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How to Reduce Hand Spasticity and Pain after Stroke

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.

disconnection between brain and nervous system causes hand spasticity

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:

1. Botox

doctor injecting botox into patient to relieve hand spasticity after stroke

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

stroke patient demonstrating hand spasticity 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?

hand therapy exercise ebook flint rehab

Bonus: Download a free 25-page Hand Rehab Exercise ebook

You’ll get a 25-page PDF with exercises and pictures. Click here to download the PDF (link will open a pop-up that will not interrupt your reading)

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

relaxed hands after spasticity has been reduced with these treatments

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.

Keep It Going: Download a Free PDF Hand Therapy Exercise Guide!

hand therapy ebook cover with example pages

Get our free, illustrated “35 Hand Therapy Exercises for Stroke Patients” ebook by signing up below!

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Get inspired with this hand recovery story!

“My husband had a torn aorta and underwent emergency open heart surgery, then there were multiple complications and he was on life support for 10 days.

After 10 weeks in the hospital, he is expected to make a full recovery. The biggest hurtle to his recovery has been his left hand, between the muscle atrophy and brain trauma, he had very little control of it.

As a professional musician, being unable to even hold a guitar was hard, to say the least. Despite weeks of PT & OT, his hand function had barely improved.

We ordered the MusicGlove and received it in 2 days. He began using it right away. He spent over an hour with it the first day. That is what makes it work so well, it’s way more interesting and rewarding than trying to pick up a peg.

In OT, he struggled to do any of the exercises, and the at-home exercises were mainly strengthening.

After only a few days with the Music Glove, he was able to pick up and hold his guitar. and after 3 weeks, he can play 3 chords.

The MusicGlove and program are engaging. He uses it daily for an hour – and he wants to do it. His 1st time using it, I could barely get it on, his hand was moving so much; his accuracy was about 30% and he had difficulty even doing some of the fingers.

Now, after only a few weeks, his uncontrolled motion is about 60% better, I can easily & quickly get the glove on, his accuracy is over 90% – on all fingers, and he now can do multiple fingers. I would highly recommend this product.”

– Jill’s MusicGlove review

More Ways to Recover with Flint Rehab:

Download Free Hand Therapy Exercises

hand therapy ebook cover with example pages

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