Hand-Grip Dynamometer

Philipp Klemm et al. (2026) · European journal of physical and rehabilitation medicine

This randomized, double-blind, sham-controlled trial of 38 analyzed adults in Bad Nauheim, Germany, explored whether mineral water baths for the hands ease pain from hand osteoarthritis (HOA). HOA is wear-and-tear damage in the finger and thumb joints that causes pain, stiffness and reduced grip. Balneotherapy, the treatment of conditions with natural mineral waters, is well known for knee osteoarthritis, but evidence for hand osteoarthritis was thin. The tested water was natural thermal brine, a salty spring water (sodium chloride and hydrogen carbonate, rich in carbon dioxide), used at its natural 25 degrees C. Participants averaged 72 years, 86% were women, and all had painful, X-ray-confirmed HOA. One group soaked both hands in thermal brine and the other in ordinary tap water at the same temperature, in identical covered bowls so neither participants nor staff knew which was which. Each bath lasted 15 minutes, with six baths over three weeks. Pain was rated on a 100 mm visual analog scale (VAS, 0 meaning no pain), alongside hand function questionnaires, grip strength, skin blood flow and a blood marker (VEGF). After six baths, pain averaged 7 mm with thermal brine versus 33 mm with tap water, a 26.4 mm gap (P < 0.0001) larger than the 20 mm threshold for a clinically meaningful change. The gap was already present after the first bath (5.3 mm, P = 0.0017) and was still about 26 to 27 mm at 4 and 12 weeks. Pain on the hand index (AUSCAN pain subscore) was also lower (5.86 points, P < 0.0001), though that difference was gone at follow-up. Stiffness, function, grip strength, skin blood flow and VEGF did not differ between groups. Satisfaction favored thermal brine: 72% (13 of 18) rated pain relief good or very good versus 32% (6 of 19) with tap water. No adverse events occurred. The trial was small, ran at one center during the COVID-19 pandemic, and lost 12 of 50 participants, so only 38 were analyzed. Tap water may also have effects of its own. Because blood flow and VEGF showed no change, how the baths relieve pain remains unexplained; the authors note that 25 degrees C is below the 32 to 35 degrees C range where carbon dioxide baths are expected to widen blood vessels. They propose thermal brine baths as a non-pharmacological adjunct and call for larger multicenter trials with longer treatment and optimized temperatures.

Salma Bouqartacha et al. (2026) · Chiropractic & manual therapies

This randomized mechanistic cross-over trial with 89 adults explored how two hands-on neck treatments differ right after they are delivered. Chronic neck pain, defined here as pain lasting at least 12 weeks, is one of the leading causes of disability worldwide. Spinal manipulation (SM) is a single quick, shallow thrust applied to a joint, and spinal mobilization (Smob) is a slower, repeated rocking pressure on the same area. Both are recommended in clinical guidelines, but they are often lumped together, so little was known about how their effects on pain, movement and muscle activity compare. Participants were aged 18 to 65, with an average of 35 years, and 65% were women. They were recruited in Zurich, Switzerland, and Trois-Rivieres, Canada. Each person attended two sessions three days apart, receiving SM in one and Smob in the other in random order. SM was one thrust to the most painful neck joint while lying face up, and Smob was 30 seconds of repeated pressure on the same level while lying face down. Pain was rated from 0 to 10, and neck movement, tenderness to pressure, grip strength and muscle electrical activity were measured before and after. Pain dropped by 0.79 points after SM and 0.37 points after Smob, a gap of 0.41 points (p = 0.002), which stayed below the 1.3 points considered clinically meaningful. Neck movement improved after both treatments, by about 4.6 degrees after SM and 3.7 degrees after Smob in bending forward and back, with no difference between them. Neck muscles responded more strongly during SM, with activity in the sternocleidomastoid about six times higher (0.144 versus 0.023). Tenderness and grip strength changed inconsistently, and the grip decrease of 1.13 kg was far under the 6 kg detectable change. Participants' own global impression of change favored SM (p < 0.001) but also stayed below the clinical threshold. Upper trapezius activity was likewise higher during SM (0.083 versus 0.024). No serious adverse events were reported. The authors state that statistically significant differences did not reach clinical significance, so the trial cannot support conclusions about which treatment works better in practice. Only immediate effects after one session were measured, many outcomes were tested, participants could tell the treatments apart, and baseline disability was mostly mild to moderate. Clinician training also differed between sites. The authors propose that future trials examine several sessions of each treatment, since a multi-session or combined approach may reach clinical relevance.