Interconnected: The Hand

The hand is a fascinating region of the body, not only in it’s intricacies, but also due to it’s impact on everything else.  I do not often work with patients that have pain in their hands. There are times when an elder elects to undergo treatment due to osteoarthritis, but insidious hand pain is less common. Despite this, I tend to provide treatment at the hand because it is so entangled with the rest of the body. Our ability to interface with the environment comes in two primary locations as adults, the hands and the feet.

Let’s use neck pain as an example. I could begin treatment by working directly on the affected area, or I could consider that the neck pain is the outcome of a complex system. The primary complaint may not be the root cause of symptoms. Further downstream the hand may be initiating contact with the environment, and if it has limitations, the requirements needed to move will travel to other parts of the body. A person’s neck may be a compensation for the hand, leading to problems.

We can all imagine how stepping on the ground with your foot would impact areas above the foot, the hand is no different. Typing on a computer has prerequisite motions, if you lack those prerequisites then a compensatory strategy will most likely develop. Say our fingers can’t reach a key, we turn our wrist over to get there, this changes the position of the elbow, and shoulder, now we’re shrugging, and our neck is bearing the load. Persist in this movement pattern and shortly thereafter the ache in our neck comes on and just won’t shut off.

Patients are surprised when I implement treatment options using their hands. The connection between their hands and their symptoms is unclear. If we can see the interactions between body regions and appreciate the ways in which we connect with our environment, then we may have a better ability to change ourselves and adapt. The more readily we can adapt, the more capable we become.

Austin Ulrich, Physical Therapist