Pain in the palm of the hand, physical therapy, treatment: Focus Physical✓

Pain in the palm of the hand represents a specific clinical issue due to the hand being an organ with the highest concentration of nerve endings and small bone structures. The palm consists of eight carpal bones and five metacarpal bones that form the base of the palm, connected by a complex system of ligaments and tendons. Given that the palm undergoes constant mechanical pressure during work, tool handling, or supporting the body weight, the soft tissues in this region are highly susceptible to microtrauma and chronic inflammatory processes.

The anatomy of the palm includes the carpal tunnel, a narrow bony and connective passage through which the median nerve and the tendons of the finger flexor muscles pass. Additionally, the palm contains specific muscle pads (thenar and hypothenar) that allow for precise movements of the thumb and little finger. Pain occurs when there is narrowing of these passages, thickening of the tendon sheaths, or direct compression of the nerves due to repetitive movements. Understanding the relationship between wrist positioning during tasks and the tension in the palm is crucial for determining the cause of discomfort. Timely physiotherapeutic diagnosis prevents the onset of permanent hand muscle atrophy and the loss of fine motor skills in either the right or left hand.

The symptoms of pain in the palm can range from a burning and tingling sensation to sharp pains that intensify when trying to squeeze tightly or fully extend the hand. Patients often report feelings of "burning" in the palm or loss of the ability to sense heat and cold in specific areas of the hand. The clinical presentation is distinctive because the pain is frequently not confined to the palm alone, but can radiate to the fingers or even extend to the wrist.

The most common symptoms accompanying pain in the palm of the hand include:

• Sharp pain at the base of the palm that intensifies when bending the hand inward or applying pressure to the wrist.
• Tingling and numbness in the palm, thumb, index, and middle fingers, especially at night or in the early morning.
• Painful "catching" or locking of the fingers (trigger finger) when trying to straighten the hand after rest.
• Loss of strength in the hand, where the patient notices that objects drop from their hand or they are unable to open a bottle.
• Hard nodules or thickening of the skin on the palm that are painful to the touch and limit finger extension.

These signs are clear indicators that the nerve pathways or tendinous canals in the palm are under strain, requiring professional evaluation. Recognizing the symptoms early allows the physiotherapist to apply decompression techniques and prevent the development of permanent neurological damage.

• Carpal tunnel syndrome
• Tenosynovitis
• Arthritis
• Injury or impact   

Treatment for pain in the palm at Physical Therapy Focus is focused on reducing swelling within the hand’s channels and restoring normal nerve conduction through the application of modern methods. The therapeutic protocol combines tissue regeneration technologies with manual techniques for mobilizing the carpal bones. Successful rehabilitation involves pain elimination and restoring full strength and mobility to the hand.

The modern rehabilitation approach includes the following phases:

• Detailed functional assessment of sensation, testing the strength of the hand muscles, and specific tests for carpal tunnel syndrome.
• Application of physical therapy procedures such as Tecar therapy, high-power laser therapy, and magnetotherapy for rapid pain and inflammation relief.
• Manual therapy and carpal bone mobilization to expand the space through which nerves and tendons pass.
• Kinesiotherapy, with a focus on neurodynamic exercises (nerve mobilization) and strengthening exercises for the hand muscles.
• Education on ergonomic adjustments, the use of gel pads for palms, and application of kinesiology tape for support.

Consistently following the recommended exercise program is crucial for maintaining the achieved results and preventing the recurrence of tingling. This comprehensive treatment restores full functionality to the palm and allows for performing precise tasks without discomfort.