Hand Therapy for Arthritis
Arthritis in its various forms affects over 46 million adults in the United States and is the leading cause of disability. In its most common form, osteoarthritis, it can affect any joint. In rheumatoid arthritis, even the eyes, mouth, and lungs might also be affected. Arthritis, whether severe or mild, can be painful as well as restrict movement in all limbs, especially in the hands. Many factors—not always easy for a person to control—will result in the development of the disease. Those people in particular whose hands are affected by arthritis will find that everyday activities and simple manipulations might be difficult or impossible to perform. Hand therapy is a non-surgical alternative that offers promising and effective options in managing arthritis.
Why Use Hand Therapy for Arthritis?
Arthritis not only inhibits movement but can also cause annoying aches, or severe pain; fortunately, hand therapy is able to addresses both of these problems. It is a non-surgical approach that does not rely on the use of additional medications. In some cases of arthritis, surgery or medications, such as cortisone injections and NSAIDs (non-steroidal anti-inflammatory drugs), are used—but these do not always provide the necessary solution to an underlying condition, even in the case of surgery. Alternative therapy, like hand therapy, can help arthritis without side effects or surgical risks. The exercise therapy that is a part of hand therapy can strengthen joints and thus improve movement. Especially as prevention against crippling or further disabling results, hand therapy can bring positive change for arthritis suffers. While pain relief can be effectively managed with both prescription and over-the-counter medications, the disadvantage of those medications are the serious side effects that mask the pain yet do not enable long-term improvement in function. Professional hand therapists will evaluate a person’s challenges before planning a treatment program, and provide arthritis suffers with an approach that works best for their circumstances and lifestyle.
How Can Hand Therapy Help Arthritis?
Hand therapy helps to maintain movement through hand exercises. It also employs the use of splints that can help reduce the pressure on the hand during movement, and other methods of assisting in the manipulation of hands and fingers, sometimes including electrical stimulation. It offers acute or chronic pain management techniques, desensitization as a result of nerve injury or trauma, sensory re-education following a nerve injury, a personalized exercise program designed to increase dexterity and manual strength, and most importantly, an opportunity to retrain a person to handle the tasks of everyday life—any household or personal task, whether it is personal hygiene care, or vacuuming, or washing dishes. Through regular practice, hand therapy will provide the benefits of increased movement; and it will possibly effect less reliance on pain or other arthritis medications that can bring serious, health threatening side effects. In treating arthritis and its effects, hand therapy focuses on the problem—increasing joint movement with as little pain as possible.
What is Hand Therapy?
Hand therapy has a self-explaining focus: the body’s uppermost extremity—the hands. Practicing a medical art that is scientifically based, a hand therapist works both as a physical therapist and as occupational therapist. Restoring better movement in the hand through specific exercises and helping the afflicted person to better manipulate the hands and fingers, this medical professional directs the patient in the three important factors that can result from hand therapy, which include preventing injury or impairment, restoring functional ability of the hand and fingers, and enhancing participation in daily life. Rehabilitation through hand therapy can occur without surgery, or can be a crucial piece of post-surgical therapy.
Hand Therapy for postoperative rehabilitation can be used for:
- Management of open or sutured wounds (in order to prevent infection and promote healing)
- Control of hypertrophic (raised or swollen) or hypersensitive scars
- Reduction of swelling
Hand Therapy for preventative, non-operative, or conservative treatment can be used for:
- Acute or chronic pain management
- Nerve desensitization
- Sensory re-education following an injury
- Splint fabrication for prevention or corrections of injury
- Life skill training through adaptive methods and equipment
What is Arthritis?
Arthritis is best defined by determining the literal meaning of the word—inflamed joint. It is an autoimmune disorder, and is a term used to describe over 100 different diseases and conditions. In a normal joint, the cartilage covered bone surfaces of the hand so they fit together smoothly. When these surfaces become irregular and do not fit together, they essentially wear down.
Though arthritis is more commonly found in adults as they age, it also affects as many as one in 250 children, with some form of arthritis or a related condition.
Common symptoms of arthritis include:
- Swelling of the joints
- Stiffness in the joints, obstructing movement
The most common forms of arthritis that are likely to benefit from hand therapy are rheumatoid arthritis; osteoarthritis; and, two other forms of osteoarthritis—arthritis of the finger joints, and arthritis of the base of the thumb.
When rheumatoid arthritis affects the hands, it is an indication that the cells that line and lubricate the joints, or synovial tissue, have been affected. The condition is systemic—meaning that it emerges from an internal condition rather than through environmental factors or injuries. The joint lining is inflamed and swollen, wearing away the cartilage and bone. When the swollen tissue is stretched around the surrounding ligaments, deformity and instability occur.
Osteoarthritis of the hand most commonly occurs as arthritis of the finger joints and at the base of the thumb. It is a degenerative joint disease (DJD). The cartilage that provides a cushion covering the bone surfaces at the joints slowly begins to wear out. It is most likely to occur with aging, or with repeated or serious injuries to the hands.
Throughout the entire body, osteoarthritis is most likely to develop at three different sites:
- At the base of the thumb
- At the end joint closest to the finger tip
- At the middle finger
Osteoarthritis can also occur in the wrist, for which the stimulation and hand therapy exercises can provide better movement and a decrease in painful swelling.
What Causes Arthritis?
In cases of rheumatoid arthritis, the cause is not yet clearly defined. Since the disease is a dysfunction of the immune system, genetic, hormonal, and environmental factors are considered as possible contributing factors.
In the case of osteoarthritis and the various forms it takes, the factors most likely to increase the risk of development include being overweight, aging, and injury.
Finding a Hand Therapy Specialist
The Hand Therapy Certification Commission (HTCC) certifies practitioners in Hand Therapy through formal standardized testing. It is advisable to request for a referral from your doctors for a Certified Hand Therapist (CHT) to ensure the highest quality of care.
The American Society of Hand Therapists (ASHT) is a professional society for hand therapists, seeking to advance the profession through communication, education, advocacy, research and clinical standards.