Tanya Coats Occupational Therapy

Stiff Hands? Move It or Lose It

Stiff hands can interfere with quality of life, whether it creates just a mild annoyance or a severe limitation.

Treatment depends on the cause; stiffness can originate with injury, arthritis, tendonitis, or a variety of other causes. A hand surgeon can help determine the underlying problem and implement an appropriate treatment plan that may involve home exercises, hand therapy, injections, and in some cases, surgery.

I jammed my finger recently, but it’s still stiff. How do I get it moving again?

Stiffness after a finger injury is common.  When you jam (sprain) your finger playing basketball or during a fall, for example, the ligaments surrounding a joint partially tear. The healing process with a jammed finger typically leads to ligaments that are thicker and less flexible.  What appears to be a relatively minor injury might lead to stiffness in a period of days to many weeks if motion and stretching exercises are not started in a timely fashion. This type of stiffness often responds well to hand therapy. Nevertheless, it may be difficult to distinguish a minor sprain from a more serious injury. X-rays may be needed to exclude a more serious injury, such as a dislocation or fracture. A hand surgeon can determine the best treatment.

Why are my hands stiff in the morning?

In some conditions, hand stiffness is worse in the morning. For example, trigger finger is a common tendonitis that can cause clicking, catching, or locking but also a stiff or stuck finger that doesn’t fully move.  If numbness or tingling in the fingers (thumb, index, middle fingers) comes with the stiffness, then carpal tunnel syndrome may be to blame. Longstanding diabetes is another cause of generalized hand stiffness. As we age, osteoarthritis (wear and tear arthritis) of the small finger joints can cause morning stiffness. Finally, certain inflammatory conditions, such as rheumatoid arthritis and psoriatic arthritis, can cause hand stiffness in addition to other signs and symptoms. In short, stiffness is a symptom of many conditions, so it is best to consult a hand surgeon or your primary doctor to choose the best course of action.

My fingers do not fully straighten. What’s going on?

If you can make a fist, but one or more fingers do not fully straighten, you could have Dupuytren’s contracture. Patients with this condition notice lumpy, bumpy thickening in the palm (palmar fibromatosis) which may look like callouses. The bent posture progresses at a variable rate over months or years. The finger position interferes with shaking hands and reaching into pockets. A hand surgeon can diagnose this condition and discuss the various treatment options with you, both surgical and nonsurgical.

What medications, creams, and home remedies work for hand stiffness?

It depends on the diagnosis. Your primary doctor or hand surgeon can make a diagnosis and then recommend an oral or topical medication if appropriate. Patients with arthritis and other types of stiffness may find that warm water is helpful. In most cases, splints and braces are not useful, but there are exceptions.

Will I need surgery for my hand stiffness?

Most of the time, the answer is no.  Many causes of hand stiffness can be managed by treating the underlying medical problem or working on exercises, possibly under the care of a hand therapist. Sometimes, a steroid injection or other medical treatment is beneficial. Dupuytren’s contracture, for example, has surgical and nonsurgical treatment options. When stiffness persists, and no further non-surgical measures are likely to be helpful, surgery may be considered an option to help regain motion.

David William Zeltser, MD is a board-certified hand surgeon in San Francisco, California and a member of the American Society for Surgery of the Hand.

Article Reference: HANDCARE

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