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UPPER EXTREMITY
A person suffering from upper extremity injuries may have difficulty with typical daily activities at home, such as dressing, grooming, and cooking; and activities at work, such as using the phone or computer.
 
Arm/Elbow/Wrist/Hand:
Waverly Health Center
 
ARM/ELBOW/WRIST/HAND 

Treating Arm/Elbow/Wrist/Hand Conditions
Because upper extremity injuries/conditions affect use of the hands, a person may have difficulty with typical daily activities at home, such as dressing, grooming, and cooking; and activities at work, such as using the phone or computer. Occupational therapy practitioners help people with upper extremity injuries/conditions to function in their home, work, and leisure environments. Occupational therapists who specialize in hand therapy can provide rehabilitation intervention that enables the hand to function well and prevent further injury. Three common conditions we treat are carpal tunnel syndrome, lateral epicondylitis (tennis elbow), and tendon/nerve injuries.

Carpal tunnel syndrome (CTS) is a term that refers to nerve compression in the wrist that results in pain, a burning sensation, numbness, and tingling in the wrist, hand, and/or fingers. Any activity that causes a repetitive movement (such as typing), awkward or uncomfortable posture, extremes of wrist position, direct pressure on the heel of the hand, or vibration may put someone at risk for developing carpal tunnel syndrome. Carpal tunnel also is associated with other medical conditions such as rheumatoid arthritis, diabetes, and pregnancy. People with carpal tunnel syndrome often complain of their hands "falling asleep."

Tennis elbow or lateral epicondylitis is a degenerative condition of the tendon fibers that attach on the bony prominence (epicondyle) on the outside (lateral side) of the elbow. The tendons involved are responsible for anchoring the muscles that extend or lift the wrist and hand. Some common activities that lead to epicondylitis include: Recreational: Tennis (groundstrokes), racquetball, squash, fencing or Occupational: Meat cutting, plumbing, painting, raking, weaving. Some patients develop tennis elbow without any specific recognizable activity leading to symptoms. Patients often complain of severe, burning pain on the outside part of the elbow. In most cases, the pain starts in a mild and slow fashion. It gradually worsens over weeks or months. The pain can be made worse by pressing on the outside part of the elbow or by gripping or lifting objects. Lifting even very light objects (such as a small book or a cup of coffee) can lead to significant discomfort.

Tendon /Nerve Injuries - When a person experiences a tendon injury in the hand that affects the ability to flex or extend the hand properly and in a safe way, he or she likely will have a difficult time completing everyday tasks, such as bathing, dressing, grooming, eating, using the bathroom, and attending to chores at home and at work. Nerve injuries can cause decreased sensation, hypersensitivity, as well as affecting functional movements. Every person's injury is different and the rate of recovery depends on the severity of the injury.

  


What can an occupational therapist do?
  • Evaluate the client's injury following care by an orthopedist to coordinate treatment plans and determine the course of intervention.
  • Analyze the client's environment at home and work to identify potential barriers to the client's performance.
  • Fabricate a protective splint for the injured part of the hand and teach the client how to manage daily activities while wearing the splint.
  • Recommend a home exercise program that will encourage optimum use of the hand.
  • Apply techniques to reduce swelling, prevent further injury, care for wounds, and improve movement.
  • Show the client how to complete activities safely and independently while the hand is being rehabilitated.
  • Incorporate the client's goals and desires into the treatment plan.
  • Recommend assistive devices and ergonomic devices to reduce repetitive motion.
  • Facilitate range of motion, endurance, and dexterity in the fingers and hands to make daily activities easier.
  • Educate the person in postural/conditioning exercises that may reduce the symptoms.
  • What can a person with a hand tendon injury do?
    • Implement a home exercise program recommended by the occupational therapist.
    • Learn how to improve coordination to increase the use of his or her hand under the supervision of an occupational therapist.
    • Strengthen the hand and progress toward full use of the hand.
    • Set short- and long-term rehabilitation terms upon consulting an occupational therapist and other health professionals.
    • Learn how to perform daily activities, such as dressing, grooming, and driving, in a safe manner while the hand is being rehabilitated.
    • Follow recommendations by the occupational therapist, such as work simplification techniques.
    • Use proper body mechanics in lifting and carrying.
    • Allocate some household responsibilities to others in the household.
     
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