Advice from a Certified Hand Therapist: Hand Edema
Hand edema is inflammation, swelling or fluid collection in the hand. Sounds basic by definition; however, edema in the hand can be extremely problematic and complex when there is a hand condition or injury.
Edema is the body’s response to healing itself, but, in the hand, large amounts and/or long-term swelling can cause permanent impairment and affect one’s ability to perform daily activities. It is one of the most common problems associated with hand injuries/conditions. Edema can be a primary focus during hand therapy as it can trigger so many other problems such as pain, lack of motion, scar tissue and decreased function of the hand and arm.
Edema can be acute in nature, which means it occurs in the first 24-48 hours after an injury or condition, or chronic (present 48-72 hours or longer after injury). Signs of acute hand edema are typically:
- Redness
- Warmth
- Throbbing
- Swelling
- Decreased mobility and use
- Tingling
- Numbness
- Pain
Chronic hand edema can be hard or soft and, typically is not warm, red or throbbing; however, it can be painful and cause scarring and/or decreased function.
What can alleviate hand edema?
Aside from anti-inflammatory medications, there are many other ways to treat hand edema. Acute hand edema treatment is as easy as R.I.C.E. – rest, ice, compression and elevation. The following can help reduce acute hand edema:
- Resting the hand by wearing an orthotic
- Applying ice packs for 10-15 minutes on and 10-15 minutes off
- Wearing a properly-fitted light compression garment
- Elevating the hand above the heart
Chronic edema is treated differently. Heat via a heating pad or hot pack can be applied to the hand for 10-15 minutes at a time. This can help to soften any hard edema, increase blood flow for healing, and loosen the structures in the hand to prepare for active range of motion (AROM) and use. Gentle, non-painful AROM can help create a natural pump to assist the lymphatic system to push the swelling out of the hand, keep the joints moving freely, and reduce potential scarring from long-term edema. In addition, wearing compression garments and performing contrast baths, which alternate hot and cold, can reduce chronic inflammation.
Please visit your local hand surgeon to be evaluated immediately if you notice hand edema. There are numerous causes of hand edema. The sooner the primary issue causing the hand edema is addressed, the fewer long-term effects. Visit www.ASHT.org to learn more about hand therapy and find a hand therapist near you.
Sara D. Tchobanoff, MOT, OTR/L, CHT is a Certified Hand Therapist and a member of the American Society of Hand Therapists (ASHT).