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Managing with a hand or wrist injury

Helpful advice around sleeping, bathing and pain management after hand or wrist injury or hand or wrist surgery.

Sleep

After injury or surgery pain and the discomfort of your cast or splint can make it difficult to sleep. It is also recommended to try to keep your arm elevated but this positioning can also make it more difficult to get a good night’s sleep. Lack of sleep can affect pain and make it harder to concentrate. It is common to find your quality of sleep is poor after an injury or surgery.
Using cushions or pillows to support your arm can help to keep it elevated and make you more comfortable. It must be raised above your heart. Taking some painkillers before bed can help manage the pain; it is common for pain to be worse at night and this should settle in the first two weeks. Do not take your splint or cast off unless instructed to do so by your therapist.

There are some basic principles of sleep hygiene that can be useful to try to improve your quality of sleep:

  • Try to avoid screens one hour before bedtime
  • Try some relaxation before bed such as calm app or headspace app
  • Try to go to bed at the same time every night
  • Exercising during the day can improve your sleep at night, however do not exercise just before bedtime and discuss with your therapist what exercise is safe to do
  • Pay attention to food and drink intake before bed: Feeling hungry or overly full at bedtime means that you're less likely to get comfortable sleep.
  • Avoid caffeine after midday.

Bathing

Keeping your arm clean and dry is important when wearing a splint or if you have a wound that is healing. This is to limit the risk of infection and allow wounds to heal without delay. If you don’t have a wound the splint is worn in the shower to ensure your injury is protected and you do not use your hand by accident or by mistake.

It is possible to purchase a waterproof cover, there are several companies who offer products that ensure no water can get in and they will deliver in 24 hours (see picture opposite). However it is also possible to use a plastic bag taped around your arm; if you choose to do this please keep your hand upright as water often can get inside if the arm is not elevated.

Pain

Some pain is normal post injury and post-surgery. Painkillers may be prescribed by your surgeon or over the counter medicine recommended. Ask the pharmacist in your local chemist if you need advice. Often the worst of the pain will settle in two weeks. However, ensuring you are getting enough sleep can also ease pain. Keeping your arm elevated above your heart can limit the throbbing pain that will be worse if you hang your arm down.

Try to get involved with small everyday tasks you can complete with your unaffected hand or spend time with friends or family – our pain is often worse when we have no distraction. Pain is also expected as you start exercises, this is completely normal and will improve. It can be useful to complete your exercises 20-30 minutes after taking pain relief when the effect is strongest. Discuss with your therapist what pain you are experiencing and they can advise you how to manage this. Using heat, such as a wheat bag or hot water bottle can ease pain but if you are very swollen ice can help. Ask your therapist for advice.

Information and resources

NHS sleep hygiene

Relaxation (all free from the app store)

  • Headspace app
  • Hand therapy app—video n°81 Relaxation and Mindfulness
  • Calm app

Waterproof protectors

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