The hand is the most complex region of the upper limb in its structure. It consists of many bones, closely grouped together. Bones are connected through 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, the hands are injured much more often than any other part of the body. Various injuries represent, according to different sources, from 30 to 50% of the total injuries of the musculoskeletal system and do not tend to decrease.
Therefore, of all the causes of pain in the fingers, the main one is trauma. Second in terms of prevalence are connective tissue diseases - rheumatoid arthritis, systemic scleroderma and lupus erythematosus, psoriasis. Much less often, pain in the joints of the fingers is due to a violation of metabolic processes in gout, osteoarthritis.
Symptoms
Signs of non-traumatic injuries that may indicate the presence of joint pathology are as follows:
- pain syndrome, which is permanent or rippling;
- pain when pressing and bending the fingers;
- swelling and redness of the skin over the joints;
- stiffness, stiffness during movements;
- deterioration of fine motor skills;
- creaking, creaking and popping during finger flexion;
- the formation of subcutaneous nodules, painless to the touch;
- thickening of the skin in the folds;
- change in joint configuration;
- increase in body temperature.
Rheumatoid arthritis
Arthritis of rheumatoid origin most often affects the fingers and simultaneously in the right and left hands. This systemic disease is characterized by a malfunction of the immune system, in which T lymphocytes begin to attack their own cells. The synovial membrane cells that line the joint capsule from the inside actively produce rheumatoid factors: pathological antibodies are protective protein molecules.
Then the rheumatoid factors enter the bloodstream and bind to normal antibodies. As a result, immune complexes are formed that settle in blood vessels and tissues. They are taken up by immune system cells - neutrophils and phagocytes, releasing substances that damage surrounding structures.
It is known that this is how inflammation develops in rheumatoid arthritis. However, scientists have not been able to determine the cause of this process. According to the latest research in this area, the culprits of connective tissue damage are cytokines - immune signaling cells. Japanese experts have come to the conclusion that the study of this type of cell will help to find an effective method of treatment.
With rheumatoid arthritis, any finger can hurt - index, middle, ring or pinky, but the injury will always be bilateral. If one or more fingers on the left hand becomes sick, the same fingers on the right hand will start to hurt almost immediately.
The phalanges in the joint area swell and redden, due to the accumulation of fluid, they do not bend well, especially in the morning. Morning stiffness can last up to 1 hour. Over time, the progression of arthritis leads to the replacement of smooth cartilaginous tissue with a fibrous structure, which disrupts the free movement of bones in the joint.
Gradually, the joints are deformed, due to a change in the position of the joint elements, the pain intensifies. With a long course of the disease, small painless formations appear near the joints on the back of the hand - rheumatoid nodules.
psoriatic arthritis
The symptoms of this disease can resemble rheumatoid arthritis and occur against the background of a dermatological pathology - psoriasis. In the vast majority of cases, the rash appears first, and after a while, the finger joints hurt.
Simultaneous manifestation of skin and joint lesions is also possible; in 20 out of 100 patients, the joints start to hurt earlier. Why psoriasis occurs is unknown. Presumably, it can be brought on by a genetic predisposition, a malfunction of the immune system and infections. The average age of patients is 40 years.
Psoriatic arthritis can begin, like rheumatoid arthritis, with general weakness and malaise, or it can manifest with unexpectedly sharp pain sensations. Not only the fingers can be affected, but also small joints in the feet, knees and shoulders. Involvement in the pathological process can be unilateral and symmetrical.
The pain syndrome is more pronounced at night and at rest. In the morning there is stiffness, during the day and with the movements the pain decreases. Most often, there is an injury on one side - on the left or on the right, and, as a rule, it hurts not one, but 2-4 joints (oligoarthritis).
After a long rest, the fingers become very swollen and become sausage-like, the tendons of the flexor muscles become inflamed, the skin over the joints takes on a bluish-purple hue. The following symptoms indicate the presence of psoriasis and psoriatic arthritis:
- red or pink scaly patches on the head, elbows, knees and thighs - may be single or cover a large area of skin;
- characteristic bumps on the skin of the hands, similar to smallpox, pigmentation on the fingers or toes;
- psoriatic plaques are hyperemic, edematous, and may itch;
- joint pain is permanent and does not go away during the day;
- hand mobility and functionality are significantly reduced.
The arthropathic form of psoriasis is one of the most serious. Usually, deformation of the joints is not observed, but if this occurs, fusion of the articular surfaces of the bones (ankylosis) is not excluded.
The danger of this disease is that the large joints and the spine are gradually involved in the pathological process. Bone osteoporosis develops, joints are destroyed, so psoriatic arthritis often leads to disability.
osteoarthritis
With osteoarthritis, the process of formation of the cartilaginous tissue that covers the articular surfaces of the bones is interrupted. This is facilitated by external and internal factors - injuries, high physical activity, hereditary predisposition and metabolic disorders.
Depending on the cause, osteoarthritis can be primary or secondary, developing in the context of an endocrine or metabolic disease. Most often, osteoarthritis affects the large joints of the lower extremities - the knee, hip and ankle - because they bear the main load when walking and standing. The upper extremities are affected much less often.
When the fingers hurt due to prolonged physical exertion and after rest the pain disappears, the development of osteoarthritis is not excluded.
Over time, other symptoms appear:
- increased pain when making a fist or stretching the fingers;
- an increase in the size of the diseased joint;
- stiffness in the morning, requiring "development" of the fingers for 10-15 minutes or more;
- characteristic crackling when bending the fingers.
Osteoarthritis develops slowly and may not cause much concern for several years or even decades. However, in some cases, there is a rapid increase in symptoms and a marked deterioration of the condition. If at first the pain occurs only during exertion, then it does not disappear even after resting.
Due to the marginal growths of the bones that form the joints, characteristic pineal formations appear. Closer to the palm, at the proximal joints of the phalanges, Bouchard's nodes are formed. Close to the distal interphalangeal joints, located close to the nails, are the nodes of Heberden.
stenosing ligamentitis
Stenosing ligamentitis affects the ligament-tendon apparatus of the hand and is manifested by the locking of one of the fingers in the flexion or extension position. The pathological process is caused by overload or excessive pressure in the area of the ligament, so the disease occurs among people engaged in manual work - bricklayers, welders, seamstresses and kitchen workers. In children, stenosing ligamentitis is extremely rare and affects only the thumb.
The main symptom of the disease is the "jump" of the finger during extension, accompanied by a click. In the future, the "snap" disappears and the finger remains immobile, changing into flexion or extensor contracture.
In the early stages, there is pain when pressing the palm to the base of the finger and difficulty in flexion/extension, especially pronounced in the morning. With a long course of ligamentitis, you can move the finger only with the help of the other hand, and after "cracking" there is pain that spreads not only to the palm, but also to the forearm.
Which doctor to contact
For finger pain, you can first contact a therapist who, if necessary, will refer you to a narrow specialist - traumatologist, rheumatologist, hematologist, neurologist or surgeon. Clinical, radiological and laboratory research methods are used for diagnosis.
To find out the cause of the pain, a delivery (history) and a physical examination are performed, after which an x-ray or CT scan, blood and urine tests are prescribed.
Treatment
How to be treated and what to do next will depend on the test results. Task number 1 is to relieve pain and inflammation: for this, drugs from the NSAID group - non-steroidal anti-inflammatory drugs are prescribed. Currently, increasingly used means of a new generation, selective action NSAIDs.
Selective NSAIDs act selectively and have less toxic effects on the body and can be taken for a long time. If the pain syndrome is moderate or mild, topical agents are used - anti-inflammatory ointments and gels.
The treatment of rheumatoid arthritis includes basic and biological products, steroid hormones. These drugs suppress the immune system, thus reducing the intensity of the inflammatory process.
The same immunosuppressive drugs are prescribed if the joints ache on the background of psoriatic arthritis. Methods such as plasmapheresis, hemosorption, and photochemotherapy are used to reduce disease activity, prolong remission periods, and shorten the duration of drug therapy.
How to treat osteoarthritis of the joints depends on the stage of the disease. In stages 1-2, it is possible to significantly delay cartilage destruction by taking chondroprotectors. Physiotherapy is effective, which enhances the effect of medications and stimulates recovery processes.
For the treatment of osteoarthritis can be prescribed:
- magnetotherapy;
- electrophoresis;
- laser;
- ultrasound;
- cryotherapy - exposure to joints with liquid nitrogen;
- balneotherapy - baths with mineral water;
- hirudotherapy - during treatment with leeches, substances that promote cartilage regeneration (hirudin, vitamins and hormones) enter the joint.
Therapeutic tactics for stenosing ligamentitis are determined taking into account the stage, the presence of provoking factors and the age of the patient. If the damage to the ligaments is minimal, it is recommended to reduce the load on the hand, if necessary, the hand is fixed with an orthosis or splint. For pain, anti-inflammatory drugs and electrophoresis with hyaluronidase are prescribed.
Second stage treatment begins with conservative methods. Lack of effect for several months is an indication of surgery to cut the damaged ligament. In patients with the third stage, conservative therapy is performed extremely rarely, in most cases surgery is performed as planned.
Reference: Due to the high risk of recurrence, it is very important to change professions if it involves a load on the hands.
Folk remedies
Means prepared according to folk recipes cannot be the main method of treatment, as they are not sufficiently effective. However, as an additional therapy, these medications will help relieve pain and increase the effect of the medications.
Mix some bay leaves with juniper needles, add a little butter and massage your hands with the resulting ointment.
In the evening, you can make a compress of crushed chalk, kefir, boiled fermented milk or cooked oatmeal.
For compresses, green potatoes are used, which must be chopped directly into the skin in a meat grinder or on a grater. Then soak the potato porridge in hot water and heat to 39-40 °. After that, put it in a linen bag and apply it to the painful joints for half an hour. The procedure can be done several times a day.
Paraffin applications relieve pain well if you place your hands in melted paraffin for 10 minutes and then hold them in any herbal decoction for 15-20 minutes. You can not be afraid of burns, as paraffin melts at a temperature of not more than 65 °. To achieve the effect, 2-3 applications per week are sufficient.
Compresses with Bischofite help accelerate tissue healing. Due to its composition, this natural mineral relieves pain and inflammation, restores joint mobility. Regular use of Bishofit maintains muscle and connective tissue tone.
It is recommended to make a compress with Bischofite as follows: heat the joints with a heating pad or keep them in a warm bath, then rub Bischofite, previously diluted in water 1: 1, on the skin of the hands. The rubbing should continue for several minutes, after which a cloth or gauze soaked in the solution is applied to the sore spot. From above, the compress is covered with polyethylene and insulated. Compresses with Bischofite are made at night, in the morning the hands are washed well with warm water. The procedure is performed every other day for three weeks.
Reference: a compress with Bischofite can be placed simultaneously in no more than three joints.
The most important
To prevent or reduce the intensity of the pain that has already appeared, it is necessary to keep the brushes warm and not expose them to hypothermia. Work that requires the same type of movement is best done intermittently, and when using vibrating tools, wear gloves and support the work brush with the other hand. When lifting and carrying heavy loads, the weight of the load must be evenly distributed on both limbs. You can also keep your joints healthy with the help of proper nutrition, which should contain foods that contain calcium and omega-3 fatty acids.