Mark is a 59 year old, right hand dominant, plumber.  He needs to continue to work until he is 65.  Mark was referred for hand therapy by his GP.

 

Mark presented with a painful, swollen right thumb.X-rays confirm that the base of the thumb has some arthritic changes.  He had poor mobility in the tip of the thumb and was struggling to pinch washers, nuts, bolts etc, or to form a strong grip.  This was having a significant impact on Mark’s ability to work.  Following an initial assessment, a customised thermoplastic splint was moulded to Mark’s thumb.  This provided instant pain relief and also improved mobility of the tip of the thumb over the top of the splint.  Mark was advised on icing techniques to reduce the swelling and taught some gentle exercises to improve the movement in his thumb.  Mark was advised to wear the splint as much as possible at work and for any functional activity at home.

 

Upon the second therapy session, Mark’s symptoms were much  improved.  The thumb was less swollen, and the pain less severe.  Mark was not able to perform all work tasks in his splint, but wore it as much as possible.  He was able to form a pinch in the splint, to pick up small objects.  The mobility in his thumb had increased.  We then progressed onto thumb stability exercises to improve stability at the base of the thumb, where the arthritic changes had occurred.

 

Upon the third treatment Mark was advised on further strengthening exercises.  His pinch grip was measured.  This had increased significantly.  A soft neoprene splint was applied.  Mark was advised to wear this for the tasks which he was unable to do in the more rigid thermoplastic splint.  Mark felt that his treatment had helped to reduce his pain and has enabled him to continue to work for longer.