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How to Reduce Hand Spasticity and Pain after Stroke

physiotherapist helping survivor with hand spasticity treatment by stretching hand with ball

If you have spasticity in your hand and your fingers are stiff and hard to move, or even painfully tight, then you’re in the right place. This guide will explain exactly how to reduce spasticity in your hand through a variety of treatments and rehabilitation methods.

Experimentation is key. What works for one person may not work for another, so explore various treatments with an open mind (and your therapist’s approval) until you find what works for you.

Table of Contents

What Causes Hand Spasticity?

Spasticity is a muscular disorder characterized by muscle tightness and stiffness, which can affect muscles throughout the body including the hand.

Spasticity is usually caused by a neurological injury like stroke or brain injury. When the nervous system sustains damage, it can disrupt the signals between the brain and muscles. As a result, certain muscles become over-active and are unable to relax, leaving them in a state of prolonged and involuntary contraction.

The severity of muscle stiffness fluctuates. For instance, a person with mild hand spasticity can still move their fingers but may struggle with coordinated movements. When hand spasticity is severe, however, the person’s fingers may curl and their hand may remain clenched in a fist, which can be painful.

When left untreated, severe spasticity can progress into contractures, where the connective tissue and joints become extremely stiff, often painful, and limit your range of motion.

Fortunately, spasticity is treatable, and you’re about to learn how. Up next, we will discuss the top rehabilitation method for hand spasticity, and then dive into a list of supplementary options.

Hand Spasticity Exercises

Rehabilitation exercise is one of the most effective ways to treat spasticity in the hand. When you practice therapeutic movements with your hand, it helps rewire the nervous system and improve communication between the brain and muscles.

This rewiring process is called neuroplasticity, and it’s the core concept behind recovery after neurological injury such as a stroke. Neuroplasticity allows the nervous system to rewire itself and create new pathways between the brain and muscles (and also strengthen existing pathways). It takes time and effort, but recovery is possible through neuroplasticity.

In order for neuroplasticity to occur, you need repetitive practice. This means practicing your hand spasticity exercises with high volume. This provides the stimulation the brain needs to rewire itself and strengthen new connections. It’s like learning a new skill: practice makes perfect.

Although rehabilitation exercises are an excellent treatment for hand spasticity, they are not accessible for everyone — at least not right away. If you have severe spasticity, you may need to spend some time stretching to allow your hand to remain in a more open position prior to your exercises.

This is also where passive exercises are helpful. When you cannot move your hand and fingers through an exercise on your own, you can use your non-affected hand to assist your fingers and wrist through the movement. When you do these passive exercises and pay attention to the movement, it helps activate neuroplasticity and address the root cause of hand spasticity.

Other Hand Spasticity Treatment Methods

Now that you know why hand therapy exercises are the best treatment for spasticity, let’s explore other treatment methods. Many of these methods work best when combined with an existing exercise regimen.

As you explore the various ways to treat hand spasticity below, keep in mind that everyone is unique. If your spasticity is the result of a stroke or other neurological injury, it’s important to work with a therapist who can help assess your condition and ensure you are exploring the right treatments.

Here are some hand spasticity treatments that your therapist may recommend:

1. Stretching and/or Splinting

Gently stretching your hand multiple times per day is essential for treating spasticity in the hand. There are many ways to go about it, too.

Your occupational therapist can help you find a proper splint that can help prop the hand open for extended periods of time. If you don’t have access to a splint, some occupational therapists suggest stretching your hand out on your thigh while you are seated, on a small- to medium-size ball, or around a dry washcloth, depending on the severity of your spasticity.

Stretching helps improve range-of-motion and prevent contractures from developing. It should be part of every person’s hand spasticity treatment regimen.

Also, keep in mind that spasticity is velocity-dependent. This means the faster you stretch the affected muscles, the stronger they contract. Therefore, it’s important to stretch your hand slowly, gently, and never to the point of pain.

Even when it’s mainly your fingers that are affected by spasticity, it is important to keep the position of your wrist in mind while stretching. This is because the muscle groups that are primarily responsible for flexing and extending the fingers are in the forearm, with their tendons crossing the wrist and connecting to the bones of the fingers.

Therefore, it will be significantly more challenging to work on fully flexing your fingers with your wrist bent forward rather than in a neutral position. Additionally, consider asking your therapist if it would be appropriate to use heat to promote increased muscle relaxation before stretching or exercising.

2. Electrical Stimulation

If your therapist deems it appropriate, electrical stimulation can be a great addition to your hand spasticity treatment regimen. During this therapy, electrical stimulation is applied to specific muscles (often those in the forearm) to make your fingers move.

In this video, you can watch an OT demonstrate electrical stimulation for finger extension. He places the pads on muscles in the arm to help extend the fingers. This is a great example of why you want and need a therapist’s help to use electrical stimulation, because they know where to place the pads and how to safely apply the stimulation.

It’s also important to note that if you are experiencing any sensation loss in your hand or forearm, be sure to tell your therapist before beginning electrical stimulation, as it could cause skin tissue injury.

Electrical stimulation works best when combined with rehabilitation exercise. This is why it’s a great supplementary treatment for hand spasticity.

3. Hand Therapy Exercise Devices

Speaking of exercise, sometimes it can get boring when you’re doing it by yourself at home. And this is where interactive hand therapy exercise devices like MusicGlove can help.

Flint Rehab’s MusicGlove is a sensorized glove that tracks your movement as you exercise your hand in sync with a musical game. It’s FDA-approved and clinically proven to improve hand function within 2 weeks of use. As hand function improves, spasticity should subside as the brain gets better at sending signals to your fingers.

Bob & Brad, two physical therapists on YouTube with over 3 million subscribers, gave MusicGlove the thumbs up. (They were not paid to review MusicGlove and they are not affiliated with Flint Rehab in any way.)

MusicGlove is perfect for individuals recovering from neurological injury. However, it does require some hand movement to get started. If you have no hand movement, or if your hand is clenched in a fist from severe spasticity, then Flint Rehab’s FitMi will be a better fit.

FitMi is a full-body, interactive home therapy device that targets the full-body including the hand. Many individuals with zero hand movement have regained mobility by passively exercising with FitMi. (You can see this in the background of Bob & Brad’s video because they also gave FitMi the thumbs up.)

4. Botox

Botox injections are an FDA-approved treatment for upper limb spasticity, which includes spasticity in the wrist and fingers. It works by blocking the release of chemicals that signal your muscles to tighten. Results are temporary and wear off after about 3 months.

However, this temporary openness in your hand and fingers provides an opportune time to practice hand spasticity exercises. This can help encourage the short-term relief to become long-term results.

5. Baclofen

Baclofen is a medication that helps relieve spasticity by inhibiting the release of body chemicals that cause muscle contractions. It can be taken orally or, when spasticity is severe, it can be administered directly to the spinal cord via an intrathecal baclofen pump.

If spasticity is not only affecting your hand but severely affecting your quality of life, you can talk to your doctor about this invasive option. It requires surgery and should be considered only once other options have been exhausted.

Combine Hand Spasticity Treatments for the Best Results

It often works best to combine multiple therapies together, especially when hand spasticity is severe.

When hand spasticity is mild, it can still help to combine stretching multiple times per day with hand therapy exercise once per day.

But when spasticity is severe, be sure to stretch your hand throughout the day and consider doing your hand therapy exercises once or twice per day. Don’t overexercise and burn yourself out, but consider exercising your hand for 30 minutes per day or for 15 minutes twice per day.

Furthermore, don’t forget to try to use your affected hand during your daily activities as much as possible. Even though it is not formal “exercise”, it’s a great way to practice integrating the movements involved in your exercises and continue promoting neuroplasticity.

Also, talk to your therapist and discuss supplementary treatment options like Botox or baclofen. You can also try electrical stimulation with your therapist; and if you like it, you can ask your therapist to train you to use it on your own at home.

No matter what you choose, don’t forget that hand therapy exercises are the staple of every hand spasticity treatment regimen. Aim for high repetition to stimulate neuroplasticity.

If you struggle with daily hand exercise due to boredom or low motivation, consider adding interactive rehab technology like MusicGlove, which helps motivate hundreds of repetitions in a 30 minute 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 on the road to recovery.

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

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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

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