Non-pharmacological treatment of Hand Osteoarthritis – a systematic review

Abstract: Introduction: Hand osteoarthritis (OA) is characterized by gradual destruction of cartilage in the joints of the hand. It is commonly characterized by pain, reduced grip strength, stiffness, and reduced pinch strength, resulting in difficulty performing basic daily tasks. Pharmacological and non-pharmacological practices are employed for hand OA treatment. Many research has been conducted on the effectiveness of treating hand OA using pharmacological and non-pharmacological practices. However, not many studies are carried out to review the effectiveness of those treatment processes, especially the non-pharmacological practices. In this thesis, I systematically review the literature to evaluate and analyze the existing non-pharmacological interventions to provide evidence-based knowledge of existing hand OA treatments. Methods:  PRISMA guidelines were used to design the study selection protocol. The identification of non-pharmacological treatments was performed using PubMed, Scopus, PEDro, Cochrane Library, and Web of Science. Initially, 268 articles were selected through a search process. Following the selection procedure, 10 articles were chosen to address the research question. The PEDro scale was used to assess the methodological quality and eligibility of the selected studies.  Result:  In the selected studies, a variety of interventions were examined for managing hand OA, such as exercise therapy, blood flow resistance training (BFRT), high intensity training (HIT)), patient education, conservative therapies (education, splints, and hand exercises), splinting. Other interventions such as paraffin therapy and kinesio taping (KT) and functional consultation were also employed. The selected studies examined pain, grip strength, hand function, pinch strength, and stiffness.  Conclusion: Based on the selected studies, it is found that non-pharmacological rehabilitative intervention has a significant impact on pain, grip strength, hand function, pinch strength, and stiffness.  BFRT and HIT are the two most feasible options for individuals with hand OA that relieve pain, grip strength and hand function and achieve the clinical outcomes that were previously set or examined by the physician.  Additionally, KT combined with paraffin therapy, splinting, and hand exercises can also significantly decrease pain and improve pinch strength, grip strength.