Efficacy of Paraffin Bath Therapy in Hand Osteoarthritis: A Single-Blinded Randomized Controlled Trial (2025)

Efficacy of Paraffin Bath Therapy in Hand Osteoarthritis: A Single-Blinded Randomized Controlled Trial Archives of Physical Medicine and Rehabilitation

Objective: To evaluate the efficacy of paraffin bath therapy on pain, function, and muscle strength in patients with hand osteoarthritis. Design: Prospective single-blinded randomized controlled trial. Setting: Department of physical medicine and rehabilitation in a university hospital. Participants: Patients with bilateral hand osteoarthritis (NZ56). Interventions: Patients were randomized into 2 groups with a random number table by using block randomization with 4 patients in a block. Group 1 (nZ29) had paraffin bath therapy (5 times per week, for 3-week duration) for both hands. Group 2 (nZ27) was the control group. All patients were informed about joint-protection techniques, and paracetamol intake was recorded. Main Outcome Measures: The primary outcome measures were pain (at last 48h) at rest and during activities of daily living (ADL), assessed with a visual analog scale (0e10cm) at 12 weeks. The secondary outcome measures were the Australian Canadian Osteoarthritis Hand Index (AUSCAN) and the Dreiser Functional Index (DFI), used for subjective functional evaluation, loss of range of motion (ROM), grip and pinch strength, painful and tender joint counts, and paracetamol intake. A researcher blind to group allocation recorded the measures for both hands at baseline, 3 weeks, and 12 weeks at the hospital setting. Results: At baseline, there were no significant differences between groups in any of the parameters (P>.05). After treatment, the paraffin group exhibited significant improvement in pain at rest and during ADL, ROM of the right hand, and pain and stiffness dimensions of the AUSCAN (P<.05). There was no significant improvement in functional dimension of the AUSCAN and the DFI (P>.05). The control group showed a significant deterioration in right hand grip and bilateral lateral pinch and right chuck pinch strength (P<.05), but there was no significant change in the other outcome measures. When the 2 groups were compared, pain at rest, both at 3 and 12 weeks, and the number of painful and tender joints at 12 weeks significantly decreased in the paraffin group (P<.05). Bilateral hand-grip strength and the left lateral and chuck pinch strength of the paraffin group were significantly higher than the control group at 12 weeks (P<.05). Conclusions: Paraffin bath therapy seemed to be effective both in reducing pain and tenderness and maintaining muscle strength in hand osteoarthritis. It may be regarded as a beneficial short-term therapy option, which is effective for a 12-week period. Archives of Physical Medicine and Rehabilitation 2013;94:642-9 ª 2013 by the American Congress of Rehabilitation Medicine

Comparison of efficacy of fluidotherapy and paraffin bath in hand osteoarthritis: A randomized controlled trial

Archives of Rheumatology, 2021

Objectives This study aims to compare the efficacy of paraffin bath therapy and fluidotherapy on pain, hand muscle strength, functional status, and quality of life (QoL) in patients with hand osteoarthritis (OA). Patients and methods This prospective randomized controlled study included 77 patients (8 males, 69 females; mean age: 63.1±10.3 years; range 39 to 88 years) with primary hand OA who applied between July 2017 and March 2018. The patients were randomized into two groups with the sealed envelope method: Paraffin bath therapy (20 min, one session per day, for two weeks) was applied for 36 patients whereas 41 patients received fluidotherapy for the same period. The pain severity of the patients, both at rest and during activities of daily living (ADL) within the last 48 hours was questioned and scored using Visual Analog Scale. Duruöz Hand Index (DHI) was used to evaluate hand functions. Gross grip strength was measured using Jamar dynamometer whereas fine grip strength was mea...

… recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including …

Annals of the …, 2007

To develop evidence based recommendations for the management of hand osteoarthritis (OA). Methods: The multidisciplinary guideline development group comprised 16 rheumatologists, one physiatrist, one orthopaedic surgeon, two allied health professionals, and one evidence based medicine expert, representing 15 different European countries. Each participant contributed up to 10 propositions describing key clinical points for management of hand OA. Final recommendations were agreed using a Delphi consensus approach. A systematic search of Medline, Embase, CINAHL, Science Citation Index, AMED, Cochrane Library, HTA, and NICE reports was used to identify the best available research evidence to support each proposition. Where possible, the effect size and number needed to treat were calculated for efficacy. Relative risk or odds ratio was estimated for safety, and incremental cost effectiveness ratio was used for cost effectiveness. The strength of recommendation was provided according to research evidence, clinical expertise, and perceived patient preference. Results: Eleven key propositions involving 17 treatment modalities were generated through three Delphi rounds. Treatment topics included general considerations (for example, clinical features, risk factors, comorbidities), non-pharmacological (for example, education plus exercise, local heat, and splint), pharmacological (for example, paracetamol, NSAIDs, NSAIDs plus gastroprotective agents, COX-2 inhibitors, systemic slow acting disease modifying drugs, intra-articular corticosteroids), and surgery. Of 17 treatment modalities, only six were supported by research evidence (education plus exercise, NSAIDs, COX-2 inhibitors, topical NSAIDs, topical capsaicin, and chondroitin sulphate). Others were supported either by evidence extrapolated from studies of OA affecting other joint sites or by expert opinion. Strength of recommendation varied according to level of evidence, benefits and harms/costs of the treatment, and clinical expertise. Conclusion: Eleven key recommendations for treatment of hand OA were developed using a combination of research based evidence and expert consensus. The evidence was evaluated and the strength of recommendation was provided.

The Turkish League Against Rheumatism Recommendations for the Management of Hand Osteoarthritis Under Guidance of the Current Literature and 2018 European League Against Rheumatism Recommendations

Archives of Rheumatology, 2020

Objectives: This study aims to explore the accordance to the 2018 European League Against Rheumatism (EULAR) recommendations for the management of hand osteoarthritis (OA) among the Turkish League Against Rheumatism (TLAR) expert panel and composition of TLAR recommendations for the management of hand OA under guidance of the current literature. Materials and methods: The TLAR convener designated an expert panel of 10 physicians experienced in hand OA for this process. The 2018 EULAR recommendations for the management of hand OA and the systematic review of the literature were sent to the expert panel via e-mails. The e-mail process which included Delphi round surveys was completed. The EULAR standard operational procedure Appraisal of Guidelines for Research and Evaluation II was followed. The level of agreement was calculated for each item and presented as mean, standard deviations, minimum and maximum and comparisons of 2018 EULAR recommendations were performed. Results: Five overarching principles and 10 recommendations were discussed. Revisions were held for the sixth, seventh, and ninth recommendations with lowest level of agreements. These recommendations were revised in accordance with suggestions from the experts and re-voted. The revised forms were approved despite the lack of statistically significant difference between these forms (p=0.400, p=0.451, p=0.496, respectively). Except for the ninth recommendation about surgery (p=0.008), no significant difference in level of agreements was observed between the EULAR and TLAR hand OA recommendations. The 11 th recommendation about paraffin bath was added. Conclusion: The optimal treatment of hand OA consists of personalized non-pharmacological (self-management, exercise, splint), pharmacological (topical non-steroidal anti-inflammatory drugs as the first choice), and interventional procedures (only for refractory cases) based on shared decision between the patient and physician. TLAR hand OA recommendations were created mainly based on the most recent literature and the last EULAR hand OA management recommendations, which are widely approved among the TLAR experts.

EULAR evidence based recommendations for the management of hand osteoarthritis: Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)

Annals of the Rheumatic Diseases, 2007

Objectives: To develop evidence based recommendations for the management of hand osteoarthritis (OA). Methods: The multidisciplinary guideline development group comprised 16 rheumatologists, 1 physiatrist, 1 orthopaedic surgeon, 2 allied health professionals and 1 evidence based medicine expert, representing 15 different European countries. Each participant contributed up to 10 propositions describing key clinical points regarding management of hand OA. Final recommendations were agreed using a Delphi consensus approach. A systematic search of MEDLINE, EMBASE, CINAHL, Science Citation Index, AMED, Cochrane Library, HTA and NICE reports was used to identify the best available research evidence to support each of the propositions. Where possible the effect size and number needed to treat were calculated for efficacy. Relative risk or odds ratio was estimated for safety and incremental cost-effectiveness ratio was used for costeffectiveness. The strength of recommendation was provided according to research evidence, clinical expertise and perceived patient preference. Results: Eleven key propositions involving 17 treatment modalities were generated through three Delphi rounds. Treatment topics included general considerations (eg, clinical features, risk factors, co-morbidities), non-pharmacological (eg, education plus exercise, local heat and splint), pharmacological (eg, paracetamol, NSAIDs, NSAIDs plus gastroprotective agents, COX-2 inhibitors, systemic slow acting disease-modifying drugs, intra-articular corticosteroid) and surgery. Of 17 treatment modalities, only 6 were supported by research evidence (education plus exercise, NSAIDs, COX-2 inhibitors, topical NSAIDs, topical capsaicin and chondroitin sulphate). Others were supported either by evidence extrapolated from studies of OA affecting other joint sites or by expert opinion. Strength of recommendation varied according to level of evidence, benefits and harms/costs of the treatment and clinical expertise. Conclusion: Eleven key recommendations for treatment of hand OA were developed using a combination of research-based evidence and expert consensus. The evidence was evaluated and the strength of recommendation was provided. Downloaded from Hand osteoarthritis (OA) is a common condition (1;2) though its prevalence varies according to the definition used. For example, the majority of people aged 55 years and over have radiographic changes of OA affecting at least one hand joint (3) while approximately one fifth of this population have symptomatic hand OA.(4) The correlation between symptoms and radiographic change is even less for hand OA than for OA of the hip or knee. Although many people affected by hand OA may never seek medical advice (5;6) the impact of hand OA and associated disability is significant (3;4;6). Importantly, many of the clinical consequences of hand OA are site-specific (e.g. interference with grip and fine precision pinch, dissatisfaction with cosmetic appearance) and distinct from those of knee and hip OA. Furthermore, compared to large joint OA, the small size and accessibility of hand joints makes them amenable to a different range of interventions. Due to differences in anatomy, function, risk factors and outcomes, OA at different sites may also show a different response to the same treatment. Therefore interventions for OA need to be examined in a site-specific fashion.

Supplementary_Material_3 – Supplemental material for The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis

2018

Supplemental material, Supplementary_Material_3 for The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis by Lucie Brosseau, Odette Thevenot, Olivia MacKiddie, Jade Taki, George A Wells, Paulette Guitard, Guillaume Léonard, Nicole Paquet, Sibel Z Aydin, Karine Toupin-April, Sabrina Cavallo, Rikke Helene Moe, Kamran Shaikh, Wendy Gifford, Laurianne Loew, Gino De Angelis, Shirin Mehdi Shallwani, Ala&#39; S Aburub, Aline Mizusaki Imoto, Prinon Rahman, Inmaculada C Álvarez Gallardo, Milkana Borges Cosic, Nina Østerås, Sabrina Lue, Tokiko Hamasaki, Nathaly Gaudreault, Tanveer E Towheed, Sahil Koppikar, Ingvild Kjeken, Dharini Mahendira, Glen P Kenny, Gail Paterson, Marie Westby, Lucie Laferrière and Guy Longchamp in Clinical Rehabilitation

There Is Inadequate Evidence to Determine the Effectiveness of Nonpharmacological and Nonsurgical Interventions for Hand Osteoarthritis: An Overview of High-Quality Systematic Reviews

Physical Therapy, 2009

Background. Patients with hand osteoarthritis are commonly treated by health care professionals (allied to medicine). Practice should be informed by updated evidence from systematic reviews of randomized controlled trials.

Italian Society for Rheumatology recommendations for the management of hand osteoarthritis

Reumatismo, 2013

Hand osteoarthritis (OA) is a common and potentially disabling disease, with different features from hip and knee OA so that a specific therapeutic approach is required. Evidence based recommendations for the management of hand OA were developed by the European League Against Rheumatism (EULAR) in 2006. The Italian Society for Rheumatology (SIR) aimed to update, adapt to national contest and disseminate the EULAR recommendations for the management of hand OA. The multidisciplinary group of experts included specialists involved in the management of patients with hand OA. In order to maintain consistency with EULAR recommendations, a similar methodology was utilized by the Italian group. The original propositions were reformulated in terms of a search query and for every recommendation a systematic search was conducted updating EULAR recommendations' review. The propositions were translated in Italian and reformulated basing on collected evidences and expert opinion. The strength of recommendation was measured for each proposition with the EULAR ordinal and visual analogue scales. The original 11 propositions of EULAR recommendations were translated and adapted to Italian context. Further evidences were collected about non-pharmacological therapies, local treatments, intra-articular injection with SYSADOA and corticosteroids, and surgery. The SIR has developed updated recommendations for the management of hand OA adapted to the Italian healthcare system. Their implementation in clinical practice is expected to improve the management of patients with hand OA.

Exercise for Hand Osteoarthritis: A Cochrane Systematic Review

The Journal of rheumatology, 2017

To assess the benefits and harms of exercise compared with other interventions, including placebo or no intervention, in people with hand osteoarthritis (OA). Systematic review using Cochrane Collaboration methodology. Six electronic databases were searched up until September 2015. randomized or controlled clinical trials comparing therapeutic exercise versus no exercise, or comparing different exercise programs. hand pain, hand function, finger joint stiffness, quality of life, adverse events, and withdrawals because of adverse effects. Risk of bias and quality of the evidence were assessed. Seven trials were included in the review, and up to 5 trials (n = 381) were included in the pooled analyses with data from postintervention. Compared to no exercise, low-quality evidence indicated that exercise may improve hand pain [5 trials, standardized mean difference (SMD) -0.27, 95% CI -0.47 to -0.07], hand function (4 trials, SMD -0.28, 95% CI -0.58 to 0.02), and finger joint stiffness (...

Therapeutic trials in hand osteoarthritis: A critical review

Osteoarthritis and Cartilage, 2000

Objective: To perform a critical review of the published therapeutic trials conducted in hand osteoarthritis (OA).