INTERVENTIONS FOR HAND OA
Although I found that interventions for hand OA are the least studied, one recent, well-designed systematic review was conducted by Ye and colleagues. They reviewed RCTs, quasi-RCTs, and crossover trials that compared a rehabilitation intervention with a control group, usual care, or no treatment and reported on at least one of three outcomes: pain, hand function, and other measures of hand impairment. Studies were rated for quality using the PEDro scale—an 11-item scale used to assess the internal validity of a trial. Six studies met the eligibility criteria and were deemed to be of higher quality (PEDro score of more than 6). Of the 10 studies included, three evaluated exercise, two looked at laser and heat therapy, and one studied splints, massage, and acupuncture. One study assessing the use of a night splint demonstrated
a large benefit at 12 months for pain, function, strength, and range of motion. Exercise showed no beneficial effects for function and a slight benefit for strength. Low-level laser therapy appeared to provide some gains in range of motion. No interventions improved stiffness. The authors concluded that growing evidence supports the use of some interventions
for hand OA, but further research is needed.