title: Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: A systematic review and meta-analysis.
abstract: METHODS
  Systematic review with meta-analysis.
  
  
  BACKGROUND
  Although corticosteroid injections are often cited as best practice in the treatment of de Quervain's disease, no reviews have compared their effectiveness to a multimodal definition of hand therapy.
  
  
  OBJECTIVE
  To compare the effectiveness of corticosteroid injections with that of i) hand therapy alone and ii) combined hand therapy/corticosteroid injection approaches in the treatment of de Quervain's disease.
  
  
  METHODS
  Searches of key databases were performed to identify experimental studies published between January 1950 and November 2014. Outcome measures included treatment success, pain, quality of life, and function.
  
  
  RESULTS
  Both corticosteroid injections and hand therapy improved pain and function from baseline, but between-group differences were not significant (across 6 studies). However, significantly more participants were treated successfully when combined orthosis/corticosteroid injection approaches were compared to i) orthoses (RR 0.53, 95% CI 0.35-0.80) and ii) injections alone (RR 0.76, 95% CI 0.64-0.89).
  
  
  CONCLUSIONS
  Combined orthosis/corticosteroid injection approaches are more effective than either intervention alone in the treatment of de Quervain's disease.
  
  
  METHODS
  1a.
authors.affiliation: Western Sydney University, Brain Rehabilitation and Neuroplasticity Unit, School of Science and Health, NSW 2560, Australia.
authors.forename: Rocco
authors.initials: R
authors.lastname: Cavaleri
authors.affiliation: Western Sydney University, Brain Rehabilitation and Neuroplasticity Unit, School of Science and Health, NSW 2560, Australia.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Schabrun
authors.affiliation: Western Sydney University, Brain Rehabilitation and Neuroplasticity Unit, School of Science and Health, NSW 2560, Australia.
authors.forename: Maxine
authors.initials: M
authors.lastname: Te
authors.affiliation: Western Sydney University, Brain Rehabilitation and Neuroplasticity Unit, School of Science and Health, NSW 2560, Australia. Electronic address: L.Chipchase@westernsydney.edu.au.
authors.forename: Lucy S
authors.initials: LS
authors.lastname: Chipchase
mesh_terms: D003131:Combined Modality Therapy; D053684:De Quervain Disease / Q000628:therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D009989:Orthotic Devices; D026741:Physical Therapy Modalities
chemical_list: D005938:Glucocorticoids
keywords: Conservative; Corticosteroid; De Quervain's; Hand therapy; Injection