A mix of existing treatments has proven successful in countering the functional limitations experienced by people with base-of-the-thumb osteoarthritis, according to clinical trial results from Australia.
This painful condition is common, occuring in up to a third of women over the age of 70, and it can severely limit use of the affected hand, investigators said. Many people with the condition have difficulty grasping objects — making it difficult to open a door, for example.
Typical therapy tends to focus on single treatments that often do not have much effect on function, the researchers said. In contrast, improved results were found in a 12-week clinical trial that used a mix of existing treatments.
All 204 participants received education from a physiotherapist about osteoarthritis and activity modification for joint protection. The treatment group also received a topical diclofenac sodium, 1%, gel, and information about hand exercises, which they would perform three times a week. All participants were assessed on pain and hand function, including thumb base pain, grip strength, stiffness, and overall quality of life and mental health.
After six weeks, the combined-treatment group had notably increased hand function when compared with the education-only control group, but no pain resolution. At 12 weeks, these participants reported better quality of life and function scores that continued to improve when compared with their control-group peers, reported lead author David Hunter, M.D., Ph.D., from the University of Sydney. There was very little difference in pain scores over time.
“The trial showed that a combination of conservative treatments for thumb base osteoarthritis conferred small-to-medium benefits on hand function that were potentially clinically meaningful,” Hunter and colleagues said. Overall effects on pain, however, clinically were no better than education alone, they added.
The results offer evidence that conservative intervention for patients with thumb base osteoarthritis is effective and safe, the authors concluded.
Full findings were published in the JAMA Internal Medicine.
