Overview

Sensory relearning (re-education) is a way to help your nerves recover from an injury.

Nerves give you feeling and tell your muscles to move. After a nerve injury, you may find that:

• it is difficult to feel things
• you feel things as painful that would not usually be

This information explains:

• a localisation technique, which helps you to know where something is touching you
• a texture and shape discrimination technique, which helps you to feel the difference between objects
• desensitisation techniques, which can help with pain by exposing your hand to different feelings
• a mirror therapy technique, which can retrain your brain to help link your movement and the feeling of that movement better
• the arrangements for your follow-up appointments
• how to help yourself if you have a hand injury or condition

If you have any questions or need more information, please speak to your hand therapist.

Localisation

Localisation helps you to know where something is touching you. This technique is made up of the following steps:

1. Close your eyes.
2. Gently rub an object like a pen or key over a small area of your injured hand. You can do this yourself or ask someone else to help.
3. Try to guess exactly where the object is touching you.
4. Open your eyes to check.
5. If you are wrong, do this again with your eyes open and concentrate on the feeling.
6. Repeat the exercise with your eyes closed over different areas of your injured hand. Try to remember the feeling.

Texture and shape discrimination

Texture and shape discrimination can help you to feel the difference between the shapes, sizes, weights and textures of objects. This technique is made up of the following steps:

1. Choose a few objects of different shapes, sizes, weights and textures. Lay them out in front of you.
2. With your eyes closed, pick up an object and try to feel which one it is. You may find it easier to start with the larger objects.
3. If you cannot feel which object it is, hold the item in your uninjured hand and concentrate on how it feels.
4. Feel the object again with your injured hand. If you are wrong or still unsure, look at the object and memorise the feeling.
5. With your eyes closed again, try to remember the feeling.
6. Use the same objects until you can easily feel what they are.

Desensitisation

After an injury, your hand can be very sensitive (hypersensitive). Things may feel painful that did not used to be. This pain does not go away by itself.

Desensitisation can help with pain by exposing your hand to different feelings. This section explains some different desensitisation techniques.

Massage

1. Using an unscented cream, massage your affected hand.
2. Start massaging gently in an area that is comfortable and then move to the more sensitive area.
3. Gradually increase the pressure.

Tapping

1. Tap lightly on the tender area of your hand. You can do this with your other hand or a light object, such as a pen.
2. Gradually increase the pressure.

Pressure

1. Using a finger, press on the sensitive area of your hand.
2. Try to hold this pressure for 15 seconds.

Textures

1. Rub objects with different textures, such as cotton wool, Velcro^®, a zip or clothing, over your injured hand.
2. Start with an object that is comfortable and gradually change the texture over time, so that you can use rougher textures.

Immersion

1. Fill a bowl full of lots of small objects, such as rice or pasta.
2. Put your injured hand in the bowl and move it around.
3. Start with objects that are more comfortable and change them over time.

Mirror therapy

Mirror therapy is used to retrain your brain to help link your movement and the feeling of that movement better. This technique is made up of the following steps:

1. Remove any jewellery or watches.
2. Position the mirror in between your hands with the reflective side showing your uninjured hand. You should not be able to see your injured hand.
3. Look at the image in the mirror. This may feel uncomfortable at first. Aim to do it 3 times a day for 2 to 3 minutes.
4. When this is more comfortable, start to move your uninjured hand while always looking in the mirror.
5. Try to copy the same movement with your injured hand, aiming to move both hands together.

Follow-up appointments

If you have a smart phone, you can download our MyChart patient app. This app lets you cancel or change hospital appointments.

Your hand therapist talks to you about your follow-up appointments, and explains how often you may need them. Some injuries or conditions involve more follow-up appointments than others.

You need to book your next appointment before you leave the hand therapy department, unless:

• it is a video appointment
• your hand therapist has told you something different

Things you can do to help yourself

If you have a hand injury or condition, there are ways to help take care of yourself.

Talking therapies

Any injury to your hand or pain in the hand can be overwhelming, and affect your mental health.

If you are struggling with how you feel and need to talk to someone, you can get help from the NHS talking therapy services.

You can speak to your doctor about talking therapies or contact the service directly.

Stopping smoking

Smoking and vaping can delay your healing and affect your recovery, especially if you have a wound. Free services are available to help you stop smoking.

Living well

If you need to wait for hand surgery, there are things that you can do to get ready. The healthier that you are before surgery, the quicker your recovery is likely to be. Healthy living can also help you after your surgery.

Even if you have had your hand injury or condition for a while, a healthy lifestyle can help with your recovery.

We have information about keeping well before surgery. You can also read about diet, exercise, sleep and other healthy living topics on the NHS live well pages.