A study of the effect of desensitization on hyperaesthesia in the hand and upper extremity after injury or surgery

Abstract

Introduction Hyperaesthesia is a common problem in hand rehabilitation. A desensitization programme has successfully been used in our occupational therapy department for patients with hyperaesthesia in the hand or upper extremity. Our objectives were to investigate self-perceived pain/discomfort at rest, with use or touch, size of sensitive skin area and occupational performance in daily occupations for patients with hyperaesthesia before and after a six-week desensitization programme. Methods Thirty-nine patients with pain/discomfort at or near scars from hand injury or surgery participated in the study. The patients were recruited consecutively to the study. They were instructed to massage the sensitive skin area three times a day with a piece of texture until numbness occurred (2–5 minutes). The textures were upgraded continuously. A study-specific questionnaire was developed including demographic data and questions concerning perceived pain/discomfort. Pain/discomfort was assessed with a visual analogue scale 0–100. The size of the sensitive skin area was assessed in mm2. Occupational performance was assessed with the Canadian Occupational Performance Measure. Results The results showed statistically significant improvements ( P ≤ 0.001) in all areas after six weeks with reduced pain/discomfort at rest and with use or touch, a decreased size of the sensitive skin area and a higher occupational performance in daily occupations. Discussion The results indicate the importance of paying attention to sensory disturbances during rehabilitation. The cost for such a programme is low. Further research is needed to confirm the results in a larger sample using a control group, and in comparison with spontaneous healing and other treatment modalities.