Rehabilitation - Hand Therapy

Introduction

Hand Therapy is a specialized area of rehabilitation. Your doctor may refer you to an occupational therapist with advanced skills or a Certified Hand Therapist (CHT) for hand therapy.  A CHT is an occupational or physical therapist that has completed continued education, supervised training, and testing to earn credentials beyond a therapy degree. Hand therapists focus on rehabilitation for conditions that affect the hand and arm.

A hand therapist provides continuing care for individuals with hand conditions resulting from medical conditions or following hand surgery or injury.  Medical conditions, such as arthritis; neurological conditions, such as stroke, traumatic brain injury, and spinal cord injury; and disorders, such as carpal tunnel syndrome; can affect the way hands move and function. Hand therapy can be helpful for people with trauma, burns, and amputations.  Additionally, hand therapy is common following hand surgery to restore tendons, nerves, and joint function.  A hand therapist may be consulted for preventive consultation, especially in the manufacturing industries.

Treatment

Your hand therapist will work with your doctor to determine treatments that are appropriate for you and that are designed to meet your goals.  Hand therapy can reduce pain and swelling.  It can help to restore strength, endurance, coordination, and movement.  It can also promote healing and reduce scar formation.  You should tell your hand therapist about your symptoms, concerns, and goals.  Your therapist will create a treatment plan that incorporates your goals for functional improvement.

At your initial evaluation, your therapist will examine your hand and take measurements.  Your hand and finger strength, coordination, and sensation will be tested.  The therapist will measure how far you can move your joints.  He or she will look at your hand for any sores, deformities, or swelling. 

Hand therapy treatments vary and depend on the type of condition you have, the extent of your condition, and your goals.  It is common for therapy to include hand exercises, splinting, and modalities.  You may need to wear hand splints while your hand is at rest, during work, or both.  Hand splints can help your hand heal, reduce pain, and improve function.  Modalities are treatments that can help relieve pain and promote movement. These include heat, ice, ultrasound, electrical stimulation, and others. Additionally, hand therapy can include wound healing treatments and burn debridement.  Your therapists can suggest adaptive devices, such as eating or writing utensils, to improve your functional independence.

In industrial settings, hand therapists perform workplace evaluations for injury prevention.  Hand therapists can recommend alternative work methods or work station changes to prevent injuries and cumulative trauma disorders.  They can also help an individual with a hand injury return to work by making workplace modifications.