and Meeting of the French Society For Hand Therapists (GEMMSOR)
Rheumatoïd arthritis : medical, social and organisational aspects of treatment (excluding surgery and drugs)
Treatment for the hand and the wrist
CELERIER Sylvain (Nancy) ANDRE-VERT Joelle (Saint Denis La Plaine) GUILLEZ Pascal (Berck-Sur-Mer) MAYOUX-BENHAMOU Marie Anne (Paris)
Dec 18, 2009 - Paris (France)
"Dynamic and aerobic physical activities are recommended (grade B). Therapeutic patient education is recommanded (Grade B).
Splints for the hand and the wrist :
The wearing of splints is recommended for analgesic, functional or corrective purposes after clinical assessment for the following inidcations :
- temporary immobilisation of very inflamed joints (during rest periods)
- stabilisation of destroyed joints (during activities)
- correction of deformities that can be reduced.
Customized splints are generaly better adapted than off-the-shelf splints (profesionel agreement).
Rest splints should be prescribed for the flare-ups involving local inflammation of the hands (Grade C).
Functional splints should be prescribed to facilitate the conduct of daily activities (Professional agreement).
Corrective splints should be prescribed to correct deformities that may be reduced (Pofessional agreement).
Specific programs for joint protection :
Every patient with RA should benefit from an educational program on joint protection that is adapted to the disease, patient and environment (Grade B).
Therapeutic exercises for the hands :
every patient whose hands are affected by rheumatism should do regular exercises for the hands (Grade C). The exercises are taught by a health professional and then carried out by the patients on their own (Professional agreement).
Physical agents for the hands :
Physical agents should not be used on their own. They may be used as an adjuvant to physiotherapy or to symptomatic treatment with analgesics after assessment with the patient of the 'excepted benefits versus constraints' ratio (Professional agreement). "
Rheumatoïd arthritis : medical, social and organisational aspects of treatments - Guidlines
Haute Autorité de Santé - Paris (France), March 2007