Wrist & Hand Pain

Although injuries can cause loss of hand function at any age, hand function tends to decrease when we get over 65. This is usually caused by changes in the brain, muscle, and joint structures secondary to ageing. There are also often worsened by having other conditions that are more common in the elderly such as:

• • • Osteoarthritis
    • Rheumatoid arthritis
    • Parkinson’s disease
    • Osteoporosis
    • Fractures
    • Strokes

The sort of difficulties someone with elderly hands may show with daily activities include:

• • • Trouble gardening
    • Stiffness in the hands/trouble getting the wrist and hands moving
    • Difficulty with opening/closing doorknobs
    • Difficulty with opening jars
    • Difficulty holding objects/dropping objects
    • Difficulty using utensils
    • Difficulty with toileting/personal hygiene
    • Trouble with dressing, especially buttons and zippers.
    • Hands that swell with activity/towards end of the day
    • Cramps in the hands when moving
    • Loss of co-ordination and dexterity in the hands i.e. having more trouble than usual with activities they used to be able to do such as music, painting, writing.

The main reason for above difficulties, however, is not due to a loss of grip strength.

As we get older, but also after hand injuries, it is common to lose muscle strength in the hand muscles. This is often worsened when experiencing pain and other conditions that can worsen strength, such as a stroke.

Losing strength in the hands and wrists can be a vicious circle. When muscles that support hands and wrists are weakened it causes an increased load and strain which results in pain. Losing the muscles that pump and keep fluid moving can cause swollen wrists that are stiff and harder to move. Pain and swelling then both cause further loss of strength as hands and wrists move less.

It is possible to regain some hand strength and function by improving grip strength, particularly if pain is treated and reduced.

Reducing swelling in the wrist and hand can also help resolve pain and regain strength.

Physiotherapy and occupational therapy treatments aim to find the cause of symptoms in wrists and hands and help improve quality of life.

We do this by:

• • • Going through what you are having the most difficulty with and problem solving with you (especially in your home – You can learn a lot in a kitchen!)
    • We may offer modifications to your home or additional equipment to make it easier to use your wrist and hands. These can be different utensils such as can openers, door openers, aids to put on clothes and use toilets.
    • Wrist/hand supports and braces
    • Treating the pain, hand cramps and hand swelling – Treatments can include massage, hot/cold therapy, wax baths/paraffin treatment, ultrasound, mobilisation, stretching, muscle stimulation and more.
    • Exercise to strengthen the small and large muscles of the hand and wrist, especially the muscles most used for the activities you want to improve.
    • Co-ordination and grip strength exercises.
    • Education on how to avoid strain and how to position your wrist and hand correctly when using and at rest.
    • Education on how to prevent or slow further degeneration and loss of movement and function.
    • Working with carers/families to help improve your quality of life and use your hands more with the activities you enjoy.
    • Hydrotherapy can be very effective to improve hand and wrist strength. The warm water and supportive environment reduce load on the joints and make it easier to move. The heat, water pressure and improved ability to exercise in water can also reduce swelling, hand cramps and stiffness. You don’t even have to get in a pool – we’ve had clients improve their hand function with a sink of warm water!