Therapy target
- Relief of symptoms
Therapy recommendations
- For non-active finger and thumb joint arthrosis and rhizarthrosis: analgesic paracetamol (best tolerated).
- In activated finger and thumb joint arthrosis as well as rhizarthrosis: non-steroidal anti-inflammatory drugs (NSAIDs), e.g. selective COX-2 inhibitors (e.g. etoricoxib)or diclofenac [no long-term therapy!]Note: No diclofenac in cardiovascular risk! Affected are patients with heart failure (cardiac insufficiency) of NYHA classes II to IV, coronary artery disease (CAD, coronary artery disease), peripheral arterial occlusive disease (PAVD) or cerebrovascular disease.
- If necessary, glucocorticoids (eg, prednisolone 10 mg daily for 6 weeks); the effect of intra-articular injection is not ensured, but may be administered if inflammation can not be controlled otherwise.
- Notice: In randomized controlled trials, intraarticular injections did not significantly improve grip strength or pain levels over the long term.
General notes
- Intravenous administration does not confer any advantages over oral administration.
- Continuous therapy should not be used.
- Different NSAIDs should not be combined!
- Alternative therapy for high cardiovascular/gastrointestinal risk → conventional NSAIDs + low-dose acetylsalicylic acid (ASA) + proton pump inhibitors (PPI) (recommendation of the Drug Commission of the German Medical Association).
