Dexterity Hand Therapy is a specialist center for the upper limb – treatment for pain and injury and rehabilitation for function. The upper limb refers to the shoulder, arm, elbow, wrist and hand. We work closely with surgeons for post-operative rehabilitation.

In addition to  manual therapy such as mobilisation, soft tissue massage, lymphatic drainage, ultrasound and exercises, we provide splinting and bracing services

If you are aware of which condition, visit our hand injury and conditions page to better understand the condition and the approximate (no one situation is exactly the same) type of therapy to expect.

If you are yet unclear about your particular upper limb condition, please feel free to drop us a line. Our contact details can be found here.

Complexity and Differential Diagnosis

Hand conditions while often appear simple on the surface can be rather complex, even with common conditions such as Carpal Tunnel Syndrome.

The Carpal Tunnel is situated at the wrist, just underneath a ligament (transverse carpal ligament) that holds together the two bones, ulna and radius of the forearm. And passing through this tunnel are 10 flexor tendons of your hand and the median nerve.

Any lesion formation, fluid retention or swelling of tendons will narrow this tunnel space and compress the median nerve.

Common signs and symptoms include

• Diminished sensation (paraesthesia) or complete loss of sensation (anasthesia) in the thumb, index, middle and half of the ring finger
• Weakness and inability to touch the thumb to other finger tips.
• Progressive loss of coordination and strength in the thumb thumb (weakness of abductor pollicis brevis and opponens pollicis muscles)

If the compression on the median nerve is not alleviated, fine motor control of the hand becomes difficult and pain can begin to radiate into the forearm, and all the way up to the shoulder and lower neck region.

However, it can be easy to misdiagnose carpal tunnel syndrome. There are several conditions with similar signs and symptoms. This is because the median nerve actually starts from nerve roots that branch out from the spine just behind the area where the neck joins the body (C6-T1 vertebra). And the different conditions affect the same nerve bundle at different places along the nerve route from the neck down to the wrist.

Some of these conditions are:

• Ulnar nerve injury
• Thoracic outlet syndrome
• Peripheral neuropathy
• Diabetic neuropathy ( diabetes is a major risk factor for CTS)
• Brachial plexus injury
• Cervical radiculopathy

Diagnosis of carpal tunnel syndrome may be delayed or missed because early symptoms, such as hand weakness, pain and tingling often develop slowly over weeks or months and easily attributed to other conditions such as aging and arthritis.

Some of the treatments for Carpal Tunnel Syndrome include

• Resting hand and/or wrist – activity modification
• Modalities to reduce swelling and inflammation of Carpal Tunnel such as cryotherapy and ultrasound
• Wrist splint immobilization