By Professional Physical Therapy with Robert Wilutis, MS, OTR, CHT
If you have an injury to your hand, wrist, arm, or elbow or are experiencing chronic pain or discomfort doing daily tasks, it’s probably time to see a hand therapist. You might wonder what kind of hand therapy treatment you will need to recover quickly; should you see an OT, PT or CHT?
The answer is you can see a physical therapist (PT), occupational therapist (OT) or certified hand therapist (CHT) to treat upper extremities including conditions related to the hand. All three have similar goals in terms of helping you heal from an injury, but there are some interesting things to know before you make an appointment with a hand therapist. We will also share the conditions they treat and techniques they use to help relieve pain.
OT vs. PT for Hand Therapy
A hand therapist is an occupational therapist (OT) or physical therapist (PT) who has advanced education and experience in treating conditions that affect the upper limb including the hand, wrist, elbow, and shoulder. Hand therapy is actually a merging of occupational therapy and physical therapy theory and practice that combines comprehensive knowledge of the structure of the upper limb with therapeutic interventions to restore function and activity.
While both PTs and OTs can effectively treat hand cases, it is less common to find a PT specializing in hand therapy and much more common to find an OT with a specialty in hand therapy. And many of these OTs are often working toward becoming a CHT (Certified Hand Therapist).
What to Know About a Certified Hand Therapist (CHT)
A Certified Hand Therapist (CHT) has the academic background of a PT or OT with an important distinction that includes being a licensed PT or OT for 3 years, plus 4,000 hours of hand and upper extremity therapy practice and have passed a certification examination demonstrating knowledge of all areas of hand and upper extremity therapy. They must renew their credential every five years through continued education and participation in hand and upper extremity therapy.
These strict requirements limit the number of practicing CHTs. For this reason, there are only about 6 thousand certified hand therapists in the United States which might make it difficult to get an appointment with one.
Most CHTs are occupational therapists (OTs). In fact, 85% of certified Hand Therapists are occupational therapists and only 15% are physical therapists (PTs). We recommend patients see a CHT for more delicate or complex cases.
Conditions Hand Therapists Treat
A qualified hand therapist that is a PT, OT or CHT can evaluate and treat any upper limb problem, providing post-operative rehabilitation, preventative, non-operative or conservative treatment, or industry consultation. They work closely with physicians and patients to provide a continuum of care, starting within days of injury or surgery and continuing until the patients return to work and have a productive lifestyle.
Hand therapists can effectively treat the following conditions related to the upper extremities.
- Tendon injuries
- Arthritis and rheumatic diseases
- Dupuytren’s disease (one or more fingers become bent)
- Carpal tunnel syndrome
- Dislocations and fractures
- Crush injuries
- Cysts and tumors
Hand Therapist Treatment Techniques
Hand therapists use a variety of techniques and tools for therapeutic intervention including:
- Adaptive and assistive devices
- Edema (swelling) management
- Ergonomic modification
- Manual therapy
- Neuromuscular and sensory re-education
- Custom and prefabricated orthotics and prosthetics
- Patient education
- Pain management
- Therapeutic exercise
- Wound care and scar management
- Custom splinting*
*Custom splinting can be performed by a CHT or an OT/PT that is working under a CHT toward his/her certification.
Preparing for Your First Appointment with a Hand Therapist
Most hand therapy appointments, whether you see a PT, OT or CHT, are made with a referral by a physician. However, based on your insurance and the state you live patients can be seen without a prescription or script (direct access). Here are some helpful guidelines*, but we advise you to confirm your insurance coverage before an appointment.
- OT/CHT Appointment, New York: Requires a Prescription*
- OT/CHT Appointment, New Jersey: Direct Access Available*
- OT/CHT Appointment, Connecticut: Requires a Prescription*
- OT/CHT Appointment, Massachusetts: Requires a Prescription*
*Guidelines are effective as of March 2023, state regulation may vary based on legislative changes.
Hand pain can be disruptive to your daily activities, and it’s crucial to address your pain issues to be appropriately diagnosed, treated, and managed as soon as possible. Professional Physical Therapy is the leading provider of hand therapy in the tristate area with 50 hand therapy locations We have more than 60 hand specialists on our team and is the largest provider of Certified Hand Therapy in the Northeast. If you are experiencing hand pain or discomfort, contact us at one of our hand therapy locations, so we can customize a rehabilitation plan just for you.