Effects of ischemic compression on trigger points in the first dorsal interosseous muscle in patients with thumb carpometacarpal osteoarthritis

Background: Thumb carpometacarpal osteoarthritis (CMC OA) is a common disorder that interferes with the ability to perform the activities of daily life. The purpose of this study was to investigate the immediate effects of ischemic compression on myofascial trigger points (MTrPs) in the first dorsal interosseous (FDI) muscle in patients with the diagnosis of thumb CMC OA. Methods: In a quasi-experimental clinical trial, thirty-one patients, 87% female (age: 82 ± 9.4 years), with thumb CMC OA, were consecutively assigned to either an experimental treatment that included the ischemic compression of the FDI MTrP or a sham treatment of the FDI MTrP for one session. The main outcome considered in the study was the pressure pain threshold (PPT). Measurements were taken pre-and post-treatment and at a 1-week follow-up period. Results: The PPT over the right (affected) FDI muscle showed statistically significant differences between groups at 1-week follow up (F = 3.518; p = 0.04) in favor of the experimental group. Conclusions: The ischemic compression of FDI-MTrPs is an appropriate part of a multimodal treatment to decrease local pain sensitivity in patients with CMC OA

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease