Trapeziometacarpal joint osteoarthritis: manual therapy
Marco Primavera, Jennifer Baldassini
Trapeziometacarpal joint osteoarthritis is a very frequent chronic degenerative condition affecting the hand. Its management primarily involves conservative treatment although there is a lack of evidence regarding the effectiveness of conservative therapies. The treatment consists of a modification of activities, rest, prescription of nonsteroidal anti-inflammatory drugs, and strengthening exercises. According to a recent systematic review which examined different therapeutic strategies for the conservative treatment of trapeziometacarpal joint osteoarthritis, the greatest efficacy is obtained through a multimodal approach using a combination of different modalities of intervention. Recent studies, however, support the use of manual therapy and show its effectiveness in reducing pain through neurodynamics and specific passive joint mobilization exercises. In this article, we describe mobilization techniques of the radial and median nerves and specific techniques of passive accessory mobilization.