Conservative Treatment of Thumb Base Osteoarthritis: A Systematic Review

Clinical Update: Conservative Management of Carpometacarpal Joint Osteoarthritis

“…Therapeutic interventions for patients with OA of the hand can include joint-protection technique instruction, manual therapy, adaptive equipment provision and instruction, heat modalities, orthotic provision, strengthening and range-of-motion exercises, adaptive technique instruction, patient education in symptom control techniques, and provision of a home exercise program 4 . There have been 2 recent systematic reviews that evaluated the quality of the evidence for the conservative management of CMC OA 5,6 . The authors of one of the reviews 5 used the Physiotherapy Evidence Database (PEDro) scale to assess the methodological quality of the studies included in the review.…”

“…The PEDro scores of the studies ranged from 3 to 10. The reviews both cite the need for additional high-quality research on the best available conservative treatment for patients with CMC OA to improve the quality of care for this large patient population 5,6 .…”

“…There is moderate quality evidence that manual therapy and therapeutic exercise improves pain in patients with thumb CMC OA at both short-and intermediate-term followup 5 . There is some evidence that both steroid and hyaluronate intraarticular injections can reduce pain 6 , and low to moderate quality evidence that magnetic therapy improves pain and function at short-term followup (effect size for pain -1.39, 95% CI -2.00 --0.78) 5 . The effect of manual therapy and therapeutic exercise had a large effect size of -116.67, with a 95% CI of -137.55 --95.78 for the reduction of pain 13 .…”

Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO)

“…While favourable results have been observed with different types of splints, prefabricated types are preferred over the custom-made version by most patients 13. Moreover, different ways of using the splint have been studied.…”

Class IV laser therapy for trapeziometacarpal joint osteoarthritis: Study protocol for a randomized placebo‐controlled trial

“…The traditional mainstay for conservative therapeutic management includes orthotic support (Hermann et al, 2014), pharmacological approach (Joshi, 2005;Salini, De Amicis, Abate, Natale, & Di Iorio, 2009), patient education (Stamm et al, 2002), therapeutic exercise (Valdes & von der Heyde, 2012), joint (Villafañe, Silva, & Fernandez-Carnero, 2012) and neural (Villafañe, Silva, & Fernandez-Carnero, 2011) mobilization, or radiotherapy (Kaltenborn, Bulling, Nitsche, Carl, & Hermann, 2016) among others, both isolated or in combination (Deveza et al, 2017). Although a number of them have shown to be effective, most of existing trials on TCMC-OA have demonstrated poor consistent case definition, sparse standardized outcome measures, and inadequate powering, thereby limiting their generalizability to clinical scenarios (Spaans et al, 2015).…”