The sample size calculations are based on the estimated mean hand pain score of 2.9 (SD 1.6; scale of 0-10) (based on values collected from subjects in the preliminary studies). For type I error of 5%, the investigators would need a total of 82 subjects (41 each group) to have 80% power to detect a mean pain score change difference of 1.0 (33% difference in pain score change). Covariates in the final model will increase the required sample size. To account for covariates and dropouts the investigators will recruit a total of 120 subjects.