain and swelling, and specific exercises.