Handling Osteoarthritis, January 13, 2016
Occupational therapy can play a role in prevention and ongoing management for patients living with osteoarthritis in their hands.
Opening a jar, buttoning a shirt or brushing your teeth are everyday activities that feel far from routine for those with arthritis in their hands, a common condition causing pain and disability for millions of Americans. But occupational therapy, or OT, focusing on the hands can ease pain and increase range of motion for these patients, whether used on its own or after surgery, according to Roxanne Perry, a licensed occupational therapist and certified hand therapist at Armonk Physical Therapy & Sports Training in Armonk, New York.
With 27 bones in each of our hands (including the carpals, which are the small wrist bones often involved when a patient has arthritic pain) perhaps it’s not surprising that osteoarthritis is the most common cause of hand arthritis; the word literally means “inflamed joint.” Osteoarthritis itself is the most common type of arthritis in the United States, affecting about 12 percent of American adults and occurring when the smooth cartilage covering joints gets worn away as a result of age or overuse, causing pain, stiffness, swelling, and, sometime, knobby finger joints.
Hand therapy is a specialized practice area among occupational therapists. The goal of occupational therapy for these patients is to preserve or increase hand mobility so they’re able to perform everyday tasks more easily and comfortably.
“As a non-surgical option or a way to boost your recovery from hand surgery, occupational therapy is tailored to fit each person’s individual situation and needs, both at home and at work,” says Perry, who has more than 20 years of clinical experience treating injuries of the upper extremity. “The ultimate goal is to restore and optimize the way your hands function as well as to improve your independence and overall quality of life.”
Preventing Further Joint Damage
For those with hand osteoarthritis for which surgery isn’t recommended, OT serves a preventive role, Perry explains. Patients are taught ways to prevent further joint damage, which can include:
Splinting: Immobilizing affected joints, particularly at night, helps them rest when you do and cuts down on joint inflammation, pain, and swelling, Perry says. Splints used during sleep are made of a thermoplastic material that stretch and mold closely to the shape of the hand, while neoprene splints may be prescribed during the day to allow movement while also providing support. An occupational therapist will ensure splints are fabricated and fitted to each patient’s needs.
Home exercise program: In addition to working with hand osteoarthritis patients during office visits, occupational therapists also teach them range-of-motion exercises and gentle strengthening techniques they can perform at home. These therapeutic movements may include finger touches, curls, stretches, and bends. A typical OT schedule involves office visits twice each week for four to six weeks and is generally covered by insurance with a prescription.
Information on pain management: Occupational therapists can offer education about over-the-counter and other types of anti-inflammatory medications to reduce pain. Other pain management techniques may include soaking the hands in warm water or dipping them in warm paraffin wax. An OT can also provide information on joint protection and adaptive equipment that can help increase patient’s independence.
“Avoiding further joint damage is a big part of effective treatment for hand arthritis,” Perry notes. “It’s not something you’d want to attempt without the guidance and expertise of an occupational therapist.”
Restoring Strength and Function after Surgery
Treatment for osteoarthritis of the hand may include surgery when a patient either suffers from too much pain or too little function. Surgical techniques can include: basal joint arthroplasty, also known as a joint replacement of the thumb,osteotomy, in which part of the bone of a joint is removed to realign the joint, and fusion of the joints, a procedure use when arthritis is particularly bad.
If surgery is recommended, occupational therapy can play a crucial role in restoring a patient’s quality of life: OT helps patients to manage post-operative pain, reduce swelling, promote wound care and healing, and restore range of motion, strength, and function.
“While a conservative, non-surgical approach is generally successful for managing hand osteoarthritis, sometimes surgery is the best course,” Perry says. “But either way, an occupational therapist can improve patients’ hand function and pain levels, reducing the stress on involved joints. OT shouldn’t be a last resort; it should be the first thought for people who develop hand arthritis.”
Armonk Physical Therapy & Sports Training has provided personalized, integrative, and skilled one-on-one physical therapy services to residents of New York’s Westchester and lower Fairfield counties since 2001.https://www.armonkptst.com/