Dexterity is the ability to use your hands in a skilled, coordinated way to grasp and manipulate objects. When someone experiences a loss of dexterity, they may notice increased clumsiness or difficulty with tasks requiring fine motor skills, like buttoning a shirt or writing. This change is not a disease itself but a symptom pointing to an underlying medical issue affecting the connection between the brain, nerves, and muscles.
Underlying Causes of Diminished Dexterity
Musculoskeletal conditions are a frequent source of dexterity problems. Osteoarthritis and rheumatoid arthritis, for instance, cause inflammation, pain, and stiffness in the hand and wrist joints. This restricts the range of motion and makes fine motor tasks difficult. Over time, the inflammation can damage the joints and surrounding tissues, further limiting function.
Another common cause is Carpal Tunnel Syndrome, where the median nerve is compressed as it passes through a narrow wrist passageway. This compression can result from repetitive hand motions, pregnancy, or other medical conditions. The pressure on the nerve leads to numbness, tingling, and weakness in the hand and fingers, impacting the ability to grip objects. In severe cases, the muscles at the base of the thumb can weaken, causing a significant loss of dexterity.
Neurological conditions affecting the central nervous system can also cause a loss of dexterity. A stroke, for example, can damage parts of the brain that control movement, resulting in weakness or paralysis in the hand. Multiple sclerosis (MS) is an autoimmune disease where the body attacks the protective sheath on nerve fibers, disrupting communication between the brain and body. This can cause muscle weakness, tremors, and a lack of coordination, impairing hand function. Parkinson’s disease affects dopamine-producing neurons, leading to tremors, rigidity, and slowness of movement that make fine motor tasks challenging.
Issues within the peripheral nervous system can also be a cause. Peripheral neuropathy, often associated with diabetes, involves nerve damage leading to numbness, tingling, and weakness, typically starting in the hands and feet. Cervical myelopathy, or compression of the spinal cord in the neck, can interfere with nerve signals to the hands and cause a decline in fine motor skills. Acute injuries like a broken wrist, the side effects of certain medications, and natural age-related changes can also contribute to a loss of dexterity.
The Diagnostic Process
A doctor’s evaluation for loss of dexterity begins with a detailed medical history and a physical examination. The doctor will ask about your symptoms and how they affect your daily activities. They will assess grip strength, coordination, and the ability to perform fine motor tasks, and check your reflexes and sensation.
Imaging tests may be ordered to examine the structures in your hand, wrist, and neck. X-rays are useful for viewing bones and joints to identify issues like fractures or arthritis. If a problem with soft tissues like nerves or the spinal cord is suspected, a magnetic resonance imaging (MRI) scan may be recommended.
If nerve damage is suspected, nerve function tests may be ordered. A nerve conduction study (NCS) measures how quickly electrical signals travel through your nerves using small electrodes on the skin. Electromyography (EMG), often performed with an NCS, involves inserting a thin needle electrode into a muscle to measure its electrical activity. These tests help diagnose conditions like carpal tunnel syndrome and peripheral neuropathy by identifying the location and extent of nerve damage.
Medical and Therapeutic Interventions
Specialized therapy is a primary approach for addressing dexterity loss. Occupational therapists focus on improving your ability to perform everyday tasks, which may involve exercises and adaptive equipment. Physical therapists work to improve strength, flexibility, and range of motion in the hands and upper extremities.
Medications are often prescribed to treat the underlying condition. For example, if arthritis is the cause, anti-inflammatory drugs may be recommended to reduce pain and swelling. For neurological conditions like MS or Parkinson’s disease, specific medications can help manage symptoms and slow disease progression.
In some situations, surgery may be an option. For carpal tunnel syndrome that has not responded to other treatments, a release surgery can relieve pressure on the median nerve by cutting the pressing ligament. Surgery may also address certain injuries or structural problems in the spine that are compressing nerves.
Exercises and Adaptive Strategies for Daily Life
Specific hand and finger exercises can help maintain or improve strength and flexibility. Using therapy putty is a common recommendation, as it can be squeezed, stretched, and pinched to work different hand muscles. Squeezing a stress ball can improve grip strength, and simple finger stretches, like touching the thumb to each fingertip, are also beneficial.
A variety of adaptive equipment is available to make daily tasks more manageable. For dressing, tools like button hooks and zipper pulls can make getting dressed easier. In the kitchen, using utensils with large, built-up grips can provide better control, and electric can openers can help those with a weak grip.
For writing, pens with wide, cushioned grips are easier to hold. These adaptive tools are designed to help individuals maintain independence by compensating for reduced dexterity.