Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 2. Drug and non-drug treatments

Abstract

The treatment of rheumatic diseases of juxta-articular soft tissues (RDJAST) of the upper extremity (rotator cuff tendinitis, epicondylitis, de Quervain’s syndrome, trigger finger, carpal tunnel syndrome) entails a combination of drug and nondrug therapies. The basic agents that have been proven to be efficacious in this pathology are nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticosteroids (GCs). The paper considers the largest and known studies that are an evidence base for the expediency of using agents, such NSAIDs, local administration of GCs, hyaluronic acid, and plateletrich plasma, as well as different non-drug treatments, in RDJAST. The latter (physiotherapy, exercises, and rehabilitation programs) should be regarded as a necessary component of the therapeutic process in patients with RDJAST-associated chronic pain. Preservation of obvious pain and impaired function despite medical therapy should be regarded as an indication for surgical treatment.

Keywords

• ревматическая патология околосуставных мягких тканей
• тендинит ротаторов плеча
• эпикондилит
• синдром де кервена
• «щелкающий палец»
• синдром запястного канала
• лечение
• нестероидные противовоспалительные препараты
• глюкокортикоиды
• гиалуроновая кислота