Our Occupational Therapist works with you to help you achieve a fulfilled life, through, the use of activity designed to achieve functional outcomes which promote health, prevent injury and improve and restore your level of independence. Occupational Therapy is about helping you to do the day-to-day tasks. The hand and wrist work together to allow you to perform activities of daily living, as well as participating in athletic and artistic endeavors. Working with your hands is not only functionally important, but can enhance your life. The goal of hand surgery is to treat pathology caused by overuse trauma, inflammatory or degenerative processes. Restoration of function and resolution of symptoms, such as pain, are critical goals of our discipline. Most conditions are amenable to initial non-operative management. Below is a list of a select hand pathologies and treatments including basic information regarding each condition.
Normal Hand Anatomy – The hand is an intricate instrument that is both tough and delicate. Its functions of sensations and motion allow us to experience and control the world around us.
Trigger Finger – The tendons of the thumb and each of the fingers pass through a sheath on the palm side of the hand. Certain diseases and overuse activities can cause a thickening of this sheath. As the tendon passes through a thickened sheath, the tendon eventually becomes irritated and swells. Pain, catching and eventually locking of the finger will occur. Symptoms usually starts with mild discomfort and tenderness at the base of the fingers and thumb. The affected digit will be painful to bend or straighten and will often pop when flexing. Causes are not always clear and can be caused by repetitive use. Some cases can be caused by rheumatoid arthritis, gout and diabetes. Early treatment can be as simple as warm or cold packs, anti-inflammatory meds, and splinting to reduce the repetitive motion of the affected finger. Resting the tendon is the important thing and then strengthening it.
Dupuytren’s Contracture – This disorder is a thickening of a ligament in the palm, resulting in nodules on the ligament which, if severe enough, can cause an inability to fully straighten the fingers. The ring and small fingers are the fingers most commonly involved. is a condition that causes the tissue just beneath the skin of the palm to tighten, drawing the fingers. Dupuytren’s contracture into the palm. Symptoms you may feel the tissue beneath your palm start to thicken and over time will cause lumps that develop in your palm and extend into your fingers making it difficult to open your hand. The tightness and bent fingers develop slowly over time, taking months or even years to develop. Treatment Options Hand therapy can help in post-operative care and management. Elizabeth can fabricate a splint to help keep your fingers extended and develop a home exercise program to help you to regain your strength and aid in regaining the use of your hand.
DeQuervains Tenosynovitis – Tendonitis on the thumb side of the wrist can be a very painful and disabling condition. Simple pinching and twisting activities can be almost impossible. The tendons to the thumb become inflamed as they pass under a ligament and the slightest motion of the wrist can cause pain. Symptoms localized pain, swelling, and tenderness on the thumb side of the wrist. Gripping and pinching become painful. Causes excessive repetitive use, stress and pressure on the affected area. Repeated gripping and pinching results in inflammation and pain. Previous wrist injuries including fractures and rheumatoid arthritis can also be associated. Treatment Options reducing repetitive motions with your thumb.
Carpal Tunnel Syndrome – is a common hand problem resulting from pressure on the median nerve at the wrist. Symptoms, which are often worse at night, consist of numbness and pain in the wrist and fingers. Eventually, there is loss of strength, fine motor control and sensation. Early treatment consists of splinting. Symptoms of pain, numbness and tingling in the fingers, hand and arms and are felt during the night and daily activities like driving or anything that causes a weakened grip or a tendency to drop things. Causes pressure on the nerve in the wrist, swelling, dislocations, fractures, arthritis, and keeping your elbow bent for long periods of time causing the nerve to be pinched.
Myofascial Release – is a form of soft tissue therapy. Fascia is a structure of connective tissue that surrounds groups of muscles, blood vessels, and nerves. It binds some structures together while permitting others to slide smoothly over each other. Fascia can become tight or restricted which can cause your pain and limit your motion. Once these limitations are released, you can experience ease and freedom of motion, comfort at rest, and relaxation.
The role of our Occupational Therapist in Orthopedics is to assist you to overcome some of the limitations due to your condition or injury. By helping you to work and live independently. The Therapist will assess your abilities and lifestyle prior to your surgery or illness, as well as your expectations of your lifestyle post-surgery. Our Therapist will consult with you and the Orthopedic surgeon in charge of the surgery to develop a program that will best suit your expectations. After major orthopedic surgery, it is imperative that your ability to become independent and able to manage your lifestyle
Orthopedic Hand and Elbow for:
- Carpel Tunnel
- Tendon Repairs
- Dupuytren’ Contractures
- Orthotics for hands, fingers, wrist and elbow
- Multiple Sclerosis
- Parkinson’s Disease.
Simple Wound Care: cleaning of wounds, monitoring and bandaging. Does not include debridement, staples or stitch removal.
Other services to include:
- Cold Laser
- Electrical Stimulation
- Manual Therapy is used for a variety of conditions.
- IASTM (Instrumented Assisted Soft Tissue Mobilization)
- MPS (Microcurrent Point Stimulation)
- ETPS (Needleless Acupuncture)
- Myofascial Release
- Scar Management to reduce adhesions and improve movement.