Pain Management for the Hand & Upper Extremity
By Macy Stonner, OTD, OTR/L · September 27, 2019
Joint immobilization is an effective strategy in the acute phase of upper extremity pain, particularly among those with arthritis and tendonitis conditions. A removable orthosis (or splint) is helpful to provide rest, prevent joint or tendon irritation, and alleviate pain associated with hand use. Orthoses are encouraged for the initial two to three weeks, and then worn as needed or helpful over time.
Physical agent modalities, such as heat or ice, provide temporary pain relief in the hand and upper extremity. Heat therapy (such as heating pads or paraffin wax) increases blood circulation, improves joint stiffness, and decreases muscle soreness. Ice application is helpful to calm overused tendons (specifically in the wrist and elbow) and decrease swelling and inflammation.
Chronic pain is often exacerbated by repetitive activity or overuse. This can be the case with sewing, lifting weights, twisting screw-drivers and other tools, using scissors, and manipulating cans, jars, and tight containers. Activity modification is an important strategy to prevent worsening joint pain during meaningful daily activities:
- Use pain as a guide during daily tasks
- Either avoid aggravating activities or modify your technique when performing them
- Consider a supportive orthosis or splint during heavy work tasks
- Use adaptive equipment, especially kitchen gadgets, to help with opening tight containers
- Avoid scrolling with the thumb during phone use (use the index finger instead)
- Use larger built-up handles around pens, toothbrushes, tennis rackets, or any device that causes pain while gripping
- Do not squeeze a stress ball if you have hand arthritis. It will make the pain worse!