{"id":8482,"date":"2022-07-26T14:42:20","date_gmt":"2022-07-26T13:42:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=8482"},"modified":"2023-09-13T08:47:32","modified_gmt":"2023-09-13T07:47:32","slug":"oa-hand-wrist-thumb","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/musculoskeletalphysiotherapy\/wrist-and-hand\/oa-hand-wrist-thumb\/","title":{"rendered":"OA Hand, Wrist &amp; Thumb"},"content":{"rendered":"\n<p>\u200bJoint inflammation is indicated by pain, swelling, stiffness and loss of function, that can result from degenerative osteoarthritis (OA). This commonly affects the thumb base CMC joints and the DIP joints (Heberden&#8217;s nodes) or PIP joints (Bouchard&#8217;s nodes) of the fingers. Middle age and older adults are predominantly affected although other risk factors include previous major or repetitive joint trauma or joint instability. Management is primarily conservative, making use of rest, anti-inflammatory medications and splints for use at night and during specific activities. Physiotherapy is often helpful.&nbsp; X-rays should be performed to confirm diagnosis before referring to physiotherapy.<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">What we will see:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diagnosis confirmed with x-ray by GP<\/li>\n\n\n\n<li>Pain management or functional difficulties<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">What we won&#8217;t see:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diagnostic difficulties<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>Analgesia: oral +\/- topical<\/li>\n\n\n\n<li>Splints: See resources and link section<\/li>\n\n\n\n<li>Education: See resources and links section<\/li>\n\n\n\n<li>Activity modification: See resources and links section<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthritisbaseofthumb\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthritisbaseofthumb\/\" target=\"_blank\">NHS Lothian Refhelp Osteoarthritis of Base of Thumb<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthritis-hand\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthritis-hand\/\" target=\"_blank\" rel=\"noreferrer noopener\">NHS Lothian Refhelp Osteoarthritis of the Hand<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthrits-wrist\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthrits-wrist\/\" target=\"_blank\" rel=\"noreferrer noopener\">NHS Lothian Refhelp Osteoarthritis of the Wrist<\/a>&nbsp;<\/li>\n\n\n\n<li><strong>Versus arthritis<\/strong>&nbsp;have a range of resources to support clinicians and patients&nbsp;<a href=\"https:\/\/www.versusarthritis.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.versusarthritis.org\/<\/a>. Versus arthritis have a&nbsp;<a href=\"https:\/\/www.versusarthritis.org\/about-arthritis\/healthcare-professionals\/professional-network-and-clinical-updates\/the-professional-network\/\" target=\"_blank\" rel=\"noreferrer noopener\">professional network<\/a>&nbsp;you can join, which gives monthly up-date on MSK. They also have a range of&nbsp;<a href=\"https:\/\/www.versusarthritis.org\/about-arthritis\/healthcare-professionals\/training-and-education-resources\/versus-arthritis-and-red-whale-webinars\/\" target=\"_blank\" rel=\"noreferrer noopener\">training programmes and resources<\/a>&nbsp;designed to improve MSK care. You might also be interested in their&nbsp;<a href=\"https:\/\/www.flipsnack.com\/BC857F5BDC9\/versus_arthritis-hcp_handbook-interactive.html\" target=\"_blank\" rel=\"noreferrer noopener\">Clinical Assessment Guide<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/www.versusarthritis.org\/about-arthritis\/healthcare-professionals\/musculoskeletal-decision-support-tools\/\" target=\"_blank\" rel=\"noreferrer noopener\">Decision Support Tools<\/a><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>NHS Lothian Virtual Hand Unit Website\u00a0<\/strong>was developed in 2021 with the aim of improving the information provided to patients following referral, and to avoid unnecessary face to face appointments. The information is intended to compliment what patients are told in clinic and offer a trusted source of information <a rel=\"noreferrer noopener\" href=\"https:\/\/lothianvirtualhandclinic.co.uk\/osteoarthritis-in-the-hand\/\" target=\"_blank\">Osteoarthritis in the Hand \u2013 Lothian Virtual Hand Clinic<\/a><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The British Society for Surgery of the Hand&nbsp;<\/strong>website provides a wealth of information for patients and medical professionals on hand conditions including injuries and disorders, hand surgery and hand therapy.&nbsp;&nbsp;<a href=\"https:\/\/www.bssh.ac.uk\/patients\/conditions\" data-type=\"URL\" data-id=\"https:\/\/www.bssh.ac.uk\/patients\/conditions\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.bssh.ac.uk\/conditions<\/a>,&nbsp;<a href=\"https:\/\/www.bssh.ac.uk\/patients\/conditions\/24\/basal_thumb_arthritis\" data-type=\"URL\" data-id=\"https:\/\/www.bssh.ac.uk\/patients\/conditions\/24\/basal_thumb_arthritis\" target=\"_blank\" rel=\"noreferrer noopener\">thumb base OA<\/a>.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The British Association of Hand Therapists&nbsp;<\/strong>(BAHT) is a registered UK charity and clinical interest group for anyone interested in the rehabilitation of hands, with a dedicated patient section on hand injuries and disorders&nbsp;&nbsp;<a href=\"https:\/\/www.hand-therapy.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.hand-therapy.co.uk\/<\/a><\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Useful Hand and Thumb OA Patient Videos<\/h4>\n\n\n\n<p>St John&#8217;s Hand Therapy Team OA Thumb Video&nbsp;&nbsp;<a href=\"https:\/\/vimeo.com\/482676602\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/vimeo.com\/482676602<\/a><\/p>\n\n\n\n<p>&#8220;Hand exercises | Hand Osteoarthritis&#8221; on YouTube&nbsp;&nbsp;<a href=\"https:\/\/youtu.be\/MKqbN_pnz8c\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/youtu.be\/MKqbN_pnz8c<\/a>&nbsp;<\/p>\n\n\n\n<p>&#8220;House and Garden Aids | Hand Osteoarthritis&#8221; on YouTube&nbsp;&nbsp;<a href=\"https:\/\/youtu.be\/j6pbNOyTRcg\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/youtu.be\/j6pbNOyTRcg<\/a>&nbsp;<\/p>\n\n\n\n<p>&#8220;Splints Demonstration and Explanation | Hand Osteoarthritis&#8221; on YouTube&nbsp;<a href=\"https:\/\/youtu.be\/U_8foTx1Nbo\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/youtu.be\/U_8foTx1Nbo<\/a>&nbsp;<\/p>\n\n\n\n<p>&#8220;Patient&#8217;s Story | Hand Osteoarthritis&#8221; on YouTube&nbsp;&nbsp;<a href=\"https:\/\/youtu.be\/3jhqCdkB5GQ\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/youtu.be\/3jhqCdkB5GQ<\/a>&nbsp;<\/p>\n\n\n\n<p>&#8220;Kitchen Aids&#8221; on YouTube&nbsp;&nbsp;<a href=\"https:\/\/www.youtube.com\/watch?v=JAUN_Ans778\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.youtube.com\/watch?v=JAUN_Ans778<\/a><\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8203;Joint inflammation is indicated by pain, swelling, stiffness and loss of function, that can result from degenerative osteoarthritis (OA). This commonly affects the thumb base CMC joints and the DIP joints (Heberden&rsquo;s nodes) or PIP joints (Bouchard&rsquo;s nodes) of the fingers. Middle age and older adults are predominantly affected although other risk factors include previous<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":8924,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[724],"class_list":["post-8482","page","type-page","status-publish","hentry","category-oa-hand-wrist--thumb"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/musculoskeletal-physiotherapy\/wrist-and-hand\/oa-hand-wrist-%ef%bc%86-thumb\/\" rel=\"tag\">OA Hand, Wrist \uff06 Thumb<\/a>","rttpg_excerpt":"&#8203;Joint inflammation is indicated by pain, swelling, stiffness and loss of function, that can result from degenerative osteoarthritis (OA). This commonly affects the thumb base CMC joints and the DIP joints (Heberden&rsquo;s nodes) or PIP joints (Bouchard&rsquo;s nodes) of the fingers. Middle age and older adults are predominantly affected although other risk factors include previous","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/8482","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=8482"}],"version-history":[{"count":9,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/8482\/revisions"}],"predecessor-version":[{"id":16206,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/8482\/revisions\/16206"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/8924"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=8482"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=8482"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}