Hand and Finger Pain

Fracture

With injury any of the bones of the hand or fingers can be fractured. There will be instant pain and swelling over the site of fracture. Bruising is likely to develop. Obvious deformity will occur if a severe fracture and related tendons can be torn. If a finger is fractured other possible signs may include a shortened finger, disappearance of a knuckle and the affected finger may cross over another when you make a fist with your hand. If fracture is suspected immediate medical referral is required. We can recommend a top London hand consultant to you in this case. Physiotherapy will be required once the fracture has healed to restore movement, strength and function back to the hand.

Dislocation

The joints between the hand and where the fingers start are the metacarpal joints and the joints between the different bones in the fingers are called the interphalangeal joints. When dislocation occurs the ligaments of the joints are disrupted and one bone will move backwards or forwards in respect to the other bone. A splint will likely to be required for a period of time to allow the ligaments to heal. We can recommend a top London hand consultant to see you. Physiotherapy will be needed once the ligaments have been repaired to restore movement, strength and function to the hand.

Ligament sprain

There are ligaments joining each joint in the hand to each other and around the finger joints. These ligaments can be sprained and some cases rupture. In some cases a splint will be required for a number of weeks. Physiotherapy is required to restore mobility, strength and function following the injury. Ultrasound and soft tissue techniques can be used aid healing of the sprain. If the injury is thought to be severe your physiotherapist will recommend a top London hand consultant to review you.

Tendon and muscle overuse

Small muscles in then hand and tendons of muscles that bend and straighten the fingers and thumb can become symptomatic if overused ie. climbing.

Physiotherapy can help with advice, treatment to help inflammation, soft tissue techniques, massage, taping and providing an exercise programme to restore function.

Mallet finger

This can occur if the end of the finger is bent and the tendon that straightens the finger is torn therefore the finger remains bent. It can happen by falling onto an outstretched hand or by a ball hitting the end of the finger when trying to catch. We can recommend a top hand consultant to you to ensure you are fitted with an appropriate splint that will be required for several weeks to allow the tendon to heal. Once healed physiotherapy will be required to restore strength to the finger.

Boutonniere deformity

This can happen by a forceful blow to a bent finger resulting in tearing of the finger tendons and the middle joint of the finger becomes bent down and the finger tip bent upwards. It can happen instantly or later down the line. People with Rheumatoid Arthritis can also develop this deformity in the fingers. We can recommend a top London hand consultant to you if this injury has happened. Splinting will be required and physiotherapy to restore movement, strength and function in the hand.

Rheumatoid Arthritis

Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. Affected joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment that includes looking at your muscle strength, joint movement and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

  • Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
  • Wheelchair assessments
  • Splinting

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related.

Complex Regional Pain Syndrome

This condition as the name suggests is complex. The pain is often constant and of a burning type. The body part affected is often very sensitive to touch and just a stroke can cause pain. There can be changes in temperature and colour of the body part and on occasions growth of excess hair and swelling. The hand can be affected by this syndrome and the pain can extend up the arm. The exact cause of it is not clearly known and can happen with no cause but there can be an event before it occurs such as a fracture. ‘The sympathetic nervous system’ has been shown to be involved which controls blood flow and skin temperature.

Physiotherapy can help with this condition by keeping the part of the body affected moving and stop it stiffening up. They can help to use techniques to desensitise the area and acupuncture can help the pain in some cases. Your physiotherapist will also recommend a top London pain consultant to you who can use treatments to block the sympathetic nervous system from firing and provide appropriate medication to help with the pain.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

  • cardiovascular symptoms
  • respiratory (breathing) symptoms
  • gynaecological symptoms
  • urinary or genital symptoms
  • digestive symptoms
  • immune system symptoms
  • lymph system symptoms
  • hormonal symptoms
  • neurological symptoms
  • dermatological (skin) symptoms
  • medication side-effects
  • virus
  • infection
  • cancer
  • disease process
  • psychological problem ie. depression, anxiety