Factors associated with pain after non-surgical treatment for trapeziometacarpal joint osteoarthritis.
Lisa M J Esteban Lopez, Lisa Hoogendam, Ruud W Selles et al.
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In 30 seconds
This secondary analysis of a randomized controlled trial examined factors associated with pain three months after non-surgical treatment for trapeziometacarpal joint osteoarthritis. It included 113 patients with Eaton-Glickel stage 2 or greater disease treated at 18 outpatient hand surgery clinics in the Netherlands. Participants received a thumb orthosis, with or without supervised therapy and a home exercise programme. Better baseline pain scores, higher treatment expectations and improved grip strength were associated with better pain outcomes; baseline pain had the strongest independent association.
Key findings
- Better baseline Michigan Hand outcomes Questionnaire pain scores had the strongest independent association with better pain at three months.
- Higher baseline expectations for treatment were associated with better pain outcomes at three months.
- Improvement in grip strength over three months was associated with better pain outcomes.
Why it matters
Pain outcomes after orthosis-based care for trapeziometacarpal osteoarthritis vary. These findings suggest that baseline pain, patients’ expectations and changes in grip strength may help explain that variation, providing useful context when discussing likely outcomes and assessing response to non-surgical treatment.
What to keep in mind
This was a secondary analysis, and the reported associations do not establish that expectations or grip-strength improvement cause better pain outcomes.