The hand is the most complex region of the upper limbs in its structure. It consists of many bones, closely grouped together. The bones are connected through 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, hands are injured much more often than any other part of the body. Different injuries make up, according to different sources, from 30 to 50% of the total number of 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. In second place in terms of prevalence are connective tissue diseases - rheumatoid arthritis, systemic scleroderma and lupus erythematosus, psoriasis. Very rarely, pain in the joints of the fingers is due to violation of metabolic processes in gout, osteoarthritis.
Symptoms
Signs of non-traumatic injury that may indicate the presence of joint pathology are as follows:
- pain syndrome, which is permanent or wavy;
- pain when pressing and flexing fingers;
- swelling and redness of the skin over the joints;
- stiffness, stiffness during movements;
- deterioration of excellent motor skills;
- cracking, creaking and creaking during flexion of the finger;
- formation of subcutaneous joints, painless to the touch;
- thickening of the skin in the folds;
- change in node configuration;
- increase in body temperature.
Rheumatoid arthritis
Arthritis of rheumatoid origin most often affects the fingers, and simultaneously on the right and left hand. This systemic disease is characterized by a malfunction in the immune system, in which T lymphocytes begin to attack their cells. Synovial membrane cells lining the ankle capsule from the inside actively produce rheumatoid factors: pathological antibodies are protective protein molecules.
Rheumatoid factors then enter the bloodstream and bind 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 the surrounding structures.
This is how inflammation of rheumatoid arthritis develops. 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 - signaling immune cells. Japanese experts concluded that the study of this type of cell will help to find an effective method of treatment.
With rheumatoid arthritis, any finger can hurt - the index finger, middle finger, ring or little finger, but the lesion will always be bilateral. If one or more fingers on the left hand get sick, then the same fingers on the right hand 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 cartilage smooth tissue with a fibrous structure, which disrupts the free movement of bone in the joints.
Gradually, the joints are deformed, due to the change in position of the articular 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 joints.
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, skin rashes appear first and after a while the finger joints ache.
Simultaneous appearance of skin and joint lesions is 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 provoked by a genetic predisposition, a malfunction of the immune system and infections. The average age of patients is 40 years.
Psoriatic arthritis can start, like rheumatoid arthritis, with general weakness and maltreatment, or it can present with sudden sharp sensations of pain. Not only the toes but also the small joints of the feet, knees and shoulders can be affected. Involvement in the pathological process can be one-sided 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, does not hurt one, but 2-4 joints (oligo-arthritis).
After a long rest, the fingers swell a lot and become like sausages, the tendons of the flexor muscles become inflamed, the skin above the joints acquires a purple-bluish tinge. The following symptoms indicate the presence of psoriasis and psoriatic arthritis:
- red or pink scaly spots on the head, elbows, knees and thighs - they may be single or cover a large area of skin;
- characteristic dimples on the skin of the hands, similar to linen, 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;
- mobility and functionality of the hand is significantly reduced.
The arthropathic form of psoriasis is one of the most severe. Usually, deformity of the joints is not noticed, but if this happens, then melting of the articular surfaces of the bones (ankylosis) is not excluded.
The risk of this disease is that the large joints and spine are gradually involved in the pathological process. Osteoporosis of the bones develops, the joints are destroyed, so psoriatic arthritis often leads to disability.
Osteoarthritis
With osteoarthritis, the process of cartilage tissue formation covering the articular surfaces of the bone is interrupted. This is facilitated by external and internal factors - injuries, high physical activity, hereditary predispositions and metabolic disorders.
Depending on the cause, osteoarthritis can be primary and secondary, developing against the background of an endocrine or metabolic disease. Most often, osteoarthritis affects the large joints of the lower extremities - the knee, hips and ankle - because they carry the main load when walking and standing. The upper limbs are affected much less frequently.
When the fingers are injured 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 squeezing a fist or squeezing fingers;
- an increase in diseased wrist size;
- morning stiffness, requiring "development" of fingers for 10-15 minutes or longer;
- characteristic crackling when bending 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 deterioration of the condition. If at first the pain appears only during exercise, then later it does not go away even after rest.
Due to the marginal growths of the bones that form the nodes, characteristic pineal formations appear. Closer to the palm, at the proximal phalangeal nodes, Bouchard nodes are formed. Near the distal interphalangeal joints, located near the nails, are the Heberden joints.
Stenotic ligaments
Stenotic ligamentitis affects the ligamento-tendon apparatus of the hand and is manifested by blocking one of the fingers in the flexion or extension position. The pathological process is caused by overload or excessive pressure on the ligament area, so the disease appears in people engaged in manual labor - builders, welders, tailors and kitchen workers. In children, stenotic ligament 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 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 with flexion / extension, especially pronounced in the morning. With a long course of ligament, the finger can be moved only with the help of the other hand, and after the "rupture" there is pain that spreads 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 specialist - a traumatologist, rheumatologist, hematologist, neurologist or surgeon. Clinical, radiation and laboratory methods are used for diagnosis.
To find out the cause of the pain, a calving (history taking) and a physical examination are performed, after which a radiograph or tomography, blood and urine analysis is prescribed.
Treatment
How to be treated and what to do next will depend on the results of the examination. Task number 1 is to relieve pain and inflammation: for this, drugs from the group NSAIDs - non-steroidal anti-inflammatory drugs are prescribed. Currently, new generation, NSAIDs of selective action are increasingly used.
Selective NSAIDs act selectively and have less toxic effects on the body, they can be taken for a long period. If the pain syndrome is moderate or mild, topical agents - ointments and anti-inflammatory gels are used.
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 against the background of psoriatic arthritis. Methods such as plasmapheresis, hemosorption and photochemotherapy are used to reduce disease activity, extend remission periods, and shorten the duration of drug therapy.
The treatment of osteoarthritis of the joints depends on the stage of the disease. In stages 1-2, it is possible to significantly slow down cartilage destruction by taking chondroprotectors. Physiotherapy is effective, which enhances the effect of medication and stimulates recovery processes.
For the treatment of osteoarthritis can be prescribed:
- magnetotherapy;
- electrophoresis;
- laser;
- ultrasound;
- cryotherapy - exposure to joints with liquid nitrogen;
- balneotherapy - mineral water baths;
- hirudotherapy - during treatment with caterpillars, substances that promote cartilage regeneration (hirudin, vitamins and hormones) enter the joints.
Therapeutic tactics for stenotic ligament are determined taking into account the stage, the presence of provocative factors and the age of the patient. If the ligament damage is minimal, it is recommended to reduce the load on the hand, if necessary, the hand is fixed with an orthosis or spine. For pain, anti-inflammatory drugs and hyaluronidase electrophoresis are prescribed.
The treatment of the second stage begins with conservative methods. 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 performed extremely rarely, in most cases the operation is performed as planned.
Reference: due to the high risk of recurrence, it is very important to change your profession if it involves a load on the hands.
Folk remedies
Remedies prepared according to popular recipes may not be the main method of treatment, as they are not quite effective. However, as an adjunct therapy, such medications will help relieve pain and increase the effect of the medication.
Mix a few laurel leaves with juniper needles, add a little butter and massage your hands with the resulting ointment.
At night, you can make a compress with crushed chalk, kefir, fermented baked milk or boiled oatmeal.
For compresses, green potatoes are used, which must be chopped directly into the peel in a meat grinder or grater. Then soak the potato kernels in hot water and heat to 39-40 °. After that, place in a linen bag and apply on sore joints for half an hour. The procedure can be performed several times a day.
Paraffin applications relieve pain well, if you put your hands in melted paraffin for 10 minutes and then keep them in some herbal decoction for 15-20 minutes. You can not be afraid of burns, as paraffin melts at a temperature of not more than 65 °. 2-3 applications per week are enough to achieve the effect.
Bischofite compresses help accelerate tissue healing. Due to its composition, this natural mineral relieves pain and inflammation, restores joint mobility. Regular use of Bishof maintains muscle and connective tissue tone.
A compress with Bischofite is recommended to be done as follows: warm the joints with a heating pad or keep in a warm bath, then rub Bischofite, previously diluted with water 1: 1, on the skin of the hands. The rubbing should continue for a few 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. Bischofite compresses are done at night, in the morning hands are washed well with warm water. The procedure is performed every other day for three weeks.
Reference: a Bischofite compress can be applied to no more than three joints at a time.
Most important
To prevent or reduce the intensity of the pain that has already appeared, you should keep the brushes warm and not expose them to hypothermia. Work that requires performing the same type of movements is best done intermittently and when using vibrating tools, use gloves and hold 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 maintain healthy joints with the help of proper nutrition, which should contain foods that contain calcium and omega-3 fatty acids.