Diabetic Hand

 

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The effects of diabetes reach far beyond simply affecting one’s blood sugar and may involve systemic changes that can lead to kidney disease, vision loss, heart disease, stroke, and neuropathy. DIabetes may also impact the immune system, blood flow to the skin, upper extremity sensation and can even cause changes to tendon/ligament/ connective tissue changes, These effects contribute to diabetic hand disorders.

The most common diabetes-related hand disorders include the following:

  • Carpal tunnel is caused by compression in a ligament that lies over the median nerve in your hand.
  • Trigger finger is caused by damage to the tendons that flex your fingers. This causes the fingers to become caught in a flexed position..
  • Dupuytren’s contracture is a gradual thickening and tightening of tissue under the skin in the hand. Individuals may notice one or more bumps at the base of their fingers or over their palms. With time, those bumps may progress to become cords that pull the fingers into flexion. While typically painless this condition may impact functional use of the affected hand.

 

OT intervention in this population may include:

  • Exercises to strengthen the muscles that support the hand joints and increase movements in the hands to keep ligaments and tendons flexible
  • Splinting (wrist support, trigger finger orthoses, extension splinting)
  • Wound Care/Scar and edema management if conditions worsen and require operative intervention
  • Range of motion (ROM) exercises
  • ADL training
  • Sensory Re-education
  • Strengthening

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