The treatment of the upper extremity that includes that hand, wrist elbow and shoulder girdle. The hand therapist utilizes comprehensive knowledge of the structure of the upper limb with function and activity. The therapist utilizes specialized skills in assessment, planning and treatment to prevent dysfunction and enhance an individual’s ability to execute tasks and to participate fully in life situations.

Hand therapy is the art and science of rehabilitation of the upper quarter of the human body. Hand therapy is a merging of occupational therapy and physical therapy theory and practice that combines comprehensive knowledge of the upper quarter, body function, and activity. Using specialized skills in assessment and treatment, hand therapists promote the goals of prevention of dysfunction, restoration of function, and/or reversal of the progression of pathology in order to enhance participation in life situations for individuals with upper quarter disease or injury.

Arthritis of the hand

A common degenerative problem where the articular surface of a joint becomes worn. This can result in a stiff and painful joint. In the hand the most common areas are the base of the thumb and finger tip joints.

Carpal Tunnel syndrome

A compression of the median nerve that occurs when it is compressed in the region where it crosses the wrist. Symptoms include numbness and weakness in the thumb with pinching activities as well as night pain and tingling in the thumb, index and middle finger.

Cubital tunnel syndrome

Compression of the ulnar nerve at the inside part of the elbow. The nerve is very superficial (also known as the “funny bone”) and can be compressed when the elbow is held in a bent position too long. Symptoms include pain, tingling and numbness in the ring and little finger and decreased grip strength.

deQuervain’s tendinitis

Inflammation of the tendons and/or the tendon sheaths on the thumb side of the wrist. These tendons move the thumb sideways and away from the palm. This painful condition is often caused by repetitive use of the thumb and wrist.

Lateral epicondylitis

Inflammation of the wrist tendons that attach on the outside of the elbow. This is also known as “tennis elbow”. This condition is typically related to overuse or repetitive stress with movements. Symptoms include pain with gripping especially with the elbow in an extended position.

Medial epicondylitis

Also known as “golfer’s elbow”. It is inflammation of the tendons of the forearm and fingers at the inside of the elbow. Also related to gripping and forceful wrist flexion/forearm rotation overuse.

Wrist Fractures

A break in one of the many bones in the wrist. A collies fracture is a break in the radius bone and often occurs with a fall on the outstretched hand.

Hand and finger fractures

A break of one of the 27 bones in the hand. These are common and often occur with a fall, a jammed finger, or a finger getting caught in a door. A boxer’s fracture occurs when someone hits a hard object with a fist and breaks the little finger metacarpal bone.

Joint sprains

An injury to the ligament that surrounds the bone. Ligaments are strong structures which hold bones together. They often occur when the joint is forced/twisted in an unnatural position. Symptoms include pain, swelling and difficulty moving the affected joint.

Joint dislocation

The separation of 2 bones where they meet at the joint. A dislocated bone is no longer in its normal position. It can also cause ligament, nerve and bone injury. Requires medical attention.

Wrist pain

A common complaint that can be caused by sudden trauma to the wrist. It can also be caused by repetitive stress, osteoarthritis and carpal tunnel. Diagnosis of the cause of wrist pain is important to determine so that treatment can accurately address the cause.

Skier’s thumb

An injury to the ulna collateral ligament of the thumb. It is common in sports and with falls.

Ganglion Cyst

Very common lumps (mucous cysts) in the hand and wrist that occur near a joint capsule or tendon sheath. Most common location is top of the wrist (70-80%).

Mallet finger

A deformity of the tip of a finger when the extensor tendon is damaged. It is often caused by a forceful blow to the tip of the finger. The finger is not able to straighten at the tip on its own.

Sensory nerve evaluation

A series of clinical tests a certified hand therapist performs to assess nerve integrity, function and reinnervation. The therapist uses both monofilaments and 2 point discrimination to assess both light touch and fine motor abilities.

Scar and edema management

Therapy interventions that are designed to address the functional deficits in the hand and wrist that are the result of scar tissue formation and swelling. Scar and swelling after an injury often lead to joint stiffness, loss of motion, and decreased functional use of the affected hand or wrist.


Therapy interventions designed to address hypersensitivity and pain caused by a nerve. Most often occurs in the hand or foot due to the amount of sensory nerve fibers to these body parts. The injury may be acute or chronic and often involves a nerve that was compressed, crushed or injured.

Sensory re-innervation

Therapy interventions that assess, treat and address sensory nerve injuries that are beginning to re-innervate or “wake up”. Techniques involve stimulation of various “systems” to facilitate the distal nerve to brain connection as a nerve is healing distally from the site of initial trauma.