The hand is the most complex region of the upper extremity in its structure. It consists of many bones, grouped together. The bones are connected through 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, the hands are injured more often than any other part of the body. Various injuries account for, according to various sources, from 30 to 50% of the total number of injuries of the musculoskeletal system and are not likely to decrease.
Therefore, of all the causes of pain in the fingers on the hands, the main one is trauma. In second place 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 caused by a violation of metabolic processes in gout, osteoarthritis.
Symptom
Non-traumatic signs of injury that may indicate joint pathology include the following:
- pain syndrome, which is permanent or bumpy;
- pain when pressing and bending the finger;
- swelling and redness of the skin over the joint;
- stiffness, stiffness during movement;
- decreased fine motor skills;
- creaks, crunches and crunches during finger flexion;
- the formation of subcutaneous nodules, painless to the touch;
- thickening of the skin in the folds;
- connection configuration changes;
- increase in body temperature.
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 breakdown of the immune system, in which T lymphocytes start attacking their own cells. Synovial membrane cells lining the joint capsule from the inside actively produce rheumatoid factor: pathological antibodies are protective protein molecules.
Next, rheumatoid factor enters the bloodstream and binds to normal antibodies. As a result, immune complexes are formed that settle in blood vessels and tissues. They are absorbed by cells of the immune system - 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 cause of connective tissue damage is cytokines - immune cell signals. Japanese experts came to the conclusion that the study of this cell type will help find effective methods of treatment.
With rheumatoid arthritis, any finger can hurt - the index, middle, ring or little finger, but the lesions will always be bilateral. If one or more fingers on the left hand hurt, then the same finger on the right hand begins to hurt immediately.
The phalanges in the area of \u200b\u200bthe joints 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 development of arthritis leads to the replacement of smooth cartilage tissue with fibrous structures, which interferes with the free movement of bones in the joints.
Gradually, the joint deforms, due to a change in the position of the articular elements, the pain increases. With a long course of the disease, small painless formations appear near the joints on the backs of the hands - rheumatoid nodules.
Psoriatic arthritis
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 skin rash appears first, and after a while the finger joints hurt.
Simultaneous manifestations of skin and joint lesions are also possible; in 20 out of a hundred patients, the joints begin to hurt earlier. Why psoriasis occurs is not known. Presumably, it can be triggered by genetic predisposition, immune system malfunction and infection. The mean age of the patients was 40 years.
Psoriatic arthritis can begin, like rheumatoid arthritis, with general weakness and malaise, or it can manifest itself with an unexpectedly sharp pain sensation. Not only the fingers can be affected, but also the small joints of the feet, knees, and shoulders. Involvement in the pathological process can be unilateral and symmetrical.
The pain syndrome is most pronounced at night and at rest. In the morning there is stiffness, during the day and with movement the pain subsides. Most often, there is a lesion on one side - on the left or right, and, as a rule, it hurts not one, but 2-4 joints (oligo-arthritis).
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 becomes purple-bluish. The following symptoms indicate the presence of psoriasis and psoriatic arthritis:
- red or pink scaly spots on the head, elbows, knees and thighs - they can be single or cover most of the skin;
- characteristic pits on the skin of the hands, similar to smallpox, pigmentation of the fingers or toes;
- psoriatic plaques are hyperemic, edematous and possibly itchy;
- pain in the joints is permanent and does not go away during the day;
- significantly reduced hand mobility and functionality.
The arthropathic form of psoriasis is one of the most severe. Usually, joint deformation is not observed, but if this occurs, then the union of the articular surfaces of the bones (ankylosis) is not excluded.
The danger of this disease is that the large joints and spine are gradually involved in the pathological process. Osteoporosis of the bones develops, the joints disintegrate, so psoriatic arthritis often leads to disability.
Osteoarthritis
With arthrosis, the process of formation of the cartilage tissue covering the articular surfaces of the bones is disturbed. This is facilitated by external and internal factors - injuries, high physical exertion, hereditary predispositions and metabolic disorders.
Depending on the cause, arthrosis can be primary and secondary, developing against the background of endocrine or metabolic diseases. Most often, arthrosis affects the large joints of the lower extremities - the knees, hips and ankles - as they bear the main load when walking and standing. The upper extremities are less commonly affected.
When the fingers hurt from prolonged physical exertion, and after rest the pain disappears, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- increased pain when clenching the fist or clenching the fingers;
- an increase in the size of the diseased joint;
- morning stiffness, requiring 10-15 minutes or more of "development" of the fingers;
- characteristic crackling when bending the fingers.
Osteoarthritis develops slowly and may not cause much concern for years or even decades. However, in some cases, there is a rapid increase in symptoms and a sharp decline in the condition. If at first the pain occurs only during activity, then it does not go away even after rest.
Due to the marginal growth of the bones that make up the joint, a characteristic pineal formation appears. Closer to the palms, in the joints of the proximal phalanges, Bouchard's nodules are formed. Next to the distal interphalangeal joint, which is located near the nail, is Heberden's nodule.
Stenotic Ligamentitis
Stenotic ligamentitis affects the ligament-tendon apparatus of the hand and is manifested by blocking one of the fingers in a flexed or extended position. The pathological process is caused by excess or excessive pressure on the ligament area, so this disease occurs among people who are engaged in manual work - builders, welders, seamstresses and kitchen workers. In children, ligamentous stenosis is very rare and affects only the thumb.
The main symptom of the disease is "jumping" of the finger during extension, accompanied by a click. In the future, the "snap" disappears, and the finger remains motionless, turning into a flexion or extensor contracture.
In the early stages, there is pain when pressing the palm at the base of the finger and difficulty in flexion/extension, especially in the morning. With long ligamentitis, you can move the finger only with the help of the other hand, and after the "snapping" there is pain that radiates not only to the palm, but also to the forearm.
Which doctor to contact?
For pain in the fingers, you can first contact a therapist who, if necessary, will refer you to a narrow specialist - a traumatologist, rheumatologist, hematologist, neurologist or surgeon. Clinical, radiation and laboratory research methods are used for diagnosis.
To find out the cause of the pain, farrowing (taking a history) and physical examination is carried out, after which X-rays or tomography, blood and urine tests are performed.
Treatment
The way of treatment and further action will depend on the results of the examination. Task number 1 is to relieve pain and inflammation: for this, drugs from the NSAID group are prescribed - nonsteroidal anti-inflammatory drugs. Currently, more and more frequently used means of a new generation, NSAIDs of selective action.
Selective NSAIDs act selectively and have less toxic effect on the body, they can be taken for a long time. If the pain syndrome is moderate or mild, topical agents are used - anti-inflammatory ointments and gels.
Treatment of rheumatoid arthritis includes the basic and biologic product, steroid hormones. These drugs suppress the immune system, thereby reducing the intensity of the inflammatory process.
The same immunosuppressive drugs are prescribed if the joints hurt against the background of psoriatic arthritis. Methods such as plasmapheresis, hemosorption and photochemotherapy are used to reduce disease activity, prolong the remission period and shorten the duration of drug therapy.
How to treat joint arthrosis depends on the stage of the disease. In stages 1-2, it is possible to significantly slow down the destruction of cartilage by using chondroprotectors. Physiotherapy is effective, which enhances the effect of drugs and stimulates the recovery process.
For the treatment of arthrosis can be prescribed:
- magnetotherapy;
- electrophoresis;
- laser;
- ultrasound;
- cryotherapy - exposure to the 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.
The tactics of therapy for ligamentous stenosis are determined taking into account the stage, the presence of precipitating 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, fix the hand with an orthosis or splint. For pain, anti-inflammatory drugs and electrophoresis with hyaluronidase are prescribed.
The second stage of treatment begins with conservative methods. The lack of effect for several months is an indication for surgery to cut the damaged ligament. In patients with the third stage, conservative therapy is carried out very rarely, in most cases the operation is carried out as planned.
Reference: due to the high risk of relapse, it is very important to change your profession if it involves weight on hand.
Traditional medicine
Means prepared according to traditional recipes cannot be the main method of treatment, because they are not effective enough. However, as an adjunct therapy, the drug will help relieve pain and enhance the effect of the drug.
Mix a few 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 lime, kefir, fermented baked milk or boiled oatmeal.
For compresses, green potatoes are used, which must be cut directly on the skin in a meat grinder or on a grater. Then dip the potato puree in hot water and warm it to 39-40 °. After that, put it in a linen bag and apply it to the sore joint for half an hour. This procedure can be done several times a day.
Paraffin application relieves pain well, if you put your hand in liquid paraffin for 10 minutes, and then hold it in any herbal concoction for 15-20 minutes. You should not be afraid of burning, because paraffin melts at a temperature of no 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 reduces pain and inflammation, restores joint mobility. Regular use of Bishofit maintains muscle tone and connective tissue.
Compresses with Bischofite are recommended to be carried out as follows: warm the joints with a heating pad or hold them in a warm bath, then rub Bischofite, previously diluted with water 1: 1, into the skin of the hands. 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 carried out in the evening, in the morning the hands are thoroughly washed with warm water. This procedure is carried out every day for three weeks.
Reference: compresses with Bischofite can be placed simultaneously on no more than three joints.
The most important
To prevent or reduce the intensity of the pain that has already appeared, you must keep the brushes warm and not expose them to hypothermia. Work that requires performing the same types of movements is best done occasionally, and when using a vibrator, wear gloves and support the work brush with the other hand. When lifting and carrying heavy loads, the load must be evenly distributed on both legs. You can also maintain healthy joints with the help of proper nutrition, which should include foods that contain calcium and omega-3 fatty acids.