Hand therapy is the art and science of rehabilitating the upper quarter of the human body after injury or illness. Hand therapy merges occupational therapy (OT) and physical therapy (PT), using specialized skills to assess and treat disease and injury, to prevent dysfunction, and to restore function and/or reverse the progression of disease that affects this vital part of the body.

Hand therapy is primarily provided on an outpatient basis. Inpatient services can also be provided for those patients requiring hand therapy immediately after an injury or illness. At Keck Hospital of USC, the hand therapists are certified in this specialty. This means that they not only are licensed occupational or physical therapists, but they have met rigorous national standards of education, experience and clinical expertise in the specialty of hand therapy.

Who Benefits From Hand Therapy?

Hand therapy can be beneficial for a range of orthopedic hand problems, including:

• Bone fracture in the hand or arm
• Crush injury
• Arthritis (osteoarthritis, rheumatoid arthritis, etc.)
• Tendon lacerations
• Repetitive motion injury (RMI) such as carpal tunnel syndrome, trigger finger (when tendons in the finger joints swell due to overuse, “locking” the finger into a fixed position) or synovitis (inflammation of the joint lining, or membrane)
• Nerve Injuries – including brachial plexus lesions (an area of abnormal tissue in the brachial plexus, the network of nerves that sends signals from the spine to the arm and hand); radial, median and ulnar nerve injuries (the nerves that supply the arm, forearm and hand).
• Reflex Sympathetic Dystrophy (RSD)/Chronic Regional Pain Syndrome (CRPS) a chronic and painful condition that usually affects an arm or leg. Signs and symptoms include intense burning or aching pain along with swelling, abnormal sweating and hypersensitivity of the area.
• Dupuytren’s Contracture, a condition in which there is a thickening and shortening of the thick band of tissue in the palm of the hand and fingers. Over time, the tissue contracts and the fingers become curled inward.

Who Benefits From Hand Therapy?

Hand therapy can be beneficial for a range of orthopedic hand problems, including:

Comprehensive Diagnostic & Treatment Resources

Based on an evaluation, we develop a treatment plan tailored to your individual needs. We also will ask you about your personal goals for treatment and incorporate them into your treatment plan. We offer a comprehensive range of state-of-the-art hand therapy treatments and resources, including:

• Treatment methods such as heat, cold, electrical stimulation, ultrasound, paraffin and iontophoresis may be used for pain management and/or muscle relaxation
• Manual therapy to improve joint, scar and nerve mobility
• Therapeutic exercise to stretch and strengthen muscles
  • A specialized piece of equipment known as the BTE Work Simulator is used in hand therapy. It is an extremely effective system that duplicates many real-world job and daily-living functions, enabling therapists to accurately test and treat functional problems and get you back to your regular activities.
• Neuromuscular re-education
  • The aim of this treatment is to retrain nerves that may be injured or hypersensitive as a result of injury; this retraining desensitizes the nerve endings and increases patient comfort as well as increases strength and coordination
  • Or, if a patient has undergone surgical muscle transfer (using a muscle from one part of the body in another), the brain has to “relearn” how to control that muscle in its new location, and neuromuscular re-education is employed
• Splinting
  • When indicated, our therapists fabricate custom splints to position and/or protect your hand/arm, control pain, stretch tight tissues/joints and improve function.
• Pain management
• Functional training to help patients get back to their everyday lives
• Recommendations for adaptive equipment

Frequently Asked Questions

Q: How long will it take for my hand to heal?
A: There simply is no single, simple answer to this question because each person is unique and there are so many variables that can affect the length of time it takes to recover from a hand injury or illness that affects the hand. Our certified hand therapists will work closely with you to establish realistic expectations, timeframes and goals, and communicate openly and honestly about your progress and prognosis.

Q: What’s the likely outcome of treatment for my hand problem?
A: Again, every person is unique, so no single answer applies. As an academic medical institution and tertiary care center, however, we treat some of the most complex cases in the Los Angeles area, which, in turn, gives you access to a depth, and breadth of specialty clinical expertise seldom found in a community hospital setting. Plus, our hand therapy specialization enables us to treat a wide range of hand conditions with confidence in our outcomes.

Common Terms Used in Hand Therapy

• Adaptive equipment – Devices that help people with a physical impairment to write, read, move, speak, hear, and otherwise conduct normal activities. These can include items to assist a patient in their Activities of Daily Living (ADL) such as cooking, bathing, dressing, etc. Also called assistive devices.
• Carpal Tunnel Syndrome – A condition in which a nerve at the wrist is compressed, producing pain, a tingling sensation and numbness in the thumb, index and middle fingers of the affected hand.
• Crush injury – An injury in which the hand is crushed, damaging the soft tissue, nerves, and/or bones of the hand.
• Functional – Generally, functional refers to something able to fulfill its purpose or function. In rehabilitation, functional exercise refers to exercise that helps a patient resume his or her regular activities or functions.
• Iontophoresis – The process of delivering drugs or other charged molecules through the skin using an electrical charge. It is commonly used with anti-inflammatory medications.
• Neuromuscular re-education – A form of rehabilitation or bodily movement that requires your muscles and nerves to learn or relearn a certain behavior or specific sequence of movements.
• Radial nerve, median nerve and ulnar nerve – These are the nerves in the body that supply the arm, forearm and hand.
• Splint – A custom or pre-fabricated brace that protects or positions the finger, hand, forearm after an injury or illness.