The term “hand specialist” refers to a group of medical providers who focus their advanced training on the complex anatomy and function of the hand, wrist, and forearm. This area involves intricate interactions between bones, joints, tendons, nerves, and soft tissues, requiring highly specialized care for injury and disease. The specific title a provider holds depends on the type of care needed, such as surgical correction, comprehensive rehabilitation, or diagnosis for a systemic condition.
Hand Surgeons: The Surgical Specialists
A Hand Surgeon is a physician dedicated to the upper extremity, completing years of post-medical school training. The pathway typically begins with a primary residency (five to seven years) in orthopedic, plastic, or general surgery. Following this, the physician must complete an additional one-year fellowship specifically accredited for hand and upper extremity surgery.
The definitive credential is the Subspecialty Certificate in Surgery of the Hand. This certification requires the surgeon to pass a rigorous examination and submit a case log demonstrating a high volume and variety of complex hand surgeries. Hand surgeons treat a wide range of conditions, from traumatic injuries like complex fractures and tendon ruptures, to chronic issues such as severe carpal tunnel syndrome and trigger finger. Their expertise is essential for restoring function when surgical intervention is required.
Certified Hand Therapists: Rehabilitation Experts
Once a condition is stable, the Certified Hand Therapist (CHT) works to restore functional use, whether post-surgery or through non-surgical management. A CHT is an occupational or physical therapist who achieves this advanced credential through the Hand Therapy Certification Commission. Qualification requires a minimum of three years of practice and at least 4,000 hours of direct experience treating the hand and upper extremity.
These rehabilitation experts specialize in conservative treatments, preventative care, and post-operative recovery. Techniques include custom orthotic fabrication (splinting) to support or immobilize specific joints and tissues. They use targeted therapeutic exercises to improve range of motion, strength, and dexterity, helping patients regain the ability to perform daily tasks. CHTs also provide education on joint protection and methods for managing chronic conditions like arthritis through activity modification.
Other Medical Providers for Diagnosis
While surgeons and therapists manage the physical structure and function of the hand, other specialists diagnose underlying medical causes. A Rheumatologist specializes in diagnosing and treating inflammatory conditions and autoimmune diseases that often affect the hand joints. Conditions such as rheumatoid arthritis, psoriatic arthritis, and gout cause inflammation leading to joint damage and deformity.
The rheumatologist manages these systemic diseases, using blood tests and diagnostic imaging to confirm the diagnosis and prescribing medications to control inflammation. A Neurologist focuses on disorders of the nervous system, including the peripheral nerves that control hand function. They are consulted to diagnose complex nerve entrapments, such as severe carpal tunnel syndrome, or to determine if hand dysfunction stems from a central nervous system disorder like a stroke or multiple sclerosis.