Persistent hand pain despite adequate immunosuppression? The distinct value of occupational therapy in the era of biologics.

Abstract

Despite the tremendous advancement in the use of biologics, many patients with inflammatory arthritis do not achieve remission, and the risk of joint damage remains high. A multidimensional approach to treatment is essential. Joint disease in the hands and wrists may prevent patients from performing daily and valued life activities. This review will discuss the role of occupational therapists in inflammatory arthritis, recent updates on joint protection and assistive devices, as well as highlighting adjunctive treatment options for rheumatologists to help patients manage their symptoms. This article describes the meaningful role of occupational therapy and assistive devices in improving the outcomes for patients with inflammatory arthritis. We describe orthoses, assistive devices and adjunctive therapies utilized in inflammatory arthritis. We provide evidence supporting joint protection and occupational therapy as ways to help with these diseases. A multidisciplinary approach including the entire healthcare provider team, including occupational therapists, is essential to providing individualized treatment focusing on maximizing mobility in each patient's daily routine. Although larger studies are needed, assessment by hand-certified occupational therapists for instruction in joint protection techniques, assistive devices and customized orthoses and devices are important adjuncts to pharmacologic management in inflammatory arthritis.