Radial nerve mobilisation had bilateral sensory effects in people with thumb carpometacarpal osteoarthritis: a randomised trial

Villafañe, Jorge Hugo; Bishop, Mark D.; Fernández‐de‐las‐Peñas, César; Langford, Dolores

doi:10.1016/s1836-9553(13)70143-7

Cited by 40 publications

(37 citation statements)

References 37 publications

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“…Clinicians should take into account the presence of central sensitization and widespread pressure pain hypersensitivity in this pain population by not limiting their intervention to the injured area. For instance, recent evidence showed that upper limb manual treatments were effective for improving pressure sensitivity over the injured area, even though they were not specifically directed to the first CMC joint [39][40][41][42][43][44]. Therefore, treatments applied to patients with thumb CMC OA should be targeted to address sensitization mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Widespread Pressure Pain Hypersensitivity in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

Chiarotto¹,

Fernández‐de‐las‐Peñas

Castaldo³

et al. 2013

Hand (New York, N,Y.)

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Background Widespread pressure hypersensitivity is one of the signs that characterize central pain sensitization in subjects with knee and hip osteoarthritis (OA). The purpose of this study was to evaluate whether widespread pressure pain hyperalgesia is a feature of individuals with unilateral symptomatic thumb carpometacarpal (CMC) OA. Methods A total of 16 patients with unilateral symptomatic thumb CMC OA and 16 healthy sex-and age-matched controls were recruited. Pressure pain thresholds (PPTs) were assessed bilaterally over the first CMC joint; the C5-C6 zygapophyseal joint; the median, ulnar, and radial nerves; and tibialis anterior muscle. Grip and key strength, intensity of pain, and function QuickDASH were also measured. Results The analyses showed that patients with thumb CMC OA present bilaterally decreased PPTs over the first CMC joint, the C5-C6 zygapophyseal joint, and the tibialis anterior, median, ulnar and radial nerve as compared to controls (all, P<0.01).Patients with thumb CMC OA also exhibited a bilateral reduction in pinch and grip strength than controls (P<0.05). A significant correlation was found between PPT over the radial nerve and QuickDASH (r=0.546, P=0.029). Conclusion This study revealed bilateral widespread pressure pain hypersensitivity in individuals with unilateral symptomatic thumb CMC OA, suggesting that central pain processing mechanisms might be a feature of this pain population. These results should be taken into consideration when addressing future treatment approaches.

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Section: Discussionmentioning

confidence: 99%

Widespread Pressure Pain Hypersensitivity in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

Chiarotto¹,

Fernández‐de‐las‐Peñas

Castaldo³

et al. 2013

Hand (New York, N,Y.)

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“…The thumb CMC joint is frequently affected by osteoarthritis (OA), a degenerative condition that can result in deterioration of the joint surfaces1, 2 ) . Individuals with CMC joint OA have decreased pinch strength that impacts hand function and their ability to perform resistive pinch tasks such as clipping nails, turning keys, or opening food packages3 ) .…”

Section: Introductionmentioning

confidence: 99%

Reliability of Pinch Strength Testing in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

Villafañe

Valdes

2014

J Phys Ther Sci

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[Purpose] The aim of this study was to examine the test-retest reliability of pinch strength testing in elderly subjects with thumb CMC OA. [Subjects and Methods] A total of 27 patients with unilateral right-thumb CMC OA (mean ± SD age: 81.3 ± 4.7 years) were recruited. Each patient performed three pain-free maximal isometric contractions on each hand on two occasions, one week apart. Three different measurements were taken: tip, tripod, and key pinch strength. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95% limits of agreement (LOA) calculations were performed. [Results] Test-retest reliability of measurements of tip, tripod, and key pinch strength was excellent for the affected side (ICC=0.93, 0.96, and 0.99) and the contralateral thumb (ICC=0.91, 0.92, and 0.94). [Conclusions] The present results indicate that maximum pinch strength can be measured reliably using the Pinch Gauge Dynamometer, in patients with thumb CMC OA, which enables its use in research and in the clinic to determine the effect of interventions on improving pinch strength.

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“…The tip and tripod pinch strength were unchanged as well. 9 Two trials studying the effect of radial nerve mobilization on patients with thumb CMC OA found it to have hypoalgesic effects on the same 10 and contralateral hand, 11 indicating bilateral hypoalgesic effects of the practice. In addition, tip pinch strength and tripod pinch strength both improved in the same hand.…”

Section: Resultsmentioning

confidence: 99%

“…20 Within balneotherapy, the use of sulphurous spa water alone was shown to be more effective than that of warm tap water exclusively in the reduction of pain in patients with hand OA. 21 Another Radial nerve mobilization 10,11 Arnica gel 30 Metacarpal osteotomy 45 Maitland's passive accessory mobilization 12 Topical analgesic + paraffin bath therapy 31 Carpometacarpal arthrodesis 45 Joint mobilization + neural mobilization + exercise 13 Intraarticular corticosteroid injections [32][33][34][35] Joint replacement 45 Custom-made splinting 17,18 Intraarticular hyaluronic acid injections 36 single-blind RCT showed that paraffin bath therapy in patients with bilateral hand OA was successful in reducing stiffness and pain at rest and during activities of daily living. As well, range of motion was enhanced in one hand, and muscle strength was better maintained as compared to the control group.…”

Section: Resultsmentioning

confidence: 99%

Hand Osteoarthritis: An Update on Therapy

Sayyid

2015

Arch Rheumatol

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Objectives:This literature review aims to summarize and discuss the most novel clinical studies relevant to the treatment of hand osteoarthritis. Materials and methods: A comprehensive search using Medline and PubMed was performed. Results were restricted to the period between January 2008 and May 2014, and included randomized controlled trials and reviews. The bibliographies of articles retrieved through this search were searched manually for additional relevant references. Results: The latest methods of nerve mobilization, splinting, exercise, and other diverse nonpharmacological treatments have led to significant functional and symptomatic improvements. Topical nonsteroidal antiinflammatory drugs' clinical beneficence was reinforced and corticosteroid injections were shown to be superior to hyaluronic acid injections. Other pharmacological therapies, such as Hylan injections and synergistic drugs, also showed promise. Antitumor necrosis factor was suggested to play role as a potential disease-modifying agent. Surgical procedures such as arthroscopic debridement, synovectomy of the trapeziometacarpal joint, and early tendon arthroplasty were promising with long-term benefits when used as early interventions. Conclusion: Recent studies show that emerging therapies may play role in the clinical setting as an upgrade over current practices, and that earlier surgical interventions should be considered in the management process.

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Radial nerve mobilisation had bilateral sensory effects in people with thumb carpometacarpal osteoarthritis: a randomised trial

Abstract: Radial nerve gliding applied to the symptomatic hand induced hypoalgesic effects on the contralateral hand in people with CMC osteoarthritis, suggesting bilateral hypoalgesic effects of the intervention.

Cited by 40 publications

References 37 publications

Widespread Pressure Pain Hypersensitivity in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

Widespread Pressure Pain Hypersensitivity in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

Reliability of Pinch Strength Testing in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

Hand Osteoarthritis: An Update on Therapy

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