Non-Surgical Care for Hand, Thumb Base and Wrist Osteoarthritis: A Systematic Review and a Randomized Exercise Trial

Physical therapists and physical therapist assistants who see adults with painful hands, thumb bases and wrists, along with occupational and hand therapists who share these caseloads. Physical therapist assistants work under the direction of the supervising physical therapist; evaluation, diagnosis and plan-of-care decisions remain with the therapist.

Physical therapists, physical therapist assistants, occupational therapists and hand therapists in outpatient orthopaedic, rheumatology and hand surgery settings.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Kjeken I, Bordvik DH, Osteras N, Haugen IK, Aasness Fjeldstad K, Skaalvik I, Kloppenburg M, Kroon FPB, Tveter AT, Smedslund G. Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review. RMD Open. 2025;11(1). doi:10.1136/rmdopen-2024-004963

Larsson SL, Ekstrand E, Dahlin LB, Björkman A, Brogren E. Long-term effects of neuromuscular exercise therapy and the need for surgical conversion in wrist osteoarthritis: 24-month results from a randomized controlled trial. BMC Musculoskelet Disord. 2025;27(1):76. doi:10.1186/s12891-025-09463-5

After completing this course, you will be able to:

1. Describe what the 2024 hand osteoarthritis systematic review reported for hand exercises, thumb orthoses and assistive devices, and how certain its authors judged that evidence to be.
2. State what the wrist osteoarthritis randomized trial found when neuromuscular exercise therapy was compared with range-of-motion exercise, and what it reported about participants going on to surgery.
3. Distinguish what these two papers support about non-surgical care from what neither of them settles about whether exercise therapy changes the surgical road ahead.

1. Start Here: How This Course Works
2. Part One: Hand and Thumb Base Osteoarthritis Across Non-Drug, Drug and Surgical Care
3. Who the Hand Osteoarthritis Review Covered and Why It Was Updated
4. How the Trials Were Searched, Pooled and Graded
5. What the Pooling Showed for Non-Drug, Drug and Surgical Treatments
6. What the Review Authors Concluded About Hand Osteoarthritis Care
7. Part Two: Neuromuscular Exercise Therapy for Wrist Osteoarthritis to Two Years
8. Who Took Part in the Wrist Osteoarthritis Trial
9. How the Two Exercise Programmes Were Delivered and Measured
10. Results at Six and Twelve Months, and Surgery by Twenty-Four Months
11. What the Trial Authors Concluded and What Weakened the Comparison
12. Bringing It Together
13. Where the Two Papers Agree on First-Line Care
14. Where They Diverge and Which Paper Found What
15. What a Therapist Can Honestly Tell a Patient About Surgery
16. What Neither Paper Settles
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Kjeken I, Bordvik DH, Osteras N, Haugen IK, Aasness Fjeldstad K, Skaalvik I, Kloppenburg M, Kroon FPB, Tveter AT, Smedslund G. Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review. RMD Open. 2025;11(1). doi:10.1136/rmdopen-2024-004963
2. Larsson SL, Ekstrand E, Dahlin LB, Björkman A, Brogren E. Long-term effects of neuromuscular exercise therapy and the need for surgical conversion in wrist osteoarthritis: 24-month results from a randomized controlled trial. BMC Musculoskelet Disord. 2025;27(1):76. doi:10.1186/s12891-025-09463-5