Distal Interphalangeal Joint Osteoarthritis is the most common site of OA in hand. This condition develops over time and can cause Herberden’s nodes and deformity. This case is about a 48 year old female complaining of join pain that wakes her up at night at times. She has had radiographs and has seen her MD. OA of DIP has been diagnosed.
We tried our shockwave treatment on her for two session. She was pain free for a whole week, without any medications or other therapies.
We used 60 mJ, 10 Hz for 500 shots. The ROM of left fifth DIP prior to treatment was only 5 degrees of movement (25 degrees of flexion to 30 degrees). After treatment, 1.5 min, the range improved by 45 degrees (15 degrees to 60). Minor pain and discomfort was reported by patient during the treatment. No pain was reported immediately after treatment. This treatment was repeated one more time the week after.
To be more objective this patient was given Upper Extremity Functional Scale to rate before and after treatments. The following bolded scores are patient’s grading before the treatment, and bolded italic are the scores after treatment.
UPPER EXTREMITY FUNCTION SCALE
We are interested in knowing whether you are having any difficulty at all with the activities listed below because of your upper limb problem for which you are currently seeking attention. Please provide an answer for each activity.
Today, do you or would you have any difficulty at all with: (Circle one number on each line)
| ACTIVITIES | Extreme Difficulty or Unable to Perform | Quite a bit of Difficulty | Moderate Difficulty | A little bit of difficulty | No difficulty |
| a. Any of your usual, housework or school activities | 0 | 1 | 2 | 3 | 4 |
| b. Your usual hobbies, recreational or sporting activities | 0 | 1 | 2 | 3 | 4 |
| c. Lifting a bag of groceries to waist level | 0 | 1 | 2 | 3 | 4 |
| d. Lifting a bag of groceries above your head | 0 | 1 | 2 | 3 | 4 |
| e. Grooming your hair | 0 | 1 | 2 | 3 | 4 |
| f. Pushing up on your hands (e.g. from bathtub or chair) | 0 | 1 | 2 | 3 | 4 |
| g. Preparing food (e.g. peeling, cutting) | 0 | 1 | 2 | 3 | 4 |
| h. Driving | 0 | 1 | 2 | 3 | 4 |
| i. Vacuuming, sweeping, or raking | 0 | 1 | 2 | 3 | 4 |
| j. Dressing | 0 | 1 | 2 | 3 | 4 |
| k. Doing up buttons | 0 | 1 | 2 | 3 | 4 |
| l. Using tools or appliances | 0 | 1 | 2 | 3 | 4 |
| m. Opening doors | 0 | 1 | 2 | 3 | 4 |
| n. Cleaning | 0 | 1 | 2 | 3 | 4 |
| o. Tying or lacing shoes | 0 | 1 | 2 | 3 | 4 |
| p. Sleeping | 0 | 1 | 2 | 3 | 4 |
| q. Laundering clothes (e.g. washing, ironing, folding) | 0 | 1 | 2 | 3 | 4 |
| r. Opening a jar | 0 | 1 | 2 | 3 | 4 |
| s. Throwing a ball | 0 | 1 | 2 | 3 | 4 |
| t. Carrying a small suitcase with your affected limb | 0 | 1 | 2 | 3 | 4 |
Total Score before treatments : 26/80
Total Score after 2 treatments: 70/80
This indicates 55% improvement with total of 3 minutes of therapies.
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| Finger Arthritis | Base of Thumb Arthritis |