Western research could expand remote access to care for thumb arthritis

From news.westernu.ca

Professor Joy MacDermid leading project funded by Ignite Innovation Grant to provide more equitable care 

The burning, grinding pain of thumb arthritis disrupts daily life for one in four older adults in Canada. Thumb splints can reduce pain and improve hand function, and now, a Western University researcher in London, Ont. is working to bring custom 3D-printed splints to patients who can’t access specialist clinics.

Joy MacDermid, a physiotherapy professor in the Faculty of Health Sciences and a member of Western’s Bone and Joint Institute, received an Ignite Innovation Grant from the Arthritis Society of Canada to fund the second phase of her study. It will improve care for people with thumb arthritis, a condition that occurs when cartilage breaks down in the carpometacarpal joint at the base of the thumb, causing pain, stiffness and weakened grip.

“We see a lot of women over 50 with thumb arthritis, especially those doing physical work,” MacDermid said. “They struggle with daily activities like turning a key or caring for grandchildren.” 

The current standard of care requires a hand therapist to see the patient in person, assess their hand and mold a thermoplastic splint directly onto it. Though a proven process, it depends on physical proximity to a specialist clinic. MacDermid and her team are devising a new solution that doesn’t require in-person visits. 

Splints improve joint alignment in thumb arthritis

As co-director of the clinical research lab at Roth | McFarlane Hand & Upper Limb Centre (Roth | McFarlane) and a scientist at Lawson Research Institute (Lawson) of St. Joseph’s Health Care London, MacDermid leads researchers studying how to measure, predict and reduce upper extremity disability.    

Marjan Saeedi, a physical therapy PhD candidate, is part of the team at Roth | McFarlane. 

“Over time, the CMC joint becomes unstable and misaligned due to cartilage degeneration, affecting the ligaments and muscles as well. Because we use our thumbs constantly, the misalignment and pain worsens,” she said. “A splint helps support joint alignment. It’s even helpful following joint replacement surgery.”   

Western engineering professor and Lawson scientist Louis Ferreira led an earlier Mitacs-funded study with MacDermid and Belgian industry partner Orfit to develop a remote splint-making process using new materials and new 3D hand-scanning technology: an iPhone scanning app or a custom scanner developed in Ferreira’s bioengineering lab. Without the patient being present, the scans captured the precise measurements needed to fabricate 3D-printed custom splints.

MacDermid’s team also developed a clinical app to remotely assess a patient’s pain levels, hand function and splint requirements, replicating the intake process normally done in person. The prototypes made with the new process showed promise.  

“The question now is whether people can use the new methods in routine clinical practice,” MacDermid said. 

Implementing, testing the innovative thumb splint 

MacDermid is leading an Arthritis Society Ignite Grant evaluating how hand therapists use the new process and how patients respond to the 3D-printed splints compared to conventional ones. Her team hopes to scale up the new process by running workshops to train hand therapists at Roth | McFarlane and in community-based clinics across London, Ont. They’re also evaluating scanners that offer more precision than iPhone apps, without the cost of their custom device. 

Patient wearing (top) 3D-printed thumb splints and (bottom) traditionally fabricated splints. (Submitted)

In the trial of the 3D-printed solution, patients receive both a traditionally fabricated splint and a digitally produced one, wearing each for six weeks while researchers assess hand strength, pain levels and patient preference.

“Most were really eager to try the 3D-printed version,” said Saeedi. “The perforations from the printing process improve air circulation, and female patients liked its smaller size and the option to choose the colour, making it like an accessory on their hand.” 

Saeedi is writing her dissertation on what makes patients adhere to consistent use of their splints. Pain relief and comfort top the list, though she has also documented a motivator outside of its main clinical use. 

“Patients say, ‘I can wear it when my grandchildren are around or on public transit, without worrying about pain or further injury if it gets bumped or jostled’,” Saeedi said. “That sense of protection helps keep them using it.” 

Addressing access barriers in thumb arthritis treatment 

The remotely designed, 3D-printed splint is not intended to replace traditional care, but to remove barriers to accessing care.   

“Some of our clients are driving from Owen Sound or Sarnia or Windsor, in the middle of winter,” MacDermid said. “In the future, if their splint gets damaged or their hand changes, we would be able to reprint it from the pattern in our system and mail it to them – no return trip needed.” 

(L to R) Western PhD candidate Marjan Saeedi; Western postdoctoral student and co-principal investigator, Maryam Farzad; research co-ordinator at the Roth | McFarlane Hand and Upper Limb Centre, Katrina Munro; and principal investigator and Western physiotherapy professor Joy MacDermid are part of a research team that aims to make 3D-printed thumb splints accessible to patients no matter where they live. (Colleen MacDonald/Western News)

The Ignite Grant includes funding for MacDermid’s team to adapt their process to make splints for patients recovering from surgery or injections to treat Dupuytren’s contracture, a separate hand condition that causes fingers to permanently bend inward due to thickening and shortening of connective tissue in the palm.  

MacDermid attributes the project’s success from the beginning to contributions from many grad students and postdoctoral scholars across faculties, including those Ferreira supervised. 

“This project is genuinely interdisciplinary. We simply can’t do the clinical work without the engineering, and vice versa,” she said. 

MacDermid says the future of the project could reach communities with some clinical infrastructure but no hand specialist. Going further still, with the help of AI-assisted remote scanning, the process would enable people in remote locations like the Arctic, with no local clinical support at all, to access custom splints.  

For now, the project is already attracting interest from therapists in other provinces who want to attend the workshops. 

“That would be a substantial accomplishment to spread a working clinical process across Canada,” MacDermid said. “This technology could make a real difference for people who currently aren’t getting care at all due to distance, disability or the absence of specialist care.” 

https://news.westernu.ca/2026/06/western-research-3d-printed-splints-thumb-arthritis/

Study Finds Surprising Link Between Sleep & This Common Joint Issue

From mindbodygreen.com

By Zhané Slambee

Sleep rarely comes up in conversations about joint health. Most guidance focuses on weight management, exercise, and avoiding injury, and for good reason.

But a large new study suggests that what happens at night may matter more for your joints than previously understood.

Researchers analysed data from nearly 500,000 adults and found that short sleep, frequent insomnia, and night shift work were all independently linked to a higher risk of developing osteoarthritis (OA), a degenerative joint disease and needing joint replacement surgery. And many of those associations held even after accounting for body weight. 

                                                                          Image by Addictive Creatives / Stocksy

About the study

Osteoarthritis develops when the cartilage cushioning your joints breaks down over time. It's driven by a mix of factors: joint injury, metabolic changes, aging, and genetics. But researchers have been looking more closely at another possible contributor—disruptions to your body's internal clock, or circadian rhythm.

Cartilage goes through daily cycles of stress and recovery. During the day, it absorbs load and metabolic demand. At night, it recovers; rebuilding thickness and water content. 

The cells that make up cartilage (called chondrocytes, which is the only cell type found in cartilage) follow their own internal daily rhythm, which helps coordinate that repair process. In animal studies, disrupting the circadian clock led to cartilage breakdown similar to what's seen in OA. 

To see whether that pattern holds in people, researchers at Washington University used data from the UK Biobank, a large prospective study of approximately 500,000 adults in the United Kingdom recruited between 2006 and 2010. Participants (median age 58, 54% female) answered baseline questions about their sleep duration, how often they experienced trouble falling or staying asleep, and whether they worked shifts.

Researchers then tracked four outcomes over the following 8 to 13 years: knee OA, hip OA, total knee replacement, and total hip replacement.

Short sleep, insomnia, & night shifts all raised OA risk

People sleeping fewer than six hours a night had a 41% higher risk of knee OA and a 31% higher risk of needing a knee replacement compared with those sleeping seven hours. 

For the hip, the numbers were similar—39% higher risk of hip OA and 21% higher risk of hip replacement.

People who "usually" had trouble falling asleep or staying asleep had a 34% higher risk of knee OA and a 40% higher risk of knee replacement compared with those who "never or rarely" experienced those problems. 

Similar increases were seen for hip OA (30% higher risk) and hip replacement (24% higher risk).

Night shift workers, specifically those working through the hours of 12 a.m. to 6 a.m., had a 24% higher risk of knee OA and a 28% higher risk of knee replacement compared with people who didn't work shifts.

Night shift work was not significantly linked to hip OA or hip replacement, a pattern the researchers note is consistent with animal research: when the circadian clock gene BMAL1 (a key protein that helps regulate the body's internal clock) is knocked out in mice, cartilage in the knee breaks down, but not in the hip.

Why the associations held even after controlling for weight 

We've always thought that poor sleep raises OA risk mainly because it contributes to weight gain, which then puts more stress on your joints. But the data here tell a more complicated story.

After accounting for body weight, all of the associations weakened but didn't disappear. People sleeping fewer than six hours still had a 31% higher risk of knee OA and a 20% higher risk of knee replacement. Insomnia remained linked to all four endpoints. Night shift work remained linked to knee OA and knee replacement specifically.

The researchers also ran a separate analysis excluding anyone who already reported at least three months of knee or hip pain at the time of their sleep assessment. This was to rule out the possibility that people were sleeping poorly simply because they were already in pain.

The associations held there too.

Why knees may be especially vulnerable

Across all three sleep factors (duration, insomnia, and shift work) the signal was strongest and most consistent for the knee. The researchers offer a few explanations.

The knee may depend more heavily on a functioning circadian clock than the hip does, partly because of differences in how the two joints are structured and how hip OA tends to develop (often through issues like hip dysplasia or impingement).

Weight also plays a bigger role in knee OA than hip OA, and disrupted sleep likely influences the knee partly through that pathway.

One other pattern stood out: among night shift workers whose jobs rarely or never required heavy physical labour, the risk increases were even larger; 43% higher knee OA risk and 40% higher knee replacement risk.

The researchers suggest that circadian disruption may have the biggest impact on people who don't already have elevated OA risk from physical wear on the job.

Sleep habits worth building for your joint health long-term

Circadian rhythms and sleep can be improved through lifestyle changes and sleep hygiene. This points to new potential ways to reduce OA risk before joint pain ever develops. Here are strategies worth considering:

Keep a consistent sleep schedule: Seven hours appears to be the protective threshold in this data. Going to bed and waking at the same time every day helps anchor your body's internal clock.

Get morning light exposure: Light is one of the most powerful cues for setting your circadian rhythm. Getting outside in the first hour after waking helps your body clock stay on track.

Limit artificial light at night: Dimming screens and lights in the hours before bed supports your body's natural melatonin production and helps protect your sleep timing.

Address insomnia early: Frequent insomnia was linked to risk increases comparable to (and in some cases greater than) sleeping fewer than six hours.

If you work night shifts, minimize circadian disruption where you can: Changing your schedule may not be an option, but strategies like timed light exposure, strategic napping, and keeping a consistent routine on days off can help reduce the mismatch between your internal clock and your work hours.

The takeaway

This large prospective study found that sleeping fewer than six hours, experiencing frequent insomnia, and working night shifts were all linked to higher osteoarthritis risk (particularly at the knee) even after accounting for body weight.

The findings suggest that sleep quality and circadian health may be modifiable risk factors for OA, alongside the more commonly discussed pillars of exercise and weight management.

https://www.mindbodygreen.com/articles/poor-sleep-could-be-quietly-raising-your-osteoarthritis-risk-study-finds

How rheumatoid arthritis affects the whole body

From msn.com/en-us

Rheumatoid arthritis is an autoimmune disease that causes joint pain, stiffness, and swelling, often in a symmetrical pattern. Beyond the joints, it can damage cartilage, bone, muscles, tendons, and ligaments, and may lead to severe complications affecting the heart, lungs, skin, eyes, and other organs. Early diagnosis and treatment are critical to managing symptoms, preventing permanent damage, and reducing the risk of life-threatening conditions.

Morning Stiffness as a Hallmark of Rheumatoid Arthritis

                                                                                       ©Photo By BSIP/UIG Via Getty Images

In rheumatoid arthritis, joint stiffness is often most severe in the morning and can persist for over 60 minutes. This prolonged stiffness, especially when affecting the same joints on both sides of the body, helps distinguish RA from other forms of arthritis. Recognizing this symptom can aid in earlier diagnosis and treatment to prevent joint damage.

Rheumatoid Arthritis Often Causes Symmetrical Joint Pain

           ©Photo By BSIP/Universal Images Group via Getty ImagesIn rheumatoid arthritis, joint pain typically appears in the same joints on both sides of the body, such as both wrists, hands, or feet. This symmetrical pattern is a distinguishing feature that helps doctors differentiate RA from other types of arthritis. Recognizing this sign can lead to earlier diagnosis and treatment, which may help prevent long-term joint damage.
Joint Swelling Can Occur Before It Is Visible

©Photo By BSIP/UIG Via Getty ImagesIn rheumatoid arthritis, patients may feel swelling in joints such as the wrists and fingers before it can be seen by others. This early swelling can cause discomfort and interfere with tasks like fitting into shoes or performing fine motor activities. Recognizing these subtle symptoms can help prompt earlier evaluation and treatment.
Inflammation in RA Destroys Cartilage and Bone

©Photo By BSIP/Universal Images Group via Getty ImagesIn rheumatoid arthritis, the immune system’s persistent inflammation can damage the cartilage that cushions joints and erode the underlying bone. This process may cause deformities, joint fusion, and loss of mobility. Without early and aggressive treatment, such damage is often permanent.

Rheumatoid Arthritis Can Cause Foot Deformities

                                                                                            ©Photo by: BSIP/Universal Images Group via Getty Images

In advanced stages, rheumatoid arthritis can lead to visible foot deformities such as claw toes, hammer toes, and bunions. These changes result from joint damage, cartilage loss, and weakened tendons and ligaments. Such deformities may impair mobility and make walking or wearing certain shoes difficult.

Muscle Loss Can Develop Early in Rheumatoid Arthritis

                                                                                                                           ©Photo By BSIP/UIG Via Getty Images

Rheumatoid arthritis can lead to significant decreases in muscle mass and strength within the first year after onset. This muscle loss, identified in imaging studies, is a serious complication that requires both controlling the underlying inflammation and engaging in rehabilitation to regain strength. Early recognition and treatment are important to minimize long-term functional impairment.

Rheumatoid Arthritis Doubles Risk of Heart Attack and Stroke

                                                                                                                              ©Photo By BSIP/UIG Via Getty Images.

People with rheumatoid arthritis face roughly twice the risk of heart attack and stroke compared to those without the condition. This elevated risk is linked to systemic inflammation, which can damage blood vessels and contribute to cardiovascular disease. Long-term RA may further increase the likelihood of these serious events.

Heart Disease as a Major Risk for RA Patients

   ©Photo By BSIP/Universal Images Group via Getty Images

People with rheumatoid arthritis face a significantly higher risk of cardiovascular disease, including atherosclerosis, heart attack, and arrhythmias. Heart disease is the leading cause of death among RA patients, with the risk of heart attack and stroke roughly doubling compared to the general population. Long-term RA can increase this risk even further, making cardiovascular health a critical concern in RA management.

RA-Related Vasculitis Can Threaten Vital Organ Function

                                                                              ©Photo by: CAVALLINI JAMES/BSIP/Universal Images Group via Getty Images

In severe cases, rheumatoid arthritis can cause vasculitis, an inflammation of blood vessels that reduces blood flow. This condition may impair circulation to vital organs such as the heart, lungs, or kidneys, leading to potentially life-threatening complications. Prompt diagnosis and treatment are essential to limit damage and preserve organ function.

Rheumatoid Arthritis and Interstitial Lung Disease

                                                                                                                               ©Photo By BSIP/UIG Via Getty Images

Some people with rheumatoid arthritis develop interstitial lung disease, a condition that causes inflammation and scarring of lung tissue. This lung involvement can lead to progressive shortness of breath and reduced respiratory function. Early recognition and treatment of RA may help lower the risk of such complications.

Rheumatoid Lung as a Complication of RA

                                                            ©Photo By BSIP/Universal Images Group via Getty Images. Lung, X-Ray Result. 

Rheumatoid arthritis can affect organs as well as joints, and may lead to a condition known as rheumatoid lung. This lung involvement is one of several possible complications of the disease. Early treatment of rheumatoid arthritis can help prevent or delay such complications.

Rheumatoid Arthritis Can Cause Breathing Difficulties

                                                                                                       ©Photo By BSIP/UIG Via Getty Images

Rheumatoid arthritis can lead to lung complications such as interstitial lung disease. This condition damages lung tissue and may cause persistent shortness of breath, particularly during physical activity. Early diagnosis and treatment of RA can help reduce the risk of severe lung involvement.

Secondary Sjögren’s Syndrome in Rheumatoid Arthritis

                                                                        ©Photo by Orlando /Three Lions/Getty Images. circa 1950

People with rheumatoid arthritis can develop secondary Sjögren’s syndrome, an autoimmune condition that targets moisture-producing glands. This can lead to inflammation of the tear glands, resulting in chronic eye dryness. Symptoms are generally milder than in primary Sjögren’s syndrome but can still affect comfort and eye health.

https://www.msn.com/en-us/health/other/how-rheumatoid-arthritis-affects-the-whole-body/ss-AA25r65I

Tiny Walking Changes Could Slow Knee Arthritis Down

From huffingtonpost.co.uk

There's a possibility it could even help delay surgery, researchers suggest 

While arthritis flare-ups can make you feel the need to rest more, the Arthritis Foundation described movement as the “best medicine” for the condition.

Exercise strengthens the muscles around your joints, creating better support for your bones. Staying active also lubricates affected areas, making them less stiff.

And according to research published in the journal The Lancet Rheumatology, a simple walking change can “reduce excessive joint loading related to disease progression”.

In other words, the smallest of changes to a person’s foot position could help to stop knee arthritis from becoming worse.

How might your foot position help with arthritis?

In this study, the foot position of 68 participants with mild knee osteoarthritis (the most common form of arthritis) seemed to affect how much stress was placed on their joints.

After gait analysis, computer models were used to find their optimal foot position. Half of the people involved underwent training to adjust their feet to their best walking posture, while others were left to keep strolling as they were.

They found that walkers who got used to changing their foot angle to the optimised position saw slower degeneration of their knee cartilage (the shock-absorbing tissue in joints which tends to break down in those with arthritis) than those who didn’t.

Their pain score also went down 2.5 points, which was equivalent to the benefits seen from pain-relieving medication.

Participants who didn’t adjust their feet, meanwhile, only enjoyed a roughly one-point pain reduction.

And advanced MRI analysis showed that those who adjusted their feet according to the researchers’ guidelines experienced 4% less load on their knees while walking. Those who stayed the same saw a 3% increase in load.

More load, or stress, on arthritic knee joints can make the condition worse.

Researchers hope simple interventions like these could delay surgery

“Altogether, our findings suggest that helping patients find their best foot angle to reduce stress on their knees may offer an easy and fairly inexpensive way to address early-stage osteoarthritis,” said Dr Valentina Mazzoli, study co-author and assistant professor of radiology at the NYU Grossman School of Medicine.

“These results highlight the importance of personalising treatment instead of taking a one-size-fits-all approach to osteoarthritis.”

She added that the intervention could even help to put off invasive medical procedures, which are sometimes needed in severe arthritis cases, for longer.

“Although our results will have to be confirmed in future studies, they raise the possibility that the new, non-invasive treatment could help delay surgery,” she shared.

https://www.huffingtonpost.co.uk/entry/walking-changes-slow-knee-arthritis_uk_6a2923eee4b0a99062fa753f