How do I reduce hand swelling, and when will it get better? These questions are asked by hand therapist on a daily basis.
Most hand injuries cause swelling of some kind. This may include acute swelling after surgery or a recent injury. Swelling may also be chronic from a past injury. Sometimes swelling occurs for no reason at all.
In this article I’ll discuss
- Swelling duration
- Swelling reduction
- Retrograde massage
- Exercises that can reduce swelling
- Edema wrapping
After reading this you should have a good understanding of how to reduce swelling and increase range of motion.
How long does it take to reduce hand swelling?
This is usually the next question I receive from my patients. Reducing hand swelling isn’t fixed in a day. Often it may take weeks or months. After surgery or traumatic injuries, swelling can even take up to 6 months.
If the injury is minor from a small sprain or bump, swelling may go away within a week or two. If the injury is major, such as surgery or an open wound, the swelling may be worse and take months.
There’s not a direct answer here, because everyone is different. I’ve seen patients come out of a major surgery with minor swelling. I’ve also had patients come out of a minor surgery with major swelling.
The best advice I can give on this topic is to be patient and do everything you can to reduce the swelling as outlined in these next few sections. If the swelling is significant after 6 months, the best answer is to consult a physician.
Remember, there will always be some appearance of swelling to the injured extremity even after it’s healed.
Compression with ice to reduce swelling
R.I.C.E
You’ve probably heard of the acronym R.I.C.E method to treat edema. It stands for rest, Ice, compression and elevation. The rice method is mostly used in the acute phase or first 3 days after the injury or surgery.
Swelling should continue to be treated after 3-5 days with compression, elevation, and ice as needed for pain. Game ready makes a pneumatic compression sleeve that involves both compression and ice. This device can be worn over the arm or hand. The device pumps ice water intermittently through the sleeve to alleviate pain and reduce swelling.
Compression and elevation
After the pain has subsided you may not wish to continue using ice. My preferred method is to keep the swollen extremity in a compression sleeve (tubagrip) fitted by a hand therapist in an elevated position (Preferably above the heart). The compression sleeve should be comfortable (Not too tight or too loose).
If the swelling is in the fingers use an arthritic compression glove. You can also combine tubagrip with compression gloves if swelling is in the hand, wrist, and forearm.
Retrograde massage to reduce hand swelling
Retrograde massage can done by either the therapists or the patient. Family or caregivers can also be educated on retrograde massage.
Method
The idea is to push the fluid by starting distal to proximal. This is done on the back of the hand (posterior hand).
Think of it as petting the back of the fingers or hand. You don’t need to apply excessive force. This will allow the fluid to drain to the lymph nodes of the hand.
Here’s a quick video to give you a visual.
Edema exercises to reduce swelling
According to the Mayo Clinic, gentle edema exercises can help reduce swelling. When the muscle contracts, the fluid can drain. This also helps with increasing joint range of motion.
Lymphedema exercises for the wrist
- Wrist flexion/extension
- Wrist pronation/supination (See video below)
- Ulnar/radial deviation
Lymphedema exercises for the fingers
Lymphedema exercises for the elbow
- Elbow flexion/extension
- Wrist pronation/supination
Lymphedema exercises for the shoulder
- Shoulder flexion/extension
- Abduction/adduction
- Internal/external rotation
See visuals by clicking here.
Edema wrapping
One other way to reduce swelling is to perform edema wrapping. This is usually done by a certified lymphedema therapist. Wrapping is done distal to proximal in a criss-cross pattern. Wrapping is only temporary and should be removed after 1-2 hours. Click here to watch a 7 minute video on how to wrap the wrist and forearm.
Conclusion
Today we’ve reviewed techniques to reduce swelling in the hands. This includes using ice, compression, elevation, retrograde massage, ROM exercises, and wrapping.
Edema can be extremely frustrating for many of these patients. It may be hard to complete daily activities such as personal hygiene, toileting, and feeding. They may need additional education on adaptive equipment and coping strategies.
To learn other edema management treatments click here.
Do you have any other strategies for managing edema? Click below to comment.
David is the lead editor of OT Focus. He has been practicing as an Occupational Therapist since 2013. He specializes in acute care, hand therapy, and ergonomics.
