Claw Hand

Claw hand is a condition in which your fingers are noticeably curved or bent. One or more of your fingers on one or both hands may be affected. The condition gets its name because the curvature of the fingers makes the hands resemble a bear’s claw.

Claw hand can be a congenital defect (a defect present at birth) or it may be due to certain disorders or injuries. Depending on the severity of the condition, you may have difficulty using your hands to pick up and grasp items.

Common causes of claw hand include:

• a congenital birth defect
• damage to the nerves in the arm or hand from injuries or diseases, such as diabetes
• scarring of the skin on the arm or hand due to a burn injury

Many conditions can cause nerve damage. Some of the common causes are:

• cervical spondylosis: abnormal wear of the cartilage or bone in your spine that can cause compression on your nerves
• carpal tunnel syndrome: damage to the nerves in your wrist that results from repetitive activities involving your wrists
• alcoholic neuropathy: damage to the nerves caused by excessive or long-term alcohol use
• diabetic neuropathy: damage to the nerves caused by uncontrolled blood sugar levels

Another cause of claw hand is the bacterial disease leprosy, which affects the skin. Leprosy is extremely rare in the United States. There are currently an estimated 6,500 people in the United States with leprosy, according to the U.S. Department of Health and Human Services, and only half of those cases cause enough symptoms to require treatment (HRSA, 2012).

Doctors can make a diagnosis of claw hand based on the appearance of your fingers. However, your doctor may perform tests to determine the cause and severity of the condition. Tests your doctor may order include:

Medical History

Your doctor may ask you questions about your medical history to determine if a past injury or illness is causing your symptoms.

Physical Examination

Your doctor may ask you to bend your fingers and grasp objects, in addition to other tests, to see how much strength and flexibility you have in your fingers and hand.

Electromyography

An electromyography (EMG) test is used to check how well your nerves are working. To perform an EMG, your doctor will insert thin needles through your skin into the muscles of your hand. The needles are connected to a machine that measures electrical impulses from your nerves when you move. You may feel a little bit of discomfort from the small needles, but it is usually mild. You may also have slight bruising or experience minor soreness for a few days after the test.

If the EMG test results show that you have abnormal nerve activity, your doctor may run more tests to determine the cause of your nerve damage. The tests your doctor will perform are dependent on your medical history and any other symptoms you may be experiencing.

Claw hand is often treatable. With treatment, your symptoms may improve or completely disappear, depending on the cause and severity of your condition. The type of treatment that is best for you is dependent on what is causing your symptoms.

Physical Therapy

Your doctor may recommend physical therapy to help you gain more flexibility in your fingers and hand. Physical therapy may consist of stretches and strengthening exercises. Physical therapy may be used as a sole treatment or in combination with other treatments.

Home Treatment

If the curvature of your fingers is caused by carpal tunnel syndrome or another similar injury, resting your hand may be the only treatment you need. Your doctor may also suggest that you wear a brace to keep your wrist straight to prevent further injury.

Surgery

You may need surgery to repair damaged nerves, ligaments, or muscles that are causing your symptoms. If your injury is due to tight skin—as is seen in people who have burn injuries—skin grafts and scar tissue removal surgery may be necessary. Multiple surgeries may be required for serious defects and for burn injuries.

Medications

Your doctor may prescribe medication to treat an underlying disease that is causing your symptoms. For example, leprosy is treated with antibiotics.

Call your doctor if you notice that you are developing claw hand or if you have claw hand and your symptoms are getting worse or are not responding to treatment.