Combined treatment with paraffin, manual therapy, pegboard and splinting in a patient with post-traumatic stiff hand.

This was one patient, so it cannot show what would happen in most people with a stiff hand. The patient received paraffin, manual therapy, pegboard, splinting, swelling control, elevation, gentle active movement and later home exercises at the same time, so the effect of any one part cannot be separated. There was no control group, no randomization and no blinding. The diagnosis of complex regional pain syndrome was considered likely but not definitely established. Force assessment was not performed at baseline because range of motion was too restricted. The authors note that paraffin is generally contraindicated with edema or acute inflammatory signs, and they do not recommend routine use of this combination. The treatment was intensive and costly, and the authors say cost may limit replication.

Do not conclude that paraffin, manual therapy, pegboard or splinting works for stiff hand. This was a single case in which all of these were given together, with no control group, so the contribution of any one component cannot be separated.