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Management of hand arthritis in Epsom & Ewell

A recent review on the management of hand arthritis has been published ;

The 2018 update of recommendations for the management of hand osteoarthritis (OA) from the European League Against Rheumatism (EULAR) incorporate new evidence developed during the last decade, emphasizing the role of the patient in the OA treatment plan and the importance of multimodal/multidisciplinary therapy.

Margreet Kloppenburg, MD, PhD and colleagues publishedonline August 28 in the Annals of the Rheumatic Diseases.

The recommendations add a new emphasis on optimizing and maximizing symptom control (rather than “joint protection”) 

EULAR recommends topical ( skin creams/gels )nonsteroidal anti-inflammatory drugs (NSAIDs) as first-line pharmacologic treatment for hand OA. EULAR also recommends education about ergonomic principles, activity pacing, use of assistive devices, and exercises to improve function and muscle strength as the initial steps in managing hand OA, with or without topical NSAIDs.

The EULAR update recommends againstusing conventional or biologic disease-modifying antirheumatic drugs in hand OA and discourages the use of heat therapies, ultrasound, most intra-articular glucocorticoid injections, Symptomatic Slow Acting Drugs for Osteoarthritis

Richard Katesmark comments;

The main principal in the management of hand OA treatment is to control symptoms and optimize hand function to maximize activity, participation, and quality of life. 

Conservative osteopathic treatment may well be of benefit if the arthritis is not too severe/advanced. Patient education is also important and should include information on the nature and course of OA, self-management principles, ergonomics, pacing of activity, exercises, use of assistive devices, and other treatment options (such as acupuncture .)

Advice on diet & the use of certain supplements can also be helpful to target & reduce the underling inflammation which is important

There are situations in which referral to a rheumatologist or other joint specialist might be appropriate. These include referral for surgery for patients with hand OA who have structural abnormalities & when other treatments have failed.

Either way an appointment with your local osteopath for an opinion is likely to be helpful in the first instance.