La osteoartritis de mano implica cambios degenerativos en las pequeñas articulaciones de la mano, que provocan dolor y limitación funcional. Existe un protocolo de primera línea estructurado para orientar el manejo en este escenario clínico.
Este protocolo de primera línea se basa en una combinación de intervenciones no farmacológicas y, cuando corresponde, procedimentales para la OA de mano — el régimen completo con graduación de evidencia, incluida la gama completa de opciones y su base clínica, está disponible a continuación.
Acupuncture was conditionally recommended for patients with knee, hip, and/or hand OA in the ACR/AF guidelines despite limited evidence, given the positive effect of acupuncture for analgesia and low risk of harm.
Thermal modalities were strongly recommended for hip OA by OARSI (conditionally not recommended for knee and polyarticular OA) and conditionally recommended by ACR/AF for knee, hip, and/or hand OA.
Cognitive behavioral therapy (CBT) was conditionally recommended for patients with knee, hip, and/or hand OA by ACR/AF on the basis of data regarding chronic pain management, although further study is needed to better assess the benefit of CBT in OA directly.
EULAR made a strong recommendation against IACS for hand OA though commented on its potential use in the case of "clear joint inflammation", whereas ACR provided a conditional recommendation for its use.
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