Treatments commonly used in hand therapy
Treatments commonly used in hand therapy:
- Swelling (oedema) management
- Wound management
- Scar management
- Exercise therapy and mobilisation techniques
- Work and activity hardening
- Soft tissue massage
- Joint protection and energy conservation techniques
Splints can be made out of thermoplastic (plastic which can be heated and moulded), neoprene (the fabric wet suits are made from) or plaster of paris.
The choice of which material to use depends on what the splint is required to do. All of the splints can be moulded to the individual to make sure they are comfortable, and allow for easy skin and wound care.
Hand therapists can make splints that:
- rest inflamed areas
- protect healing structures
- increase range of movement
- prevent or correct deformities
- assist with function
Swelling following surgery or an injury can be part of a natural process, but it can also be part of a disease process.
Treatment must focus on decreasing the amount of swelling levels so there are no long-term effects on other structures.
Compression, elevation, massage and cooling methods can all help decrease unwanted swelling.
Our hand therapists are all training in wound management, and can make sure the correct wound care and advice is given.
This may include changing dressings, removing stitches and starting scar work when appropriate.
Scars are formed as part of the natural healing process following injury, surgery or burns. Whilst scars are maturing it is important to help prevent the scar becoming tight or stuck down onto underlying structures.
This could lead to a reduced range of movement and cause problems with function of the hand. Firm scar massage can help prevent these problems by improving the quality of the scar.
Other techniques such as friction to the scar or electrotherapy in the form of ultrasound can also be used. Silicone products and pressure garments can also be useful to hydrate and flatten scars.
Pressure garments can be specifically measured and made for the individual and are very useful for managing skin grafts and burns.
Ultrasound can be used to treat scars, encourage healing and help reduce pain. TENS machines can also be used to help control painful hand and forearm conditions.
Exercise therapy and mobilisation techniques
Following injury or surgery to the hand stiffness can be a problem. Exercises form the basis of therapy programmes, and home exercise is encouraged to promote the best possible outcome for the patient.
Exercise programmes are monitored and adjusted in response to continued healing process. Resistance exercises can be added to help strengthen the affected area.
If specific joints are stiff then mobilisation techniques can be started to help improve the range of movement. Wax therapy can also be used prior to mobilisations to help decrease pain levels and promote relaxation.
Work activity and hardening
Functional assessments can provide detailed information on how a patient uses their hand, arm and body.
Through discussion and observation the therapist can gain a good insight into the patient’s life, and in turn assist in advising about adaptation to task performance, or relevant assistive devices. This advice can be particularly useful for people following complex multiple trauma.
Soft tissue massage
Muscular tension can develop as a result of over working that particular area. Treatment can include: trigger pointing, soft tissue massage, stretching, icing, home acupressure and activity modification (such as how to carry items, or modify sleeping positions to reduce symptoms).
Joint protection and energy conservation techniques
Joint changes can occur due to diseases such as Rheumatoid or Osteoarthritis. Pain, instability and a loss of functional use of the hand can happen. Careful instruction on how to use the hand and body can decrease progression or development of deformities.
This can include educating how to spread strain to larger joints, or avoid gripping for prolonged period of time on small or narrow objects.
Energy conservation techniques can also be taught so patients can spend more time on the tasks they enjoy doing rather than exhausting themselves with tasks of daily living. Splinting can also be very useful in helping protect affected joints.