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Rehabilitation · Clinically reviewed

Hand and wrist therapy, precise, staged rehab for small, complex structures.

Specialist hand therapy by BAHT-accredited physiotherapists and occupational therapists - splints, exercises and manual work that protect healing and restore function.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against BAHT, BSSH, NICE and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK hand therapy practice including custom splinting, tendon and nerve gliding, and scar management.

Key facts

Hand therapy at a glance.

What specialist hand therapy is, who delivers it, and why it matters after injury or surgery in the UK today.

  • What it is

    A specialist branch of rehabilitation for the hand, wrist and forearm delivered by physiotherapists and occupational therapists.

  • Who provides it

    BAHT-accredited hand therapists working alongside hand surgeons in specialist hand centres and community clinics.

  • Why it matters

    Small hand structures need precise, staged rehab - outcomes after fracture, tendon repair or nerve surgery depend on it.

  • Twelve techniques

    Splinting, exercises, manual therapy, scar and oedema work, sensory re-education, electrotherapy, orthotics and ergonomics.

  • When it starts

    Often within days of injury or surgery - early protected motion is a mainstay of modern hand rehabilitation.

  • How long it lasts

    Weeks for a simple sprain, months for complex tendon or nerve reconstruction - guided by surgical protocol.

Why this guide matters

A staged programme, not a single gadget.

Good hand therapy stitches several techniques together and adjusts them as tissues heal - three principles shape everything else on this page.

  • BAHT accreditation matters

    Look for a therapist accredited by the British Association of Hand Therapists - a marker of post-registration training in the hand.

  • Splints support, they do not cure

    A splint protects healing structures and controls motion - real recovery comes from the exercises done inside and outside it.

  • Function is the endpoint

    The aim is not degrees on a goniometer - it is dressing, typing, tools, an instrument or a sport back in the hand.

How assessment works

From referral to a clear rehab plan.

The steps a UK BAHT-accredited hand therapist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Referral and triage

    From a hand surgeon, GP, A&E or self-referral - triage identifies red flags and the urgency of first contact.

  2. 02

    Assessing

    Subjective assessment

    History of injury or surgery, hand dominance, occupation, hobbies, musical instruments and daily functional demands.

  3. 03

    Assessing

    Objective examination

    Range of motion, grip and pinch strength, oedema, scar, sensation, tendon glide and joint stability - measured with goniometer and dynamometer.

  4. 04

    Confirming

    Outcome measures

    DASH, QuickDASH, PRWE or MHQ to score baseline function - repeated to track progress objectively.

  5. 05

    Confirming

    Liaison with the surgical team

    Protocols after tendon repair, nerve reconstruction or joint replacement come from the operating surgeon - the therapist follows them.

  6. 06

    Planning

    Treatment plan

    A staged programme of splinting, exercises, manual and adjunct techniques - reviewed at each session and progressed as tissues heal.

  7. 07

    Planning

    Discharge and self-management

    A home programme, ergonomic advice, activity modification and clear escalation criteria if symptoms change.

Typical timeline: a first session within days of referral, and a staged plan agreed on the day.

Who it helps

The conditions hand therapy treats.

From fractures and post-surgical rehab to arthritis, tendinopathies, nerve compression, CRPS and sports or musical injuries.

  • Post-fracture stiffness

    After distal radius, scaphoid or metacarpal fractures - see /conditions/hand-fractures/ for the injuries themselves.

  • Post-surgical rehab

    Following Dupuytren fasciectomy, carpal tunnel release, tendon repair, joint replacement or arthrodesis.

  • Nerve compression

    Carpal tunnel and cubital tunnel syndromes benefit from splinting, nerve gliding and workplace advice.

  • Arthritis of hand and wrist

    Splints, joint protection and adaptive equipment help - see /conditions/hand-and-wrist-osteoarthritis/.

  • Tendinopathy and tenosynovitis

    De Quervain, trigger finger and epicondylitis respond well to graded loading and orthoses.

  • Complex regional pain syndrome

    Desensitisation, graded motor imagery and mirror therapy - see /conditions/crps-complex-regional-pain-syndrome/.

  • Sports and musical injuries

    Precision loading and technique review for climbers, musicians, gamers and manual workers.

  • Nerve injury recovery

    Sensory re-education and motor retraining after laceration or crush injury.

Techniques

The twelve tools of hand therapy.

Splinting, exercise and manual therapy sit at the core - the rest are targeted adjuncts used when the presentation calls for them.

  • Custom splinting

    Thermoplastic splints moulded to the hand - static for rest and protection, dynamic for controlled motion. See /conditions/hand-and-wrist-splinting/.

  • Off-the-shelf orthoses

    Prefabricated wrist, thumb and finger splints for stable conditions - carpal tunnel night splints, thumb spicas and buddy loops.

  • Range of motion exercises

    Active, active-assisted and passive movements to restore joint mobility - staged to respect healing tissues.

  • Strengthening

    Isometric, then isotonic then functional loading with putty, hand grippers and resistance bands.

  • Tendon and nerve gliding

    Specific glide sequences to prevent adhesions after tendon repair and to mobilise entrapped nerves.

  • Manual therapy

    Soft-tissue massage, joint mobilisation, distraction and Maitland techniques to restore accessory glide and reduce pain.

  • Scar management

    Massage, silicone gel or sheeting, Coban wrap and desensitisation to soften and flatten surgical scars.

  • Oedema management

    Elevation, compression gloves, Coban wrap and retrograde massage to control swelling and speed recovery.

  • Sensory re-education

    Graded texture, shape and localisation work to retrain the brain after nerve repair - see /conditions/function-loss-from-old-nerve-injury/.

  • Electrotherapy

    TENS for pain, therapeutic ultrasound, iontophoresis for tendinopathy and low-level laser - used selectively as adjuncts.

  • Functional retraining

    Task-specific practice, ADL adaptation, activity modification and Access to Work assessments for return to occupation.

  • Workplace ergonomics

    Keyboard, mouse and tool review, posture correction and pacing to prevent recurrence and support return to work.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your hand surgeon or hand therapist knows your injury, surgery and goals - and can tell you which parts apply to you. If in doubt, get seen.

  • British Association of Hand Therapists (BAHT). Standards of practice and accreditation framework.

  • British Society for Surgery of the Hand (BSSH). Evidence-based practice guidance for hand conditions.

  • NICE. Referral, rehabilitation and management guidance for musculoskeletal hand and wrist conditions.

  • Chartered Society of Physiotherapy (CSP). Standards for hand and upper limb rehabilitation.

  • Royal College of Occupational Therapists (RCOT). Practice guidance for hand therapy and splinting.

Red flags

When to pause therapy and be seen.

Most rehab is uncomplicated. These are the situations where the hand needs a surgical or emergency review, not more exercises.

  • Suspected acute infection

    Spreading erythema, throbbing pain, systemic upset or a hot swollen tendon sheath - urgent hand surgical review, not therapy.

  • Compartment syndrome

    Severe pain out of proportion, tense forearm and pain on passive stretch - a surgical emergency.

  • Tendon rupture after repair

    A sudden loss of movement or a pop during exercises - stop, splint and contact the surgical team immediately.

  • New or worsening neurological loss

    Progressive weakness or numbness after surgery needs urgent surgical review, not more therapy.

  • Uncontrolled swelling and stiffness

    A hand that will not settle with elevation and compression may need earlier surgical input or CRPS assessment.

  • CRPS warning signs

    Burning pain, allodynia, colour or temperature change and disproportionate stiffness - see the CRPS guide.

  • Ulcerated or breaking-down scar

    A scar that opens, weeps or bleeds should be seen by the surgical team before any further scar work.

  • Loss of vascular supply

    A cold, pale, pulseless finger after injury or surgery is an emergency - go to A&E.

  • Falls or fresh trauma

    A new injury on top of an existing problem needs re-imaging and reassessment before therapy resumes.

Living with it

Rehab is a partnership, not a passive treatment.

Four habits do most of the heavy lifting - wearing the splint, working the home programme, pacing daily tasks and using workplace support.

A quiet reminder

Little and often, kept up for months.

A hand that is worked gently every day recovers better than one blitzed once a week - your therapist will show you how.

  1. 01 Wear

    Wear the splint as advised

    Splinting only works when it is worn - your therapist will be specific about day, night and activity use.

  2. 02 Home

    Do your home programme

    Little and often beats a heroic weekly session - short, frequent sets of exercises drive real change.

  3. 03 Pacing

    Pace and modify

    Break tasks into shorter blocks, use both hands, and swap tools or techniques while tissues heal.

  4. 04 Work

    Talk to your workplace

    Access to Work and occupational health can fund equipment and adjustments - your therapist can support the case.

Frequently asked

Everything we get asked about hand therapy.

Quick answers on BAHT accreditation, timing after surgery, splints, electrotherapy and return to work.

  • What is a specialist hand therapist?

    A physiotherapist or occupational therapist with post-registration training in the hand, wrist and upper limb. BAHT accreditation (Levels 1, 2 and Accredited) marks graded expertise in hand therapy in the UK.

  • Who needs hand therapy?

    People recovering from hand fractures, tendon or nerve repairs, Dupuytren and carpal tunnel surgery, joint replacement or arthrodesis, arthritis flares, tendinopathies such as De Quervain and trigger finger, epicondylitis, CRPS and sports or musical injuries.

  • How soon after surgery should therapy start?

    Often within days. Modern protocols use early protected motion after many tendon and nerve repairs to prevent stiffness and adhesions. Your surgical team and hand therapist will agree the timing.

  • Do I need a custom splint or an off-the-shelf one?

    Both have a place. Off-the-shelf splints work well for stable conditions like night splinting for carpal tunnel. Custom thermoplastic splints are needed after surgery, for complex deformities and where a precise fit matters for healing.

  • Will electrotherapy speed up my recovery?

    Used selectively - TENS can help with pain, ultrasound and iontophoresis are sometimes used in tendinopathy, and low-level laser has a role in scar work. They are adjuncts to splinting, exercise and manual therapy, not a substitute.

  • Can hand therapy help me get back to work or music?

    Yes. Functional retraining, activity modification, ergonomic review and Access to Work support are core parts of hand therapy - the goal is a hand that does what you need it to do, not just a hand that moves in clinic.

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