Treatment
Hand
Table 1. Nonpharmacologic Recommendations for the
Management of Hand Osteoarthritis (OA)
a
The ACR conditionally recommends that health professionals should do the
following:
• Evaluate the ability to perform activities of daily living (ADLs)
• Instruct in joint protection techniques
• Provide assistive devices, as needed, to help patients perform ADLs
• Instruct in use of thermal modalities
• Provide splints for patients with trapeziometacarpal joint OA
a
No strong recommendations were made for the nonpharmacologic management of hand OA. e
evidence supporting these interventions demonstrated only a small to moderate effect.
Table 2. Pharmacologic Recommendations for the Initial
Management of Hand Osteoarthritis (OA)
a
The ACR conditionally recommends that health professionals should use one or
more of the following:
• Topical capsaicin
• Topical NSAIDs, including trolamine salicylate
• Oral NSAIDs, including COX-2 selective inhibitors
• Tramadol
The ACR conditionally recommends that health professionals should NOT use the
following:
• Intraarticular therapies
• Opioid analgesics
The ACR conditionally recommends:
• That persons age ≥75 years should use topical rather than oral NSAIDs.
• In persons age <75 years, the ACR expresses no preference for using topical rather than oral
NSAIDs.
a
No strong recommendations were made for the pharmacologic management of hand OA.
