Research Gives Thumbs Up to Arthritis Treatment

Healthnotes Newswire (July 16, 2009)—One might expect that the wear and tear that occurs in joints over long periods of time would also take a long time to repair, and so it appears for osteoarthritis of the thumb. A new study found that people with osteoarthritis at the base of the thumb, a common site for this condition, had reduced pain and improved function if they used a custom-made nighttime splint for 12 months.

The study, published in the Annals of Internal Medicine, included 112 people with osteoarthritis in the joint at the base of the thumb. They were randomly assigned to receive usual care plus a custom-made neoprene splint, or usual care with no splint. People receiving splints, which covered the base of the thumb and held the joint rigid with respect to the first finger, were instructed to wear them only at night. Tests were performed after 1 month, 6 months, and 12 months to evaluate changes in pain, function, and disability.

Nighttime splinting needs time to work

At the 1-month evaluation, people using splints and not using splints had similar changes in pain, function, and disability; however, people using splints had more improvement in pain, function, and disability by the 12-month evaluation. More than half of the people using splints, but only 11% of those not using splints, reported that their condition had improved after a year.

“Our findings suggest that, for patients with base-of-thumb osteoarthritis, use of splints has no effect on pain at 1 month but results in reductions in pain and disability at 12 months,” said study co-author Dr. Serge Poiraudeau of the Service de Médecine Physique et Réadaptation in Paris. “These findings are highly relevant because base-of-thumb osteoarthritis is extremely common; furthermore, the splints were inexpensive and were well-tolerated by the study participants.”

Symptom relief vs. cartilage repair

Osteoarthritis develops when the cartilage layer responsible for protecting the surfaces of bone where they meet as joints degenerates. It is a common cause of pain, stiffness, and disability among older people. Most treatment strategies are aimed at minimizing pain and inflammation, and a few are aimed at restoring cartilage.

Nighttime splinting has been an uncommon recommendation for base-of-thumb osteoarthritis, and this is the first controlled trial to evaluate its effectiveness. X-rays taken before and after the trial showed that the splinting did not increase the thickness of the cartilage layer in this study, suggesting that symptom relief was achieved through some other mechanism.

Other treatment options

In addition to nighttime splinting, people with base-of-thumb osteoarthritis might benefit from some of the following suggestions:

• Keep moving: even though pain and stiffness can make you feel like skipping your exercise routine, research shows that staying active can help keep arthritis symptoms under control.

• Alternating hot and cold water therapy: targeting arthritic joints with water therapy improves circulation and reduces inflammation, and some practitioners believe it improves the health of the entire joint.

• Glucosamine sulfate: this nutritional supplement has been found to stimulate cartilage repair in arthritic joints

• Consider using herbs that have been used traditionally to treat arthritis, such as boswellia, turmeric, and ginger: these herbs have demonstrated anti-inflammatory properties.

(Ann Intern Med 2009;150:661-9)

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice on Cortes Island in British Columbia, Canada, and has done extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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