Common Workers’ Compensation Hand Injuries: The Crucial Role of Physical and Occupational Therapy

Hand and wrist injuries are prevalent musculoskeletal conditions experienced by workers in a variety of fields. These injuries can severely impair an individual’s ability to perform their job and carry out daily tasks. From acute trauma to repetitive stress injuries, the hands and wrists are particularly vulnerable in a wide range of occupations, from manufacturing and construction to office work and healthcare. This blog will explore some of the most common types of work-related hand and wrist injuries, their impact on function, and how physical and occupational therapy (PT/OT) are integral to both surgical and non-surgical recovery pathways.

Prevalence and Types of Work-Related Hand and Wrist Injuries

The hand and wrist comprise a complex system of bones, tendons, nerves, ligaments, and muscles that enable fine motor skills and heavy lifting alike. Injuries to these structures can arise from acute trauma, such as crush injuries, falls, or cuts, as well as from repetitive strain due to overuse.

Common Workplace Hand and Wrist Injuries

:

Carpal Tunnel Syndrome

A repetitive strain injury caused by compression of the median nerve at the wrist. This injury is commonly seen in occupations requiring use of vibrating tools, sustained awkward or repetitive wrist positions, or repetitive gripping.1

Tendonitis

Inflammation of tendons due to overuse, particularly in the wrist flexors or extensors. Frequently observed in assembly line workers or those performing repetitive tasks.

Fractures

The distal radius and scaphoid are commonly fractured in falls or crush injuries.2 These injuries are prevalent in construction and industrial jobs (although a fall can happen in any work setting).

Lacerations and Amputations

Often the result of accidents with machinery, these injuries can require extensive surgical and rehabilitative care.

De Quervain’s Tenosynovitis

A painful condition affecting the tendons on the thumb side of the wrist, often linked to lifting and repetitive thumb movements.1

Trigger Finger

A condition where a finger becomes stuck in a bent position due to tendon sheath inflammation. It’s common among those using tools that require repetitive gripping and pinching.1,3

Initial Management: Surgical vs. Non-Surgical

Treatment for hand and wrist injuries depends on severity, mechanism of injury, and individual functional goals. Non-surgical management often involves rest, immobilization, anti-inflammatory medications, physical/occupational therapy and corticosteroid injections. However, for conditions like severe CTS, tendon ruptures, or fractures with displacement, surgical intervention may be necessary.
In both scenarios, rehabilitation overseen by a physical or occupational therapist plays a central role in recovery. In fact, early referral to physical or occupational therapy is linked to better functional outcomes and reduced time away from work.4

The Role of Physical and Occupational Therapy in Recovery

Restoring Range of Motion and Strength

Following an injury or surgery, stiffness and weakness are common. PT/OT interventions focus initially on restoring range of motion through passive and active exercises. Manual therapy techniques including massage, joint mobilizations, and neural gliding can also be very helpful in reducing pain and improving range of motion.
Once mobility improves, therapists work to rebuild strength, particularly in the intrinsic hand muscles and wrist stabilizers. Additionally, modalities such as heat, ultrasound, and electrical stimulation can also support tissue healing and reduce pain, enabling more effective participation in active therapy.

Scar and Edema Management

Post-operative and post-injury swelling can inhibit motion and healing. Therapists can use manual lymphatic drainage, compression wrapping, and kinesiology taping to help control edema. Scar management may involve massage, silicone gels, and desensitization techniques to prevent adhesions and improve tissue pliability.

Splinting and Bracing

Specialized therapists often fabricate custom orthotics to protect healing tissues, prevent deformity, and support function during the recovery process. In non-surgical cases such as tendonitis, wrist braces may reduce stress on inflamed tissues. After surgery, dynamic splints may be used to promote controlled motion.

Functional Retraining and Ergonomics

Therapists are especially critical in helping patients regain the fine motor skills and hand coordination required for job-specific tasks. This may include simulated work activities, adaptive equipment training, and ergonomic education to prevent reinjury or aid in return to work. This type of treatment may begin in therapy as part of the normal rehab process, but eventually transition into work conditioning as the injured worker’s tolerance to activity improves.

Evidence Supporting Rehabilitation

Numerous studies confirm that rehabilitation is essential to optimal recovery and return to work following hand and wrist injuries:

  • A systematic review found that therapy significantly improves pain and function in patients with carpal tunnel syndrome in the short and medium term.5
  • Another systematic review outlined that “current evidence demonstrates a significant benefit from splinting, ultrasound, nerve gliding exercises, carpal bone mobilization, and exercise for people with carpal tunnel syndrome.”6
  • In tendon repair surgeries, early controlled mobilization under the guidance of a hand therapist has been shown to improve functional outcomes and reduce complications such as tendon adhesion.7
  • A 2021 study highlighted that “incorporating the performance of graded, modified activities during the early weeks of rehabilitation created opportunities for wrist movement, enhanced wellbeing, and assisted in the habituation of wrist movement. Activities and occupations can be used as a therapeutic strategy to promote recovery from surgical treatment.”8 Therapists are in a prime position to provide guidance on graded exposure to activity following an injury, ensuring that rehab focuses on work specific tasks as a precursor for return to work. As highlighted in the research, this can have profound implications for return to work and functional outcomes.

Conclusion

Hand and wrist injuries are common in the workplace and can have profound impacts on an individual’s livelihood and quality of life. Whether managed surgically or conservatively, physical and occupational therapy are indispensable to restoring strength, function, and independence. By tailoring rehabilitation to the injury and the job demands, therapists play a central role in facilitating a safe return to work while reducing the likelihood of reinjury.
Upstream Rehabilitation and our family of brands offer physical therapy and occupational therapy. We also have numerous Certified Hand Therapists across the nation in our clinical footprint.
To learn more about how Upstream Rehabilitation and our family of brands can assist with Workers’ Compensation and how physical therapy plays an effective role in helping injured workers return to work, contact our Workers’ Compensation team today!

 

  1. American Academy of Orthopaedic Surgeons. (2021). Carpal tunnel syndrome. https://orthoinfo.aaos.org
  2. National Safety Council. (2022). Injury facts: Hand injuries in the workplace. https://injuryfacts.nsc.org
  3. Cavaliere, C. M., et al. (2019). Trigger finger in the workplace: Etiology and treatment outcomes. Journal of Hand Surgery, 44(3), 234–240.
  4. MacDermid, J. C., & Michlovitz, S. L. (2006). Postoperative rehabilitation of the hand and wrist. Journal of Hand Therapy, 19(1), 2–11
  5. Huisstede BM, Hoogvliet P, Franke TP, Randsdorp MS, Koes BW. Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials. Arch Phys Med Rehabil. 2018 Aug;99(8):1623-1634.e23. doi: 10.1016/j.apmr.2017.08.482.
  6. Muller M, Tsui D, Schnurr R, Biddulph-Deisroth L, Hard J, MacDermid JC. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review. J Hand Ther. 2004 Apr-Jun;17(2):210-28. doi: 10.1197/j.jht.2004.02.009. PMID: 15162107.
  7. Tang, J. B. (2005). Tendon injuries across the world: Treatment methods, outcomes, and research needs. Hand Clinics, 21(2), 161–167.
  8. Collis, J. M., Mayland, E. C., Wright-St Clair, V., & Signal, N. (2021). “The more I do, the more I can do”: perspectives on how performing daily activities and occupations influences recovery after surgical repair of a distal radius fracture. Disability and Rehabilitation, 44(19), 5440–5449. https://doi.org/10.1080/09638288.2021.1936219
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