Self-management strategies used by patients who are hypersensitive to cold following a hand injury. A prospective study with two years follow-up

Abstract

Study design: Prospective cohort study.

Introduction: Knowledge of the strategies used by patients with injuries of the hand to manage cold hypersensitivity should guide information given by health-care workers.

Purpose: To explore the use of cold-associated self-management strategies in patients with severe hand injuries.

Methods: Seventy patients being cold hypersensitive following a hand injury, reported use of strategies to limit cold-induced symptoms in the injured hand(s) and the severity of cold-associated activity limitations one and two years after surgery.

Results: The patients used several strategies, including clothing (100%), use of own body (movement/use of muscles to produce heat or massage of the fingers) (94%), and heating aids (48%), but were still limited in valued cold-associated activities two years after surgery. The number of patients staying indoors, using heating aids and hand wear indoors and during summer-time increased with severity of cold hypersensitivity. Patients both implemented and discontinued different strategies after the first year, but for most strategies, the proportions of users were quite stable.

Conclusion: The most common strategies used to limit cold-induced symptoms in the injured hand(s) were clothing and use of own body. Many patients also seemed to benefit from using heating aids. After one year, a number of patients still experimented in finding the best strategies and were still limited in valued cold-associated activities.

Level of evidence: 2b.

Keywords: Cold hypersensitivity; Cold intolerance; Cold sensitivity; Compensatory strategies; Hand injury; Heating aids; Self-management strategies.