Common Hand and Wrist Problems in Ehlers-Danlos Syndrome - How Hand Therapy Can Help

Understanding Ehlers-Danlos Syndrome and Its Impact on the Hands and Wrists.

Ehlers-Danlos Syndrome (EDS) is a group of hereditary connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. While EDS affects the body systemically, the hands and wrists are particularly vulnerable to frequent strain, instability, and pain due to their complex anatomy and constant use.

For many people living with EDS, even routine tasks like writing, opening jars, or using a phone can lead to discomfort. That's where hand therapy plays a vital role - not only in symptom management but in long-term joint preservation.

Common Hand and Wrist Problems in EDS

At Bayside Hand Therapy, we work with many clients living with Ehlers-Danlos Syndrome (EDS). Some of the most common problems we see include the following:

Pain and Fatigue

There are numerous reasons why someone with EDS may have pain in their fingers, hands or wrists. Sometimes the pain is a result of the joints being used in extreme positions whilst performing a task, such as holding a pen with the tips of the fingertips (DIP joints) in hyperextension for extended periods. However, there are numerous other conditions which could be causing pain beyond just the hypermobility of the joints. Some of these are outlined below.

Wrist Ganglions

WriStable® Wrist Brace

One issue we commonly see, which is not unique to people with EDS, is the presence of wrist

ganglions. A wrist ganglion is a fluid filled cyst arising from a small defect in one of the wrist ligaments. Wrist ganglions may cause pain on weight bearing through the hands, such as attempting a push up. Not all wrist ganglions are visible on inspection of the wrist. Our hand therapists can help to determine the likely cause of wrist pain, in order to devise the most effective treatment plan, which may include a period of rest in a wrist splint, or a device to enhance wrist stability.

Tendonitis or Tenosynovitis

While certainly not unique to people with EDS, tendon inflammation is another common problem we see in EDS. It is important to assess which tendons may be involved in order to treat the condition appropriately.

Nerve Compressions

Nerve compressions or entrapments are also common in EDS. Nerve compressions will usually present as pins and needles or numbness but may also cause pain. Our hand therapists can assess which nerve is compressed in order to ensure appropriate treatment.

Osteoarthritis

Unfortunately, people with EDS are more likely to develop osteoarthritis. This is because, the lack of stability from ligaments creates greater shear stresses through joints which over time causes greater wear on the cartilage within joints. Our hand therapists at Bayside Hand Therapy can provide a range of pain-relieving treatment modalities, splints and gloves to support painful joints as well as advice on joint protection and devices to make life easier.

What Does Hand Therapy for EDS Involve?

Hand therapy is a form of rehabilitation that focuses on the hands and upper limbs. For people with EDS, it can help manage joint instability, reduce pain, and build strength and control. Here's what we focus on:

1. Thorough Assessment - EDS affects each person differently, which is why our hand therapists will perform a thorough assessment to ensure therapy is meeting your individual needs. We take a practical, problem-solving approach and aim to build a treatment plan that suits your goals, lifestyle, and the way you use your hands every day.
   

2. Strengthening and Stability Exercises - People with EDS rarely have a problem with gross grip strength. This is because the muscles we use for gripping with our fingers are located in the forearm, so if your fingers are in a stable position, such as gripping a hammer or golf club, people with EDS usually have good grip strength. The problems occur when tasks require joint stability- such as pinching between thumb and index, or weight bearing onto the hand with the wrist extended. You may feel your wrists are weak because your wrists lack stability.
   

   If wrist stability is a problem, specific exercises are needed to strengthen the secondary stabilisers of the wrist, namely the muscles which control wrist movement. People with EDS also have poor joint proprioception, the ability to perceive precise information about joint position. Therefore, our hand therapists can prescribe exercises to improve joint proprioception which in turn helps to promote better stability and less pain.

   

   Proprioceptive Wrist Exercises

3. Splints - Splints can be a great help in providing stability to unstable joints in the fingers, thumb or wrist if used appropriately. Excessive use of certain splints, such as wrist splints can contribute to weakness so it is important that splints are only used for certain tasks, or used short term to treat certain conditions, or are used in conjunction with an exercise program.   At Bayside Hand Therapy we stock a wide range of all the best splints, most appropriate for use in EDS.  We can also fabricate custom-made light weight thermoplastic splints and measure for custom-made Silver Ring Splints.

   

   Silver Ring Splints

4. Pain Management Strategies - Chronic pain in the hands and wrists is common in EDS. We provide a range of pain relieving treatment modalities, as well as practical strategies you can use at home to help manage discomfort.

   

   
   

5. Support for Daily Activities - We can discuss the ways your hand problems affect your daily activities, and look for ways to modify your activities to reduce strain on your joints and prevent injury.  We stock a range of tools to make everyday activities easier. Whether it’s help with holding a pen, using a keyboard, or opening jars, we work with you to find solutions that reduce pain and improve independence.
   

Supporting You at Every Step

Whether you’ve recently been diagnosed or have been living with EDS for years, we’re here to help.  To learn more, get in touch with our friendly team to book a consultation or ask a question.

Serving Brisbane’s Bayside and surrounding communities, Bayside Hand Therapy is your local specialist in treating hypermobility and joint instability conditions like EDS.