Multiple Sclerosis and Finger Curl: About Contractures or ‘Claw Hand’ | MyMSTeam

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Multiple Sclerosis and Finger Curl: About Contractures or ‘Claw Hand’

Posted on April 20, 2023

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.

What Does Claw Hand Look Like?

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” refers to the shape formed when your fingers curl in toward your wrist or palm as a result of nerve damage. This condition might be a symptom of MS but can also develop after an injury or illness. (Adobe Stock)

Impact of Claw Hand

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.

Why Finger Curl or Claw Hand Occurs

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:

  • Injury — One of the nerves that run from your neck, chest, or arms to your hands is damaged.
  • Nerve entrapment — Nerves in the arm or hand are compressed against the bone.
  • Cubital tunnel syndrome — The ulnar nerve, which controls small hand muscles, gets squeezed into the elbow.
  • Congenital differences — The hand forms in an unusual way in the uterus.
  • Fibrosis — Thick scar tissue builds in hands or fingers after an injury or severe burn.
  • Dupuytren’s contracture — A knot formed below the skin pulls on and bends the fingers.

    Rarely, an infection such as leprosy can result in claw hand.

    MS Symptoms That Can Cause Fingers To Curl

    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.

    When MS lesions disrupt communication between the nerves and muscles of your arm or hand, your fingers may curl inward. (Adobe Stock)

    Spasticity

    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:

    • Sudden movements
    • Changes in temperature or humidity
    • Infections
    • Tight clothing

    Muscle Spasms

    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.

    Joint Contractures

    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.

    Diagnosis of Claw Hand

    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.

    Treatment of Claw Hand

    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.

    If muscle spasms are the cause, you may take medications to relax the muscle, such as baclofen (Lioresal) and tizanidine (Zanaflex).

    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.

    Talk With Others Who Understand

    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.

      Posted on April 20, 2023
      All updates must be accompanied by text or a picture.

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      Luc Jasmin, M.D., Ph.D., FRCS (C), FACS is a board-certified neurosurgery specialist. Learn more about him here
      Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here

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