L'arthrose de la main implique des modifications dégénératives des petites articulations de la main, entraînant des douleurs et une limitation fonctionnelle. Un protocole de première ligne structuré existe pour guider la prise en charge dans ce contexte clinique.
Ce protocole de première ligne s'appuie sur une combinaison d'interventions non pharmacologiques et, le cas échéant, procédurales pour l'arthrose de la main — le protocole complet avec gradation des preuves, incluant l'ensemble des options et leur base clinique, est disponible ci-dessous.
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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