Ask Trevor CHT: exercising with diffuse scleroderma
"I have diffuse scleroderma with my hands and wrists extremely effected (curled hands).
My doctor has recommended hand exercises but whenever I regularly exercise them it feels that the clawing/curling progresses further. Any thoughts?"
"Pain like your describing is unfortunately very common with diffuse scleroderma, particularly if you are within the first few years of development of symptoms. It is a good idea to keep your fingers and wrist moving as much as possible but you also have to respect the pain and give yourself a rest.
What happens with scleroderma, as I'm sure your doctor has explained to you, is that your body is creating an excessive thickening of soft tissue in the affected areas. Basically your body is creating scar tissue in all of the connective tissue which then thickens and contracts as it matures.
The reason it's important to keep moving is to maintain as much joint health as possible so that as the disease runs its course, you can maintain full motion and use of your hands and wrists.
Try to keep exercises gentle and consistent. You don't want to be pain avoidant, per se, but you also need to learn your limits so that your hands don't feel worn out and useless for hours after doing your exercises.
Gentle, moist heat will probably also help somewhat since a lot of the burning pain you are describing is most likely due to the fact that the fibrotic tissue you've laid down is prone to micro-tears and irritation during movement and heating it up before movement should help increase the elasticity of all your tissues to prevent this trauma.
Splints may be helpful, particularly at night if you notice that your wrist and fingers are painfully curled in the morning, or during the day if you are having trouble with weakness in your wrists and/or hand joints during functional tasks."
*This content is presented for informational purposes only, and should not be seen as any kind of health, nutritional, medical or legal advice. You should consult a licensed medical practitioner if you are experiencing pain and/or discomfort or have a medical issue or suspect that you have a medical issue. If you choose to rely on the information presented in the Grace & Able LLC website, blog or social media posts, you do so at your own risk.*
Trevor Petrie, Certified Hand Therapist
Trevor Petrie is a Certified Hand Therapist with a Master’s degree in Occupational Therapy from the University of Washington.
He has been helping people with hand and upper extremity pain and injuries since 2012.
Over the course of his career, he has treated hundreds of people with chronic pain stemming from a myriad of causes including osteoarthritis, rheumatoid arthritis, carpal tunnel, and tendinitis.
No two people experience these issues the exact same way, so Trevor strives to find the best evidence-based approach that works for each person’s individual needs in order to get back to living their best lives.