Hand Therapist Nigel Chua

A weak grip has three causes and they behave differently. Pain-limited, nerve, or tendon. Weakness with no pain is the one that needs a clock on it.

Therapy and surgery are sequenced, not opposed. What decides the timing is the tissue deadline — and for some hand injuries, waiting is not conservative.

Burning in the hands is a nerve symptom, not a joint one. Which fingers, one hand or both, whether your feet burn too, and whether it followed an injury tells you which cause you’re dealing with and what actually helps.

Tissue heals on a timetable; pain doesn’t always follow it. What to rule out first, why sensitivity outlasts damage, and what actually turns the alarm down.

Most post-surgery night pain is swelling, and swelling is a position problem. How to set up pillows, when to take pain relief, and how long the bad nights last.

There’s no universal date. The real test is whether you could control the car in an emergency — plus the insurance point most people find out about too late.

Return to training is a sequence of positions, not a date. Which positions come back first, how fast to add load, and what the next morning tells you.

Latency, velocity, amplitude — what the numbers on a nerve conduction study mean, why a normal result doesn’t rule out carpal tunnel, and what changes the plan.

Custom splints made from flat sheet, measurements in degrees and kilos, and protocols indexed to the day of your surgery. What hand therapy actually involves, what a course looks like, when it’s worth it, and when it isn’t.

Ice for the first 48 hours, heat for stiffness, neither for nerve problems. What each actually does, when to use neither, and the free thing that beats both.