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PT or OT? Choosing the Best Therapy for Hand Disorders

The function of the hand is very important in our daily lives. Learn more about how hand therapy is critical to recovery and regaining function after injury.

If you've experienced an injury to your hand, wrist, arm or elbow, you may have trouble with daily tasks and wonder what kind of treatment you need to help you recover quickly. While some minor injuries or pain could feel better with rest and ibuprofen, other conditions such as fractures and chronic pain will require a trip to the doctor, or even surgery. Also, many serious injuries or conditions will require weeks of physical therapy with a trained medical professional.

Woman with hand injury

What to look for in a therapist

For the upper extremities, which include everything from your fingers to your shoulders, it's important to see a therapist who specializes in that body area. There are two types of therapists you might see:

  • A physical therapist (PT) focuses on how the body moves and functions.
  • An occupational therapist (OT) focuses on fine motor function and the psychosocial aspects of recovery.

Both a PT and an OT can treat hand and upper extremity injuries. However, there is a third classification that is crucial to look for: a certified hand therapist (CHT).

A CHT has the academic background of a PT or OT, but is also required to amass thousands of hours of experience in direct clinical practice taking care of patients in need of upper extremity rehabilitation. The movement of the elbow, wrist, and hand are very complex, but these parts of the body don't receive as much attention in PT and OT training as other body parts such as the back, knees and hips.

When to seek hand therapy

The function of the hand is very important in our daily lives. Hand therapy is critical to speeding up your recovery and regaining function. CHTs treat a variety of hand disorders, such as carpal tunnel and cubital tunnel syndrome, tennis elbow, tendonitis and nerve issues. They deal with traumatic injuries like broken bones in the hand and wrist. CHTs are also trained to recognize problems in the neck that may show up in the upper extremities.

It is especially important to seek a CHT if you have:

  • complex fracture
  • a dislocation
  • had tendon surgery or reconstruction that requires custom splinting

To recover quickly, you need a CHT who understands the anatomy, movement and function of the upper extremities and who has experience working with injuries to the area.

The goals of hand therapy

Your CHT is part of your medical team. They will work with you to set goals for where you want to be when therapy is complete. If you had an injury or surgery, the goal of treatment is healing and recovery of your previous activity level. For a chronic condition, the goal is to help you adapt by minimizing your pain and discomfort and maximizing your function and independence. You'll probably see your CHT once or twice a week, but it could be as much as three times a week for extremely complex cases.

Hand therapy is often prescribed as a standalone treatment, but it is also an essential component for a successful recovery after surgery. Many people don't realize how important their participation in physical therapy is to their overall outcome. Your recovery will depend not only on your therapy sessions but also on regularly doing the exercises you will be taught to do at home, which are critical for success. It can take three or four months to reach your goals, so patience and commitment to your program are crucial.

The role of telehealth

You may be able to benefit from virtual hand therapy sessions if your rehabilitation needs are not too complex. Following the therapy prescription provided by your hand surgeon, your CHT may be able to guide you through your exercises remotely. This may also be an option if you are seeing your therapist in person sometimes and are able to have virtual visits at other times. Your hand surgeon and CHT will let you know if this is an option for you.

This article is from the Health Connection: Keeping the Hand and Upper Extremity Healthy issue and brought to you by Public and Patient Education.

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