Category : Hand Therapy

Arthritis Hand Hand Therapy Thumb Arthritis

Advice from a Certified Hand Therapist: Surgery for Thumb Arthritis Pain

Thumb arthritis pain can be debilitating, making everyday self-care tasks intolerable. There is a surgical option when other treatments, such as injections and therapy, fail to adequately reduce pain. A carpometacarpal arthroplasty or CMC arthroplasty is a joint replacement procedure for the base of your thumb. It eliminates the grinding and pain felt from the rubbing of bone on bone after the protective cartilage has worn away, usually caused by arthritis.

Below are some commonly asked questions regarding this procedure:

Will I be in a cast?

Yes. You will likely be in a cast for 2-4 weeks. You will also use either a removable orthosis a hand therapist will custom make for you or an off-the-shelf thumb and wrist splint for a month after the cast has been removed. This will help maintain the optimum position of your thumb as you are healing and protect your new thumb joint.

What happens after my thumb has been immobilized?

Any time a joint has been immobilized, it takes time to regain your flexibility. For this surgery, the wrist and thumb are usually quite stiff. Your doctor will likely recommend you see a hand therapist to assist you with regaining the range of motion and strength safely.

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Food Hand Hand Therapy Knife Safety

Advice from a Certified Hand Therapist: Kitchen Knife Safety

Serious hand injuries can occur during daily activities such as preparing food. Many hand injuries can be prevented with simple adjustments to routines. In preparation for the upcoming fall cooking season, please consider some safe, simple adjustments to your own routine in cutting various food items to prevent knife slips, which can cause injuries to the tendons or the nerves in your hand.

Mangoes

This delicious, yet slippery fruit can be a challenge when it comes to cutting and preparing for serving. The danger arises from removing the outside peel of the fruit. Once this is removed, the fruit center is extremely juicy and becomes difficult to hold. The fruit is also oval-shaped, difficult to place on a cutting board and has a large pit in the center.

Here’s a safe method for preparing mangoes:

  1. Keep the peel intact! Instead, stand the mango on a cutting board with stem side down and cut mango into two large pieces from either side of the pit. Be sure to cut toward a cutting board or solid surface and not the palm of your hand.
  2. Taking the two large pieces with peel side on cutting board, you can use a paring knife to cut cubes or slices of the mango, being sure not to cut through the peel. Again, be certain you are cutting toward a hard surface and not your hand.
  3. Once all your cuts are made, you can begin to peel away the skin of the mango by turning the skin inside out OR you can use a spoon (not anything sharp) and scoop the cut pieces away from the skin of the mango.
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Hand Hand Conditions Hand Pain Hand Therapy

Advice from a Certified Hand Therapist: Hand Edema

Hand edema is inflammation, swelling or fluid collection in the hand. Sounds basic by definition; however, edema in the hand can be extremely problematic and complex when there is a hand condition or injury.

Edema is the body’s response to healing itself, but, in the hand, large amounts and/or long-term swelling can cause permanent impairment and affect one’s ability to perform daily activities. It is one of the most common problems associated with hand injuries/conditions. Edema can be a primary focus during hand therapy as it can trigger so many other problems such as pain, lack of motion, scar tissue and decreased function of the hand and arm.

Edema can be acute in nature, which means it occurs in the first 24-48 hours after an injury or condition, or chronic (present 48-72 hours or longer after injury). Signs of acute hand edema are typically:

  • Redness
  • Warmth
  • Throbbing
  • Swelling
  • Decreased mobility and use
  • Tingling
  • Numbness
  • Pain

Chronic hand edema can be hard or soft and, typically is not warm, red or throbbing; however, it can be painful and cause scarring and/or decreased function.

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Hand Hand Therapy Paraffin Wax

What is Paraffin Wax?

Paraffin Wax Unit

Paraffin wax is a type of wax used for candles that can also be used to relieve pain from arthritis, sore joints or sore muscles. When the wax is melted and becomes hot, submerging your hands in the wax can be a great method to sooth pain. Paraffin wax is an at-home treatment that has been recommended by hand specialists.

You should NOT use paraffin wax if you have an open cut/wound on your hands or if you’ve had past issues with sensation in your hands.

This at-home treatment can be completed by either renting or purchasing a paraffin wax unit, both of which are low-cost options. You can buy a unit at a local drugstore.

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Hand Hand Therapy Pencil Grip

Advice from a Certified Hand Therapist: Modifications to Pencil Grip for Handwriting

As a pediatric hand therapist, I see clients who hold their pens and pencils a little bit differently than most. Typically, these clients are using a different grip to compensate for weakness or loose joints. An altered grasp is not in itself a bad thing until it creates a problem.

The problem is usually a complaint of pain with handwriting. An individual with loose joints develops an altered grasp pattern in order to increase stability when writing, thus allowing them to write clearly. An example of a modified grip is excessive extension of the tip of the fingers or thumb along with excessive flexion of the second joint of the thumb.

Another example involves holding the pencil tight in the first web space while using all four fingers and thumb to stabilize the pencil.

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Arthritis Hand Hand Therapy Thumb Thumb Arthritis

Ask a Therapist: Thumb Arthritis

Certified Hand Therapist Michelle McMurray, MOT, OTR/L, CHT discusses thumb arthritis, also known as basal joint arthritis.


Basal joint arthritis, or thumb arthritis, is the most common site of arthritis in the hand.  This may also be referred to as the CMC (carpometacarpal) joint.  Pain typically occurs at the base of the thumb where the hand meets the wrist.  People typically report pain and weakness with grasping or pinching activities. Most people do not realize how important this particular joint is to the function of the hand until it hurts.  The amount of force transmitted through the CMC joint holding a 1-pound object at the tip is amplified to over 13 pounds at the CMC joint.  Basic activities of daily living can require between 6 and 8 pounds of pinch at the tip of the thumb, which would be amplified more than 10 times that at the base of the thumb!  Over time, this can cause break-down of the joint with loss of cartilage (the smooth part of the joint) and inflammation.  This is sometimes a painful process.

When this occurs in the body, what options do we have to feel better?  Most people do not choose surgery as their first option, and it is often not recommended as the first option.  Initial options may include injections, splinting, medications and/or rest.  Additionally, there are modifications that can be made to our daily activities which may also help to decrease the pain.

Here are a few examples of some easy and inexpensive ways to protect your hands to decrease the stress and inflammation at your thumb:

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Hand Hand Surgery Hand Therapy

What is a Hand Therapist?

I have been told to see a hand therapist, but am unsure what that means. Who provides “hand therapy”?

A hand therapist is an occupational therapist (OT) or physical therapist (PT) who has specific training and expertise in treating hand and arm conditions. Typically, this person has spent many additional years gaining expertise with hand and arm injuries and treatment. When an OT or PT has reached this higher level of experience, they often become a Certified Hand Therapist (CHT).

So I can see anyone that is a PT, OT or CHT to take care of my problem?

You will want to ensure that the therapist you see, whether it is an OT or a PT, is qualified to treat your condition. If they are a CHT, it means they have had extra training and passed a rigorous exam to demonstrate their skill. If they are an OT or a PT, they may still treat hand and arm conditions, but you should ask questions to ensure they have spent extra time after their formal education learning about the hand and arm. To find a hand therapist near you, click here.

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Hand Hand Therapy Mirror Therapy Pain

Advice from a Certified Hand Therapist: Mirror Therapy for Chronic Pain

Chronic pain that does not respond to conventional treatment can be frustrating for both the person with the pain and the team of people trying to help alleviate the pain. You may have heard of mirror therapy, but are unsure of what it is or who can benefit. To answer these questions, I consulted Susan Stralka, PT, DPT, MS. Susan has many years of experience treating patients with chronic pain and has lectured around the world on this topic.

What is mirror therapy?

Mirror therapy is a rehabilitation technique that uses the mirror image of a non-painful limb to retrain the brain about its perception of a painful limb. The non-painful limb (such as a hand or foot) is placed in front of a mirror and the painful limb is placed behind the mirror out of sight.

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