Highlights
- •Patients with TMO can experience moderate to severe pain, disability, disturbed emotional well-being, limited quality of life, and reduced work productivity.
- •Pain frequency and magnitude of disability accounted for 59.0% of the variance in TMO pain intensity while sex, pain intensity, depression, and education explained 60.1% of the variance in magnitude of disability.
- •The greater the intensity of the pain and the magnitude of the disability, the more the hand therapist should be attentive to depressive symptoms (eg, feelings of worry or despair).
- •Education in ergonomic principles and assistive devices are provided to only a small proportion of the participants (20%); since the efficacy of these interventions has been soundly demonstrated, they should be more broadly offered.
- •Since pain experience is unique to each individual, patients with TMO should benefit from interventions most suited to their specific needs from a biopsychosocial perspective.
Abstract
Background
Trapeziometacarpal osteoarthritis (TMO) is one of the most prevalent and painful forms
of hand osteoarthritis.
Purpose
This study aimed at (1) describing the TMO pain experience, (2) identifying biopsychosocial
factors associated with pain intensity and disability, and 3) documenting the use
of non-surgical management modalities.
Study Design
Cross-sectional.
Methods
Participants who presented for care for TMO were recruited from 15 healthcare institutions.
They completed a questionnaire addressing sociodemographic, pain, disability, psychological
well-being, quality of life (QoL), productivity, and treatment modalities employed.
Multivariable regression analyses identified biopsychosocial factors associated with
pain intensity and magnitude of disability.
Results
Among our 228 participants aged 62.6 years, 78.1% were women. More than 80% of the
participants reported average pain of moderate to severe intensity in the last 7 days.
Nearly 30 % of them scored clinically significant levels of anxiodepressive symptoms.
The participants’ norm-based physical QoL score on the SF-12v2 was 41/100. Among the
79 employed respondents, 13 reported having missed complete or part of workdays in
the previous month and 18 reported being at risk of losing their job due to TMO. Factors
independently associated with more intense pain included higher pain frequency and
greater disability, accounting for 59.0% of the variance. The mean DASH score was
46.1 of 100, and the factors associated with greater magnitude of disability were
higher pain intensity, greater levels of depression, female sex, and lower level of
education, explaining 60.1% of the variance. Acetaminophen, oral non-steroid anti-inflammatory
drugs, cortisone injections, orthoses, hand massage/exercises, and heat/cold application
were the most frequently employed modalities. Most participants never used assistive
devices, ergonomic techniques, and psychosocial services.
Conclusions
Patients with TMO can experience severe pain, disability, disturbed emotional well-being,
limited QoL and reduced productivity. As disability is associated with TMO pain, and
depressive symptoms with disability, reducing such modifiable factors should be one
of the clinicians’ priorities.
Keywords
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Article info
Publication history
Published online: March 12, 2023
Accepted:
October 9,
2022
Received in revised form:
October 6,
2022
Received:
June 30,
2021
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: All named authors hereby declare that they have no conflicts of interest to disclose.
Identification
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