Hand pain responds well to physiotherapy treatment and is something we see regularly at Walker and Hall.
We know how disabling it can be, affecting every aspect of your life e.g., dressing – particularly fastening buttons, eating – especially holding a knife or fork, writing, typing, using a key and even drinking.
The most common types of hand pain we treat are
Osteoarthritis of the thumb and fingers
Trigger finger
Fracture of the metacarpals
Referred pain
If your condition is not listed above please contact us
We have extensive experience in treating these conditions and managing your recovery.
To see how Walker and Hall can help you please click on the links below:
Osteoarthritis of the thumb and fingers
In our experience this is the most common form of thumb and hand pain. It is extremely disabling and if it involves your dominant hand (the hand you write with) then it can affect all aspects of your life from washing and dressing, to work related activities to sports and leisure activities.
Fortunately osteoarthritis of the thumb and fingers responds well to physiotherapy treatment.
Anatomy
Osteoarthritis is damage to and a loss of the cartilage that covers the bones in the joints of the thumb and hand. It is most frequently seen in the thumb but can affect all the fingers of the hand.
Causes of osteoarthritis of the thumb and fingers
- Repetitive use – the repetitive use of the joints of the thumb and fingers can lead to wear and tear. Activities such as joinery, carpentry, painting, bricklaying, the use of a hammer, and screw driver, the use of vibrating machinery, sports such as golf, racket sports, bowling and rowing, and social activities such as knitting, can all contribute to osteoarthritis of the thumb and fingers
- As a result of pre-existing damage, osteoarthritis of the thumb and fingers may occur following damage to the thumb and fingers e.g., fractures of the thumb and fingers, ligament injuries and or as a consequence of other types of arthritis.
Osteoarthritis of the thumb and fingers may occur as a result of pre-existing damage e.g., fractures of the thumb and fingers, ligament injuries and/or as a consequence of other types of arthritis.
Signs and symptoms of osteoarthritis of the thumb and fingers
Symptoms of osteoarthritis thumb and fingers say include
- Pain and stiffness in the thumb and finger joints
- Reduced range of movement of the thumb and finger joints
How can Walker and Hall help you
Osteoarthritis of the thumb and fingers responds well to physiotherapy treatment.
A thorough musculoskeletal examination is required to determine which joints in the thumb and fingers are causing the problem. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for treating osteoarthritis of the thumb and fingers include
- Heat to reduce pain and muscle spasm in the thumb and fingers
- electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain, swelling and muscle spasm
- gentle joint mobilization techniques to improve the range of movements
- soft tissue massage to reduce swelling, pain and muscle spasm
- a home exercise programme to improve strength and maintain and improve thumb and fingers mobility
- anti-inflammatory advice
- Advice with regards to using wrist braces and supports that may be of benefit and reduce your pain during activity
- Advice with regards to improving your independence at home and work, i.e., how to carrying shopping, use computer equipment, open containers etc.
Fracture of the metacarpals (also known as a metacarpal fracture)
This is one of the most common hand injuries treated at Walker and Hall and we know through personal experience how disabling it can be, particularly if it involves your dominant hand (the hand you write with). It can affect all aspects of your life from washing and dressing, to work related activities to sports and leisure activities.
Fortunately a fracture of the metacarpals of the hand responds well to physiotherapy treatment.
Anatomy
The hand (palm) consists of 5 long bones known as metacarpals and these bones form joints with the small bones of the wrist (carpal bones) and the small bones of the fingers (phalanges). During certain activities such as a punch or direct impact to the hand, stress is placed on the metacarpal bones. When this stress is traumatic and beyond what the bone(s) can withstand a break in one or more metacarpals may occur. This condition is known as a fracture of the metacarpal(s).
Due to the large forces necessary to break a metacarpal bone, a metacarpal fracture is often seen in association with other injuries to the wrist or fingers e.g., joint sprains, dislocations or other fractures of the hand or wrist.
Cause of a metacarpal fracture
- Trauma – a metacarpal fracture most commonly occurs as a result of a punch against a hard object e.g., door or wall
Occasionally it may occur as a result of direct impact to the hand from an object travelling at high speed e.g., a cricket ball or a fall onto the fingers or thumb
Signs and symptoms of a metacarpal fracture
- Pain. A sudden onset of intense hand pain felt at the time of injury. This may be felt on the front, back or sides of the hand and occasionally can settle quickly leaving you with an ache in the hand that is particularly noticeable during the night or on waking. It may also radiate into the fingers or wrist of the affected hand. The pain may increase with certain movements of the wrist and fingers such as opening and closing the hand and fingers, activities involving gripping, lifting, carrying objects and pushing through the affected hand
- Swelling and bruising – the swelling will occur immediately and the bruising may appear after a couple of hours
- Weakness of the hand particularly when attempting to use the hand for physical activities such as opening jars, gripping, lifting and carrying objects
- Deformity – this may be seen in severe cases of metacarpal fractures
How can Walker and Hall help you?
Depending upon the extent of the fracture, treatment can range from immobilisation in a plaster cast to surgery.
If treatment in a plaster cast is chosen, then the hand and wrist will be immobilised for 4 – 6 weeks during which time it is important that the shoulder and elbow joints are gently exercised.
Once the cast is removed physiotherapy treatment is very effective and will include
- Gentle thumb, finger and wrist mobilising techniques to increase the range of movement in a controlled manner
- Pain relieving techniques e.g., electrical therapy such as ultrasound and interferential therapy and soft tissue massage to reduce pain and muscle spasm
- Muscle strengthening techniques
- Home exercise programme to continue with the treatment and in particular to maintain joint range and muscle stability and strength
- Advice with regards to returning to active sport, usually at the 6 week mark depending upon the improvement achieved during treatment.
Dislocated Finger (also known as a finger dislocation)
This is the most common dislocation we treat at Walker and Hall and often occurs in sports such as rugby. Following the appropriate medical management it responds very well to physiotherapy treatment.
Anatomy
Each of the 4 fingers (excluding the thumb) comprises 3 small bones known as the phalanges. These small bones join to each other at the IP joints (interphalangeal joints) and to the bones of the hand (metacarpals) at the MCP joints (metacarpophalangeal joints) thereby forming 3 joints for each finger. Each of these joints is supported by strong connective tissue which wraps around the bony ends, and cartilage which lies between the joint surfaces, cushioning the impact of one bone on another during activity. During certain movements of the fingers, stretching forces are placed on the finger joints. If these forces are excessive due to too much repetition or being too high, injury to the joints may occur. This typically involves damage or tearing to the connective tissue surrounding the joint. When the forces involved are too great and beyond what the connective tissue and supporting muscles can withstand, one or more small bones of the fingers may displace or ‘pop out’ of their normal position. When this occurs, the condition is known as a dislocated finger. A dislocated finger may occur by itself or may be associated with damage to other structures such as the tendons and bones. If this is the case then a fracture of the finger may also occur with the dislocation and this is known as a fracture-dislocation of the finger.
Causes of a dislocated finger
- Trauma. Dislocation of the fingers is especially common in sports that involve catching e.g., basketball, netball, cricket or football, and typically occur due to a specific incident that forcibly bends the finger in the wrong direction (such as a hyperextension force or a sideways force)
- A direct blow to the point of the finger may also cause a dislocation such as in basketball
- A direct collision can also cause a dislocated finger e.g., martial arts
Signs and symptoms of a dislocated finger
- A sudden onset of intense finger pain at the time of the injury. This may be felt on the front, back or sides of the affected finger. Occasionally it may also be referred further along the finger or into the hand on the affected side.
Once the dislocated finger has been “reduced” (put back), you may experience pain and stiffness following certain activities or with rest e.g., on waking. The pain may increase due to activities that involve the use of the hand and fingers e.g., opening jars, opening doors, writing, using a key board, lifting heavy objects, cooking and household activities with a weakness or ‘instability’ such that the finger may easily ‘pop out’ again. Bruising may also occur following injury, but this may take a number of days to develop.
- Swelling in the dislocated joint, which may occur instantly or develop over a number of hours following the injury
- Bruising of the affected joint after a few days
- A feeling of weakness or ‘instability’ in the finger
- Pins, needles or numbness in the affected finger(s)
- An obvious deformity of the bones that have been dislocated i.e., a loss of the normal contour and “look” of the finger
- A tearing sound may be heard at the time of the injury
How can Walker and Hall help you
Once the dislocated finger has been “reduced” (put back) it will respond well to physiotherapy treatment.
A thorough musculoskeletal examination is required to determine the extent of the joint damage and specifically which structures have been damaged in the dislocation. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for treating a dislocated finger are
- R-I-C-E – For the first 48 to 72 hours the standard soft tissue treatment of R-I-C-E is used. This involves Resting from aggravating activities, the regular use of Ice, the use of a Compression bandage and keeping the arm Elevated (providing this is comfortable)
- Pain relieving techniques e.g., gentle joint mobilising techniques, electrical therapy e.g., ultrasound and interferential therapy and soft tissue massage to reduce pain and muscle spasm
- Finger joint mobilising techniques e.g., gentle stretching and muscle release techniques.
- Home exercise programme – a graduated mobilising and strengthening programme to ensure an optimal outcome.
- Anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist
- Advice with regards to returning to active sport, usually depending upon the improvement achieved during treatment.
Referred Pain
Not all pain experienced in the hand is necessarily coming from a problem within the hand. Occasionally pain felt in this area can be referred or caused by a problem in another area of the body such as the neck or spine. This is called referred pain.
What is Referred Pain?
Referred pain occurs when pain is experienced in an area away from the actual injury or problem. This is not uncommon, examples being sciatica, where pain is felt down the leg whilst the problem is in the back, and a heart attack, where the pain is felt in the shoulder, arms and neck.
What structures can refer pain into the hand?
The following structures have the ability to refer pain into the hand
- The cervical and upper thoracic spines (from the 3rd cervical vertebra to the 4th thoracic vertebra – C3 to T4). Any problems affecting the intervertebral discs, ligaments, nerves and muscles of this area of the spine can mimic a wrist problem
- The shoulder joint (gleno-humeral joint) and the acromioclavicular joint
- The elbow joint (radio-humeral joint, humero-ulnar joint and the superior radio-ulna joint)
- Joints of the forearm (inferior radio-ulna joint)
- The wrist joint
- The muscles of the rotator cuff
- The muscles of the upper arm i.e., biceps and triceps muscles
- The muscles of the forearm
How can Walker and Hall help you distinguish between forearm pain and referred pain
At Walker and Hall you will receive a thorough musculoskeletal examination which will examine all the structures that could possibly be responsible for the pain in your hand.
It is only following such an accurate examination and diagnosis that a treatment plan can be devised to address your problems.
You will be involved in all stages of your treatment given every opportunity to ask questions.
