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Hand Therapy

Regain Function and Motion in Your Hand, Wrist, Elbow, Forearm or Shoulder

You may be referred for hand therapy following an injury, surgery or condition that affects your hand, wrist, elbow, forearm or shoulder. Hand therapy can help you regain motion and function following a fracture; nerve, tendon, or ligament injury; joint instability; and/or arthritis.

Hand therapy is performed by Duke occupational therapists who specialize in hand therapy. They work closely with orthopedic hand surgeons and plastic surgeons to evaluate your concerns and develop a personalized treatment plan to help you achieve your personal goals. These goals can range from dressing yourself and caring for your children to returning to work or sports. The OT hand therapists are often part of your doctor’s clinics, which ensures your hand therapist has consistent and direct contact with your provider. We work as a team to ensure we meet your needs.

Many Duke OT hand therapists are board-certified specialists. This means they have met the rigorous requirements set by the Hand Therapy Certification Commission. The requirements include three years of experience, 4,000 hours of patient care specific to hand and arm rehabilitation, and passing a comprehensive examination. To maintain the certified hand therapist (CHT) credential, Duke hand therapists must complete continuing education in hand and arm rehabilitation.

Occupation-based Care

As occupational therapists, our hand therapists focus on returning you to your occupation. Occupation refers to activities you do every day, such as dressing, bathing, grooming or feeding. Higher-level activities like sports, playing a musical instrument, work and caregiving are also things we help with.

Our hand therapy team teaches you how to reduce pain and protect the joints in your arm. We help you learn to use adaptive equipment such as can openers, rocker knives and built-up handles while also promoting activity modifications, such as learning better carrying techniques when lifting.

Hand Therapy Treatments

Your first session with a hand therapist will include a comprehensive evaluation, identification of your personal goals and an initial treatment. We use a wide variety of hand therapy treatments. Our hand therapy providers are experts in the use of the latest advances in equipment to meet your hand and arm rehabilitative needs. Your hand therapist may teach you to perform exercises that will improve your range of motion and strength.

Custom Orthotics

Following an operation, your surgeon and hand therapist may recommend a custom orthotic brace or device to protect your hand. The orthoses are made from thermoplastic which is molded to your arm in the clinic by your hand therapist. Other types of orthoses may be recommended to improve function, increase your range of motion and regain your strength.

Our hand therapists are trained and skilled in identifying, designing and creating a wide variety of orthoses. Occasionally, your hand therapist will work with other providers to help you obtain prefabricated, mass-produced braces or devices.

Manual Therapy

You may be a candidate for some or all of these manual therapies listed below. These treatments can help you recover and improve function. Your hand therapist will perform a complete assessment to determine which of these techniques is right for you.

  • Sports taping techniques
  • Joint mobilization
  • Scar massage and treatments
  • *Instrument-assisted soft tissue mobilization uses specially designed tools to work on soft tissues

*OT hand therapists at the North Carolina Orthopedic Center are trained in ASTYM techniques, a type of instrument-assisted soft tissue mobilization

On-going Research

Our hand therapy team is active in the research community and often assists with research alongside our hand surgeons. The hand therapy team participates in ongoing journal article reviews to ensure we stay up to date on new evidence. Several hand therapy team members have presented on rehabilitation topics at the national and state level.

Obtaining a Referral

Depending on your insurance, physical therapy and occupational therapy services require a referral and prescription from your primary care physician or specialist. If your insurance company requires pre-certification, that will need to be completed before an appointment is scheduled.

Making an Appointment

After a referral/authorization is completed, an appointment can be scheduledd by calling (919) 684-2445, Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.

We have several locations throughout the Raleigh-Durham area. Click here for a list of the locations where hand therapy is provided.