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Gentle stretching improves joint flexibility.
Arthritis -- a painful, inflammatory condition of the joints -- is a progressively debilitating condition that frequently affects joints in the hands and fingers. As a result, functional abilities decrease and quality of life is affected as activities of daily living become more difficult. Physical therapy interventions reduce pain, improve range of motion and make daily tasks easier for people with arthritis.
Physical therapy interventions aim to reduce pain caused by arthritis in the hand and fingers. Ice is prescribed immediately after a painful activity for 15 minutes at a time to decrease sharp pain caused by inflammation. Heat is applied for 15 to 20 minutes to increase blood flow and decrease the aching associated with chronic arthritis. Often, physical therapy sessions begin with heat application to help muscles relax and to prepare the joints for exercise and manual stretching. Several different types of heat therapy can be used. Hydrotherapy involves submerging the painful hand into a warm whirlpool bath for approximately 15 minutes. Fluidotherapy is a dry heat, with circulating particles of ground corn husks or a similar medium, contained in a device that the hand is placed in. Both of these treatments allow the patient to move their hand and fingers as the heat is applied. Arthritic pain also responds well to paraffin treatments. Hands are dipped into hot wax multiple times to form an insulated glove, then wrapped in plastic to retain the heat. Another common application for heat are hot packs that have been soaked in a hot tank of water, then wrapped in several layers of towels and applied to the patient's hand.
Range of Motion Exercises & Manual Techniques
Arthritis causes joints to swell and become stiff. As a result, the range of motion in the fingers and hand is decreased. This can significantly impact the patient's ability to perform most daily activities. Physical therapy professionals use manual techniques to improve joint mobility and range of motion. The therapist gently stretches each joint and passive range of motion -- moving the joint to the point of resistance to improve flexibility. Active range of motion exercises -- which, in contrast, are performed by the patient rather than the therapist -- are given to maintain joint flexibility between therapy sessions. Hand and finger strengthening exercises are cautiously used to improve dexterity and grip strength. However, too much exercise can worsen arthritic pain.
Splinting techniques are used by physical therapists to support arthritic joints, reduce pain and restrict movement of unstable joints. Resting splints are worn to hold the fingers and hand in one position. These splints are often worn at night to prevent the hand from moving into a painful position. A variety of splints are available to support arthritic joints and improve functional use of the fingers and hand during daily tasks as well. Physical therapists utilize splints that specifically address the needs of each individual patient.
Patient education is an important component of physical therapy for patients with arthritic fingers and hands. Patients are taught joint protection techniques -- ways to minimize strain on the affected joints during daily activities. Adaptive equipment can be utilized to assist with feeding, writing, cutting, food preparation and many other daily tasks that can be difficult with arthritis. Patients are also taught pain management techniques to use at home with homemade microwavable hot packs, ice and home paraffin wax units. Caution must be used with home heat, paraffin wax and ice application to avoid injury. Follow the exact instructions of your health care professional and the instructions included with your paraffin wax unit to reduce this risk.