Physiotherapy for Hand Pain: Everything You Need to Know

Hand pain can be debilitating, impacting every aspect of your life from performing simple tasks to your overall quality of life.

One of the most effective ways to manage and alleviate this pain is through physiotherapy.

This article provides a detailed guide to understanding hand pain and the role of physiotherapy in its management.

Understanding Hand Pain

Hand pain can be caused by a wide range of conditions, including repetitive strain injuries, arthritis, and accidents.

The symptoms can vary from a mild discomfort to severe pain, and they often worsen when performing tasks that involve the hand.

Hand pain can affect your ability to work, participate in hobbies, and carry out daily activities.

Therefore, it’s essential to seek professional help when you experience persistent hand pain.

What is Physiotherapy?

Physiotherapy is a healthcare profession dedicated to enhancing and restoring functional ability and quality of life.

It involves the prevention, diagnosis, and treatment of a wide range of health conditions through physical means such as exercise, manual therapy, and education.

When it comes to hand pain, physiotherapy can help reduce discomfort, improve function, and prevent further injury.

Common Hand Conditions That Benefit From Physiotherapy

Many hand conditions can be effectively managed through physiotherapy. Here are some of the most common ones:

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a common condition that arises due to compression of the median nerve as it passes through the carpal tunnel in the wrist. This can be due to repetitive strain, wrist injuries, or conditions like diabetes and rheumatoid arthritis. Symptoms include numbness, tingling, and pain in the thumb, index, middle, and ring fingers, often worsening at night. Pain can sometimes extend to the forearm and shoulder.

Trigger Finger

Trigger Finger, or stenosing tenosynovitis, is a condition where one or more fingers get stuck in a bent position. This happens when inflammation narrows the space within the sheath surrounding the tendon in the affected finger. It’s common in people performing repetitive gripping actions and in those with conditions like rheumatoid arthritis or diabetes. Symptoms include finger stiffness, popping or clicking sensation, tenderness, and a bump at the base of the affected finger.

Osteoarthritis of the Hand

Osteoarthritis (OA) is a degenerative joint disease caused by the breakdown of cartilage — the protective tissue at the ends of bones. OA of the hand affects the small joints, leading to pain, stiffness, swelling, and reduced range of motion. Risk factors include age, genetics, previous injury, and excessive use of the hand.

De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis affects the tendons on the thumb side of the wrist, causing pain and swelling. It is often the result of repetitive hand or wrist movements, and can be exacerbated by activities such as gardening, racket sports, or lifting a child. Symptoms include pain and swelling near the base of the thumb, difficulty moving the thumb and wrist when grasping or pinching, and a “sticking” or “stop-and-go” sensation in the thumb.

Dupuytren’s Contracture

Dupuytren’s Contracture is a hand condition that progressively affects the connective tissue within the palm. The disease forces one or more fingers to bend towards the palm, restricting motion. The ring and little fingers are most commonly affected. The exact cause is unknown, but it’s thought to be linked to genetics, and it’s more common in people of Northern European descent.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disorder affecting many joints, including those in the hands. RA can cause pain, swelling, stiffness, and loss of function in the joints. It is an autoimmune disorder, which means the body’s immune system mistakenly attacks its tissues.

Ganglion Cysts

Ganglion cysts are small, fluid-filled sacs that commonly develop along the tendons or joints of the wrists or hands. They can also form in other parts of the body, such as the ankles and feet. The cause of ganglion cysts is not well understood, but they may arise from trauma or the degeneration of tissues. These cysts are generally harmless and often painless, but if they press on a nerve, they can cause pain, tingling, and muscle weakness.

Wrist sprain or strain

A strain or overuse injury can lead to inflammation of the tendons within the wrist. It’s typically treated with rest, splinting, NSAIDs, corticosteroid injections, and physio. A sprain can result from an injury or fall, causing severe pain, swelling, and difficulty using the hand and wrist.

Hand and wrist fractures

These are common injuries that involve a break or crack in one or more of the bones of the wrist or hand. The most common of these injuries occurs in the wrist (distal radius fracture) when people try to catch themselves during a fall and land hard on an outstretched hand​​.

Skier’s Thumb

Skier’s thumb is a common sports injury that often happens when a person falls while holding a ski pole or experiences a similar force that causes the thumb to move away from the fingers, leading to injury of the ulnar collateral ligament of the thumb.

The Physiotherapy Process for Hand Pain

  1. Initial Assessment and Diagnosis: The therapist will first examine your hand, review your medical history, and may use imaging tests to understand the underlying cause of the pain. This can help in diagnosing conditions like arthritis, carpal tunnel syndrome, or fractures.
  2. Treatment Plan Development: Based on the diagnosis, the therapist will develop a tailored treatment plan. This plan could include techniques like manual therapy, exercises, electrotherapy, hydrotherapy, or the use of assistive devices.
  3. Execution of Treatment Plan: The therapist will guide you through the various exercises and techniques in the treatment plan. This may include educating the patient on how to use assistive devices or perform exercises at home.
  4. Progress Monitoring and Plan Adjustment: The therapist will monitor your progress regularly. Depending on the improvement or any new symptoms, the treatment plan may be adjusted.
  5. Final Evaluation: Once the treatment period is over, the therapist will perform a final evaluation to assess the improvement in hand function and reduction in pain.

Get a physio assessment here.

Physiotherapy Techniques for Hand Pain

  • Manual Therapy: This involves the therapist using their hands to mobilise joints and soft tissues. This can help reduce pain, improve circulation, and enhance movement.
  • Exercise Therapy: The therapist will guide you through a series of exercises designed to strengthen the hand and improve flexibility. These exercises can also be performed at home.
  • Electrotherapy: Techniques like TENS or ultrasound can be used to reduce pain and promote healing.
  • Assistive Devices: Depending on the condition, the therapist may recommend assistive devices like splints for support or adaptive tools to help with daily tasks.

Home Exercises for Hand Pain

The benefits of physiotherapy for hand pain can be amplified by incorporating simple exercises into your daily routine.

Here, we present a detailed guide of several exercises that can help in easing the discomfort and enhancing mobility.

  1. Finger Lifts: Place your hand flat on a table, keeping your fingers close together. Lift one finger at a time off the table, hold for a few seconds and then lower it. Repeat this for each finger, including the thumb.
  2. Fist Making: Slowly clench your hand into a fist. Keep your thumb on the outside of your fingers, not tucked under. Hold for a moment, then slowly unclench your fist.
  3. Thumb Extension: With your palm facing you, move your thumb away from your fingers as far as you can. Hold for a few seconds and bring it back to the starting position.
  4. Finger Bends: Bend each finger towards your palm. Do this one finger at a time, ensuring to maintain the bend for a few seconds before straightening back out.
  5. Wrist Flexion/Extension: Rest your forearm on a table with your hand hanging over the edge. Slowly, bend your wrist up and down, maximising the range of motion.
  6. Finger Taps: With your hand laid flat on a table, lift your thumb and tap the tip of each finger starting from your index to your little finger. Try to perform this sequence smoothly and rhythmically.
  7. Wrist Rotations: Extend your arm with your palm facing down. Gently rotate your wrist clockwise and then anti-clockwise. Be careful not to move your arm during this exercise, keep the motion limited to your wrist.
  8. Grip Strengthening: Using a stress ball or a similar object, squeeze gently and hold for a few seconds before releasing. This helps to strengthen the muscles in your hand and forearm.
  9. Towel Wrings: Hold a small towel or washcloth with both hands. Twist as if you’re wringing water out of it. Perform this action in both directions.
  10. Thumb Touches: With your palm open, touch the tip of each finger starting from your index to your little finger with your thumb. Make a round shape as if you’re creating the letter ‘O’.

These exercises should be performed gently and slowly.

Never force a movement if you encounter sharp or severe pain.

It’s important to note that these exercises are for mild to moderate hand pain.

If you have severe pain, it’s best to consult with a physiotherapist before attempting any exercises at home.

Case Studies

There are numerous instances illustrating the transformative power of physiotherapy in managing hand pain.

For instance, Mrs. Smith (shared with permission), a 50-year-old woman who had been dealing with chronic arthritis in her hands, saw tremendous relief through a well-structured physiotherapy programme. Initially struggling with everyday tasks like holding utensils, she can now enjoy a far better quality of life after six months of regular physiotherapy sessions and a customised home exercise regimen.

Another example is Mr. Johnson (shared with permission), a 30-year-old computer programmer who suffered from repetitive strain injury due to prolonged keyboard use. After just three months of targeted physiotherapy and lifestyle adjustments – including postural and ergonomic modifications, he reported a complete resolution in his symptoms.

Choosing the Right Physio

Choosing a physiotherapist who specialises in hand pain is crucial to ensure you receive the most effective treatment. Here are some key factors to consider:

  • Qualifications: The physiotherapist should have the necessary qualifications and specialisations in dealing with hand pain conditions.
  • Experience: Look for a physiotherapist with a solid track record in treating similar conditions.
  • Approach to Treatment: Discuss the potential treatment strategies, ensuring they align with your comfort levels and expectations.
  • Communication: A good physiotherapist should be able to effectively communicate the treatment plan and make you feel comfortable during the process.


The importance of physiotherapy for hand pain cannot be overstated.

It offers a non-invasive and effective approach to managing and alleviating pain, while also improving mobility and function.

Home exercises are a crucial component of this approach, reinforcing the work done in physiotherapy sessions.

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