Hand osteoarthritis is managed with a structured first-line pharmacological approach. Guideline recommendations address agent selection, patient-specific risk factors, and adjunctive options — with notable differences in recommendation strength across major guidelines.

First-line management centres on locally applied anti-inflammatory therapy, with oral analgesic alternatives and gastroprotective considerations available for patients where topical treatment is insufficient or not tolerated.

The complete protocol specifies agent selection, which patients require gastroprotection, how adjunctive options fit in, and the decision pathway — all available via the full regimen below.

References

Topical NSAIDs were uniformly strongly recommended for knee OA by all guidelines and were strongly and conditionally recommended for hand OA by EULAR and ACR/AF, respectively, with the strength of recommendation influenced by practicality of using topical agents on finger joints.
Oral NSAIDs were generally recommended for all sites of OA, but strength of recommendations (conditional/weak versus strong) varied among guidelines, primarily reflecting concerns about adverse effects.
Consider adding proton pump inhibitor or misoprostol in patients at risk for upper gastrointestinal events who require treatment with NSAIDs or COX-2 inhibitors.

DOI: 10.1016/j.rdc.2022.03.009. View source ↗

What Is the Treatment of Hand Osteoarthritis?

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