Reduced hand function in our daily lives
by Nicola Lawson
As a clinical specialist in hand therapy, I often receive apologies from patients for wasting my time in clinic for a simple hand injury. First, there is no such thing as a simple hand injury. Secondly, if left untreated, hand injuries can result in permanent hand dysfunction leading to serious consequences in other aspects of a person’s life.
A hand injury can be more debilitating to an individual than the loss of a lower limb. The multiple functional tasks the hand performs and how we use them to express ourselves mean that loss of function can cause major problems for an individual.
The hand is an exceptional tool. It is designed to perform many complex movements and static positions in order to manipulate and hold objects, communicate with others and react to touch.
Simple tasks such as brushing your teeth, putting your clothes on, holding your child’s hand or even putting your hands in your pocket can be impossible for people with hand injuries and hand related conditions. These daily challenges are frustrating and distressing to individuals as they become more dependent on splints, equipment or others for support. Specialist products such as the “Spill Not Jar and Bottle Opener”, electric can openers, tap turners and key turners (to name but a few) can make such a difference to a person’s independence.
The long term implications of reduced hand function may impact on the individual’s ability to return to work, resulting in a short term loss of income or even unemployment. The employer will need to consider alternative roles for these employees or adapt the work environment to accommodate their limited hand function. An experienced hand therapist has a vast amount of product knowledge and can advise an employer on different companies to approach which specialise in ergonomic work tools. Common ergonomic office products include split keyboards, moulded PC mice and document holders which can be provided by supplies such as: Posturite and Posture People. For industrial and manual work environments, the therapist is likely to consider electric power tools and protective gloves to enable the client to continue working. Products can vary from electric screwdrivers to nail guns which can be supplied by most DIY manufacturers. These tools reduce the effort, manipulation and force on the injured hand.
We all use our hands as a communication tool. Subconsciously we express ourselves using our hands to make our point clearer. To a deaf person who relies on sign language this can be devastating. Hand injuries can affect their social skills as well as their ability to perform daily functional tasks.
The appearance of our hands can reflect on how much care we take with ourselves or give clues about a person’s age. I recall treating a smartly dressed lady who sustained a minor rose thorn injury to her dominant hand. The wound became infected, resulting in extensive removal of the effected tissue and many subsequent operations to reconstruct the hand. Two years later she continued to be troubled by the appearance of her hand which prevented her from socialising. She would not leave the house without her gloves on to hide the disfigurement. Her rehabilitation included scar management and cosmetic camouflage. Products included: “Dermacolor” camourflage make up and “Biodermis” silicone gel to reduce the appearance of the scars.
A loss of sensation to the hand can put the individual at risk from further injuries. Individuals are unable to detect risks such as burning or entrapment. I once treated a gentleman who sustained burns to his hands whilst a work. The loss of sensation to his fingertips reduced his dexterity to the point that he could not manipulate the small electrical wires and tools he used in his work as an electrician. He was provided with bespoke pressure gloves supplied by “Second Skin”. These were then adapted at the finger tips by stitching silicon sheeting to the pressure glove to enable him to hold and manipulate the electrical wires. There are many ways of reducing the impact of hand dysfunction. Specialist advice from a qualified hand therapist can improve function, appearance and reduce discomfort. Specific exercises, scar massage, splinting, adaptive equipment and counselling can be extremely beneficial to the individual helping them to maintain their independence in all areas of their life. Occupational Therapists work closely with patients to minimise the effect that hand dysfunction has on a person’s life by considering their daily functional needs, hobbies, work role, environment and psychosocial needs.
A hand injury may seem insignificant yet can have a major impact on a person’s life. Intervention by a specialist hand therapist can help prevent loss of independence, unemployment and even improve their mental well-being.
