Self-management in chronic hand pain: Clinician perspectives from members of the American Society of Hand Therapists

BACKGROUND: Chronic hand pain significantly impacts function and quality of life. While self-management strategies are critical for symptom management, there is limited research on clinicians' perspectives regarding patient adherence to these strategies before and after initiating therapy. PURPOSE: This study aimed to examine self-management strategies prescribed by hand therapists for chronic hand pain and to explore clinician perceptions of patient adherence and effectiveness across the continuum of care. STUDY DESIGN: Cross-sectional survey. METHODS: A survey was distributed to members of the American Society of Hand Therapists (ASHT). Respondents (n = 120) reported their practice patterns, prescribed self-management strategies, perceived patient adherence, and factors influencing strategy use. Descriptive statistics were used to analyze quantitative data, and qualitative responses were thematically analyzed. RESULTS: Most clinicians (92%) reported treating chronic hand pain. Prior to therapy, patients most used over-the-counter medications, prescribed medications, and heat modalities. Clinicians most frequently prescribed exercise/stretching (97%), joint protection strategies (96%), and ergonomic modifications (94%). Heat modalities and exercise/stretching were perceived as the most beneficial strategies, whereas cold modalities and TENS were rated least beneficial. Factors negatively influencing adherence included time constraints, cost, and lack of knowledge, while greater health literacy and access to healthcare providers improved self-management. CONCLUSIONS: Hand therapists actively prescribe self-management strategies for chronic hand pain, but adoption and adherence vary due to multiple factors. Enhancing patient education, addressing barriers, and promoting individualized self-management plans may improve long-term adherence and outcomes. Future research should explore patient perspectives on self-management and its impact on functional outcomes.