People living with multiple sclerosis (MS) can experience many different symptoms from the nerve damage MS causes. For some, their fingers bend or curl toward their palm. This may make the hand look like the claw of an animal — hence the term “claw hand.”
“Does anyone experience their fingers curling into a ball? Or when you hold your hand out, your index finger falls down and the pinky goes up?” asked one MyMSTeam member.
People with MS may have claw hand due to symptoms of MS or from an unrelated condition.
Claw hand refers to a hand deformity in which your fingers curl in toward your wrist or palm into a claw shape. It may be difficult to extend or open your hand. This condition can be temporary or permanent, depending on the cause.
Members have described how claw hand affects them: “My left hand is curled up in the morning. I have to pry my fingers open, and I have a lot of itching.”
Another member said, “Digging my nails into my palm and having the ‘claw’ issue causes me to constantly stretch my palms and fingers.”
Claw hand may limit how well you can use your hands. Even if you have little to no MS-related disability in the rest of your body, the condition can severely affect your hand function. In a study of more than 20,000 people with MS, about 60 percent were experiencing hand function impairment when they were diagnosed. Lost sensation, strength, or motor control forced up to 40 percent of those people to make adjustments in their daily life.
Difficulty with using your hands is a common early symptom of MS. “My MS started with two fingers on my left hand. Gradually, all of my fingers felt a diminished sensation at the fingertips,” said one MyMSTeam member.
Diminished or unusual sensations in your hands — called peripheral neuropathy — is another common symptom of MS.
Having impaired manual dexterity (ease of using your hands) can reduce your level of independence. You might find it harder to complete tasks of daily living, such as getting dressed, cooking, and using the toilet. A MyMSTeam member shared, "My hands will spasm into claws so badly that I refrain from driving any farther than the store.”
Working may also become more difficult if you can’t use your hands. In countries that link health insurance and employment, keeping your job is essential to maintaining access to affordable health care.
Any condition that affects the nerves in the hand can cause your fingers to bend inward. Claw hand can be congenital (present at birth) or develop after an injury or a health condition. People with MS can experience finger curl as a symptom of MS or an unrelated condition.
Possible causes of finger curl include:
Rarely, an infection such as leprosy can result in claw hand.
MS is an autoimmune disease that attacks the nerves of the central nervous system (CNS). People living with MS can experience a wide range of symptoms based on which part of the CNS is affected. If MS causes a lesion (damage) that affects how your nerves communicate with the muscles of your arms or hands, it could cause claw hand.
Spasticity (involuntary muscle spasms or stiffness), muscle spasms, and joint contractures are possible symptoms of MS that can cause your fingers to curl.
Spasticity is one of the most common symptoms of MS. In findings from a large U.S. survey, more than 80 percent of people with MS experienced some form of spasticity. This symptom usually involves the legs, but it can affect any limb. If spasticity occurs in the arms or hands, it could cause claw hand.
There are two types of spasticity: flexor and extensor. In flexor spasticity, tight muscles keep affected joints bent and hard to straighten. In extensor, tight muscles keep joints straight and hard to bend.
Spasticity can happen for no reason, or it could be triggered or worsened by factors such as:
From 40 percent to 80 percent of people with MS experience muscle spasms. These involuntary muscle contractions can occur for a long time or cause a sudden movement. If a muscle spasm occurs in a muscle controlling your hands, it may cause your fingers to curl.
A joint contracture refers to a joint that is frozen or immobilized. Untreated spasticity can cause muscles and ligaments (bands of tissue around joints) to harden, limiting the range of motion of the affected joint.
An immobilized joint could also contribute to muscle weakness. If a joint contracture keeps your hand from working, the muscles can atrophy (become thinner) from the lack of use. It’s important to treat any spasticity and muscle spasms in your hand to avoid joint contractures that can make finger curl permanent.
Claw hand is diagnosed by a neurologist — a doctor specializing in treating diseases of the brain, spinal cord, and nerves.
The doctor will perform a physical exam to see how you bend and move your fingers and hand. They may also use an electromyography (EMG) test, which checks for nerve damage by measuring electrical activity when you move your muscles.
If you have claw hand, your treatment depends on your symptoms and the reason your fingers have curled. Talk to your neurologist about the best approach for you.
Your doctor or physical therapist may also recommend wearing a splint or a brace to help hold your fingers straight.
Physical therapy and stretching exercises can help you gain strength and flexibility in your hand and fingers. An occupational therapist can help you learn strategies to make everyday tasks, such as showering or bathing, easier so you can remain as independent as possible.
Some cases of claw hand may require onabotulinumtoxin A (Botox) or surgery to repair nerve injury or tendons.
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. More than 197,000 MyMSTeam members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Have you experienced finger curl or claw hand? Do you have tips for making daily tasks easier to accomplish? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.