Hand spasticity and pain after stroke can be treated through a variety of methods.
The trick is to know how to combine the right treatments for the best results — and this article will teach you how.
Let’s start by understanding the root cause of hand spasticity.
Understanding Hand Spasticity
Spasticity is a condition characterized by muscle tightness and stiffness after stroke or neurological injury.
It’s usually caused by disruption in the connection between the brain and the rest of the nervous system.
When the brain’s messages to the muscles are disrupted in some way (often due to damage in the motor cortex), it can affect the balance of inhibitory and excitatory signals. In the case of spasticity, certain muscles become over-active and are unable to relax, leaving them in a state of prolonged contraction.
Sometimes spasticity is painful, especially if the stiffness is severe or has progressed into contractures. That’s why it’s essential to treat hand spasticity as soon as possible.
The best hand spasticity treatments address the root problem by restoring the brain-muscle connection. There are also other treatments that can help without “getting the brain on board.”
Treatments for Hand Spasticity and Pain
There are several treatments for hand spasticity, and it often works best to combine several approaches. Here are the best options:
To temporarily relieve hand spasticity after stroke, you can try botulinum toxin (Botox) injections.
Botox is a “nerve block” that prevents the release of chemicals that signal your muscles to tighten. It’s an FDA-approved treatment for spasticity in the upper limbs.
This is a temporary treatment, though, so it will require repeat treatments once the Botox wears off.
However, if you combine this treatment with others, you can keep some of the gains long-term — so stick with us.
2. Hand Splints
Another way to help reduce hand spasticity is by using splints to prop the hand open. Splints are a type of hand brace that strap to the palm of your hand/wrist to keep the hand open. Your occupational therapist should be the one to guide you towards a proper splint based on your hand.
If you don’t have access to a splint, some occupational therapists suggest stretching your hand out on a rolled-up washcloth, or a small to medium-size ball, depending on the severity of your spasticity.
While stretching can help open the hand after stroke, it does not help restore movement in the hand. Instead, the best way to restore movement is with the following treatment…
3. Hand Therapy Exercises
Hand therapy exercises, including weight-bearing exercises, can help reduce spasticity by restoring the brain-muscle connection through neuroplasticity. Weight-bearing exercises consist of bearing some weight through the open hand, which can be done on a therapy mat table, a countertop, etc. You/your therapist may need to spend some time stretching out the spastic hand prior to weight-bearing to allow it to remain in a more open position. If you are able to put some weight through the hand, you will be sending the correct signals to the brain about which muscles should be contracting and which should be relaxing, effectively engaging neuroplasticity.
Neuroplasticity is the process the brain uses to form new neural connections. These new connections help the brain send the correct signals to the hand again.
As this mind-muscle communication improves through exercise, the hand muscles can relax and stop contracting. As a result, the hand spasticity is reduced and hand mobility is improved!
This addresses the root problem, which is why hand therapy exercise is one of the best ways to reduce hand spasticity.
But if exercise is the best option, why did we mention it last?
Combine Hand Spasticity Treatments for Best Results
When hand spasticity is severe – which often results in clenched hands after stroke – sometimes hand exercise is not accessible.
If the hand is clenched in a fist, then it might be impossible to open it enough to exercise and rewire the brain.
That’s where Botox and/or hand splints can help you out.
These treatments help loosen the hand and create a “window of opportunity” for you to exercise your hand.
While Botox is only a temporary solution, you can use the short-term mobility after treatment to exercise your hand daily.
In that time, you can work hard to rewire the brain and regain control of your hand muscles.
Then, when the Botox wears off, some of those gains will remain because now the brain is on board.
How to Boost Your Hand Recovery
If you want to speed up your hand recovery, then practicing high repetition of hand therapy exercises is key.
Repetition helps stimulate neuroplasticity and strengthen the new neural connections that are growing. The more reps you accomplish, the stronger those new pathways become.
As your brain begins to rewire itself, the spasticity will subside. The nervous system no longer needs to involuntarily contract your muscles. Instead, you will start to regain control of your hand movements.
The more repetitions you practice, the better your brain will get at controlling your hand.
A great way to motivate yourself to accomplish high repetition is by using Flint Rehab’s MusicGlove. It “gamifies” hand therapy to help you achieve hundreds of repetitions per session.
Reducing Hand Spasticity
Overall, hand therapy exercise is the best treatment for stiff hands caused by spasticity.
Exercise will help rewire the brain and reduce the spasticity long-term. Supplementary treatments like Botox and hand splints can help boost the process.
Whatever treatment options you choose, focus on reconnecting mind to muscle through repetitive exercise.
Get your reps in, and you’ll be well on the road to recovery.