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Hand exercises for CRPS

Hand & wrist · Complex regional pain syndrome (CRPS) of the hand

How to use this sheet. Using the hand gently and regularly is the main treatment, even if it feels unsafe to move. In CRPS the pain is real, but it does not mean the hand is being damaged. Move only within comfort and never force: some discomfort is fine, sharp pain is not. Do a little, often, every day, and keep to about the same amount on good days and bad days. Do not keep the hand in a plaster or a sling unless we have told you to. When the hand is swollen, rest it on a pillow raised above the level of your heart and gently open and close the fingers; take off tight rings and bangles. Keep the elbow and shoulder moving too. Do not let anyone, including a bone setter, massage the hand hard, rub oil in forcefully, or pull and manipulate it. Retraining the brain, in three steps (we will tell you when to move on to the next one): first, look at pictures of hands and say quickly whether each is a left or a right hand; next, imagine moving the painful hand slowly, without moving it; last, the mirror work in exercise 6. Pain like this can spoil sleep and mood. Tell us if it does, because help is available for that too.

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Tendon glides

Tendon glides

Move the fingers through the positions slowly to keep them mobile.

  • 10 times
  • 3 times a day

Should feel: The fingers moving freely Should not feel: Pain that lasts hours afterwards

Finger to thumb touches

Finger to thumb touches

Touch each fingertip to the thumb.

  • 10 rounds
  • 2 times a day

Should feel: Control Should not feel: Pinching pain

Wrist circles

Wrist circles

Make slow, gentle circles with the wrist, only as far as is comfortable.

  • 10 each way
  • 2 times a day

Should feel: Free movement Should not feel: Forcing into sharp pain

Forearm rotation

Forearm rotation

Elbow tucked in, turn the palm up and down slowly.

  • 10 times
  • 2 times a day

Should feel: Free movement Should not feel: Clicking with pain

Touching different textures

Touching different textures

Gently stroke the sensitive skin with something soft, such as cotton wool or a soft cotton cloth. When that feels ordinary, move on to something a little rougher: a towel, then a woollen shawl. You can also rest the hand in a bowl of dry rice or dal and move the fingers through it. Start at the edge of the most sensitive area and work inwards.

  • 5 minutes
  • 3 times a day

Should feel: The touch feeling a little more ordinary each week Should not feel: Pain that stays raised for hours afterwards

Mirror work

Mirror work

Sit at a table with a mirror standing upright in the middle, its shiny side facing your good hand. Put the painful hand behind the mirror, out of sight. Look only at the reflection while you slowly move the good hand: open and close it, touch the thumb to each fingertip, turn the palm up and down. It will look as if the painful hand is moving easily. Start this when we tell you, after the first two steps above.

  • 5–10 minutes
  • 3 times a day

Should feel: The hand in the mirror looking like your own painful hand Should not feel: Pain or swelling going up during or after

Using the hand for daily jobs

Using the hand for daily jobs

Use the painful hand in ordinary jobs every day, adding a little more as it allows: holding a glass of water, eating with that hand, combing your hair, buttoning a shirt, folding clothes. Start with light, easy jobs. Keep it steady: do not do a lot on a good day.

  • Every day
  • Little and often

Should feel: The hand joining in a little more each week Should not feel: Much more pain the day after a busy day

Stop and telephone us if

  • You have a fever, or pus or fluid comes from a wound or operation scar on that arm
  • The wrist or hand looks newly bent or out of shape, or a plate, wire or screw seems to be pushing up under the skin
  • The hand is quickly getting stiffer or harder to use, even though you are doing the exercises

Ready when you are.

Call either clinic during consulting hours, or send a WhatsApp message any time.