Graduate Degree Type
Occupational Therapy (M.S.)
Dianna Lunsford, Gannon University
Susan Betz, Hand Therapy of Colorado
Background: Osteoarthritis (OA) is the most common type of arthritis characterized by a slow and progressive loss of joint function. Carpometacarpal joint (CMC) OA can result in pain and functional limitations including grasping and manipulating objects. Management of thumb CMC OA using a combination of treatments is common in clinical practice; however, evidence for the efficacy of specific combinations is lacking. The retrospective study reviewed clinical records that have employed a specific combination of treatments including: orthotics, joint protection, paraffin, and the dynamic stability approach.
Methods: A retrospective chart review was conducted of 89 patients seen by a certified hand therapist between June of 2015 and February of 2021. The inclusion criteria included: referred to Hand Therapy of Colorado, received all four interventions, treated by a specific clinician between the dates of June 12, 2015, and October 25, 2021, and diagnosed with CMC OA. Exclusion criteria included patients who were not diagnosed with CMC OA or patients who were treated for comorbid hand diagnoses. Data extraction outcome measures included the Numeric Pain Rating scale (NPRS) and the QuickDASH.
Results: There were 16 participants that met the inclusion criteria; three patients had their L hand treated, four were treated for their R hand, and nine patients were treated bilaterally, for a total of 25 hands. Results at the end of the treatment intervention protocol demonstrated improvements in worst (NPRS) pain (7.38 to 5.5, a change of 1.88) and function (QuickDASH scores) (45.94 to 32.13, a change of 13.81) both statistically significant improvements. The results also demonstrated a minimal clinically important difference of more than 1.6 points for worst pain.
Conclusions: The combined protocol of orthotics, joint protection, paraffin, and the dynamic stability approach in this study, resulted in significant improvements in decreased pain and improved function.
Forden, Kristina; Freeman, Ashley; Klebba, Rachel; Larkins, Tad; and Luis, Geanina, "Conservative therapeutic management of thumb carpometacarpal joint osteoarthritis: Four combined interventions" (2023). Masters Theses. 1107.
Available for download on Friday, July 10, 2026