Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: a systematic review and meta-analysis

Rocco Cavaleri; Siobhan M Schabrun; Maxine Te; Lucy S Chipchase

doi:10.1016/j.jht.2015.10.004

Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: a systematic review and meta-analysis

Rocco Cavaleri, Siobhan M Schabrun, Maxine Te, Lucy S Chipchase

Research output: Contribution to journal › Article › peer-review

34 Citations (Scopus)

Abstract

STUDY DESIGN: Systematic review with meta-analysis.

INTRODUCTION: Although corticosteroid injections are often cited as best practice in the treatment of de Quervain's disease, no reviews have compared their effectiveness to a multimodal definition of hand therapy.

PURPOSE: To compare the effectiveness of corticosteroid injections with that of i) hand therapy alone and ii) combined hand therapy/corticosteroid injection approaches in the treatment of de Quervain's disease.

METHODS: Searches of key databases were performed to identify experimental studies published between January 1950 and November 2014. Outcome measures included treatment success, pain, quality of life, and function.

RESULTS: Both corticosteroid injections and hand therapy improved pain and function from baseline, but between-group differences were not significant (across 6 studies). However, significantly more participants were treated successfully when combined orthosis/corticosteroid injection approaches were compared to i) orthoses (RR 0.53, 95% CI 0.35-0.80) and ii) injections alone (RR 0.76, 95% CI 0.64-0.89).

CONCLUSION: Combined orthosis/corticosteroid injection approaches are more effective than either intervention alone in the treatment of de Quervain's disease.

LEVEL OF EVIDENCE: 1a.

Original language	English
Pages (from-to)	3-11
Number of pages	9
Journal	Journal of Hand Therapy
Volume	29
Issue number	1
DOIs	https://doi.org/10.1016/j.jht.2015.10.004
Publication status	Published - Jan 2016
Externally published	Yes

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10.1016/j.jht.2015.10.004

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title = "Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: a systematic review and meta-analysis",

abstract = "STUDY DESIGN: Systematic review with meta-analysis.INTRODUCTION: Although corticosteroid injections are often cited as best practice in the treatment of de Quervain's disease, no reviews have compared their effectiveness to a multimodal definition of hand therapy.PURPOSE: To compare the effectiveness of corticosteroid injections with that of i) hand therapy alone and ii) combined hand therapy/corticosteroid injection approaches in the treatment of de Quervain's disease.METHODS: Searches of key databases were performed to identify experimental studies published between January 1950 and November 2014. Outcome measures included treatment success, pain, quality of life, and function.RESULTS: Both corticosteroid injections and hand therapy improved pain and function from baseline, but between-group differences were not significant (across 6 studies). However, significantly more participants were treated successfully when combined orthosis/corticosteroid injection approaches were compared to i) orthoses (RR 0.53, 95% CI 0.35-0.80) and ii) injections alone (RR 0.76, 95% CI 0.64-0.89).CONCLUSION: Combined orthosis/corticosteroid injection approaches are more effective than either intervention alone in the treatment of de Quervain's disease.LEVEL OF EVIDENCE: 1a.",

keywords = "Combined Modality Therapy, De Quervain Disease, Glucocorticoids, Humans, Injections, Orthotic Devices, Physical Therapy Modalities, Journal Article, Meta-Analysis, Review, Corticosteroid, Hand therapy, Injection, De Quervain's, Conservative",

author = "Rocco Cavaleri and Schabrun, {Siobhan M} and Maxine Te and Chipchase, {Lucy S}",

year = "2016",

month = jan,

doi = "10.1016/j.jht.2015.10.004",

language = "English",

volume = "29",

pages = "3--11",

journal = "Journal of Hand Therapy",

issn = "0894-1130",

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AU - Schabrun, Siobhan M

AU - Te, Maxine

AU - Chipchase, Lucy S

PY - 2016/1

Y1 - 2016/1

N2 - STUDY DESIGN: Systematic review with meta-analysis.INTRODUCTION: Although corticosteroid injections are often cited as best practice in the treatment of de Quervain's disease, no reviews have compared their effectiveness to a multimodal definition of hand therapy.PURPOSE: To compare the effectiveness of corticosteroid injections with that of i) hand therapy alone and ii) combined hand therapy/corticosteroid injection approaches in the treatment of de Quervain's disease.METHODS: Searches of key databases were performed to identify experimental studies published between January 1950 and November 2014. Outcome measures included treatment success, pain, quality of life, and function.RESULTS: Both corticosteroid injections and hand therapy improved pain and function from baseline, but between-group differences were not significant (across 6 studies). However, significantly more participants were treated successfully when combined orthosis/corticosteroid injection approaches were compared to i) orthoses (RR 0.53, 95% CI 0.35-0.80) and ii) injections alone (RR 0.76, 95% CI 0.64-0.89).CONCLUSION: Combined orthosis/corticosteroid injection approaches are more effective than either intervention alone in the treatment of de Quervain's disease.LEVEL OF EVIDENCE: 1a.

AB - STUDY DESIGN: Systematic review with meta-analysis.INTRODUCTION: Although corticosteroid injections are often cited as best practice in the treatment of de Quervain's disease, no reviews have compared their effectiveness to a multimodal definition of hand therapy.PURPOSE: To compare the effectiveness of corticosteroid injections with that of i) hand therapy alone and ii) combined hand therapy/corticosteroid injection approaches in the treatment of de Quervain's disease.METHODS: Searches of key databases were performed to identify experimental studies published between January 1950 and November 2014. Outcome measures included treatment success, pain, quality of life, and function.RESULTS: Both corticosteroid injections and hand therapy improved pain and function from baseline, but between-group differences were not significant (across 6 studies). However, significantly more participants were treated successfully when combined orthosis/corticosteroid injection approaches were compared to i) orthoses (RR 0.53, 95% CI 0.35-0.80) and ii) injections alone (RR 0.76, 95% CI 0.64-0.89).CONCLUSION: Combined orthosis/corticosteroid injection approaches are more effective than either intervention alone in the treatment of de Quervain's disease.LEVEL OF EVIDENCE: 1a.

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KW - Review

KW - Corticosteroid

KW - Hand therapy

KW - Injection

KW - De Quervain's

KW - Conservative

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Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: a systematic review and meta-analysis

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