The hand is the most difficult region of the upper limb in its structure. It consists of many bones, tightly grouped. The bones are connected by 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, the hands are injured more often than other parts of the body. Different injuries, according to different sources, account for 30 to 50% of the total number of injuries to the musculoskeletal system and do not tend to decrease.
This is why trauma is the leading cause of pain in the fingers. In second place in terms of prevalence are connective tissue diseases - rheumatoid arthritis, systemic scleroderma and lupus erythematosus, psoriasis. Less often, pain in the joints of the fingers is caused by a disorder of metabolic processes in gout, osteoarthritis.
Symptoms
Signs of non-traumatic injuries that may indicate joint pathology are as follows:
- Pain syndrome that is constant or wavy;
- Pain when pressing and bending fingers;
- Swelling and redness of the skin on the joints;
- Tightness, firmness during movements;
- Deterioration of fine motor skills;
- Crackling, crackling, and crackling when turning a finger;
- Formation of subcutaneous nodules, painless to the touch;
- Thickening of the skin with folds;
- Change the configuration of funds;
- Increase in body temperature.
მაevatoid arthritis
Rheumatoid arthritis most commonly affects the fingers and the right and left hands at the same time. This systemic disease is characterized by a malfunction of the immune system, during which T-lymphocytes begin to attack their own cells. The cells lining the synovial membrane of the joint capsule actively produce rheumatoid factors from the inside: pathological antibodies are protective protein molecules.
Then, rheumatoid factors enter the bloodstream and bind to normal antibodies. As a result, immune complexes are formed that break down in blood vessels and tissues. They are absorbed by cells of the immune system - neutrophils and phagocytes, secreting substances that damage surrounding structures.
It is known that this is how inflammation develops during rheumatoid arthritis. However, scientists have not been able to determine the cause of this process. According to the latest research in this field, cytokines - the signaling system of immune cells - are to blame for connective tissue damage. Japanese experts have come to the conclusion that the study of this type of cell will help to find an effective method of treatment.
In rheumatoid arthritis, any finger can hurt - the thumb, middle, ring or little finger, but the injury will always be bilateral. If one or more fingers on the left hand get sick, then the same finger on the right hand starts to hurt almost immediately.
The phalanges around the joints are swollen and red, not leaning well due to fluid accumulation, especially in the morning. Morning firmness can last up to 1 hour. Over time, the progression of arthritis leads to the replacement of smooth cartilage tissue with a fibrous structure, which disrupts the free movement of bones in the joint.
Gradually the joints become deformed, the pain intensifies due to the change in the position of the joint elements. During the long course of the disease, small painless growths appear on the back joints of the hand - rheumatoid nodules.
Psoriatic arthritis
The symptoms of this disease can resemble rheumatoid arthritis and occur against the background of dermatological pathology - psoriasis. In the vast majority of cases, a rash appears on the skin first, and after a while the joints of the fingers hurt.
Simultaneous manifestation of skin and joint lesions is also possible, in 20 out of a hundred patients the joints start to ache earlier. Why psoriasis occurs is unknown. Most likely, it can be provoked by genetic predisposition, immune system malfunctions and infections. The average age of patients is 40 years.
Psoriatic arthritis can start, like rheumatoid arthritis, with general weakness and weakness, or it can be manifested by a sudden sensation of sharp pain. Not only the fingers but also the small joints of the feet, knees and shoulders can be affected. Involvement in the pathological process can be both unilateral and symmetrical.
Pain syndrome is most pronounced at night and at rest. In the morning there is tightness, during the day and the pain decreases with movements. Most often on one side - on the left or right there is an injury and usually hurts not one, but 2-4 joints (oligo-arthritis).
After a long rest, the fingers are very swollen and look like sausage, the tendons of the flexor muscles are inflamed, the skin on 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 pits on the skin of the hands, similar to chickenpox, pigmentation on the toes or toes;
- Psoriatic plaques are hyperemic, swollen, and may itch;
- Joint pain is constant and does not disappear during the day;
- Significantly reduced hand mobility and functionality.
The arthropathic form of psoriasis is one of the most severe. Normally, deformation of the joints is not observed, but if this occurs, then fusion of the articular surfaces of the bones (ankylosis) is not ruled out.
The danger of this disease is that the pathological process gradually involves large joints and the spinal column. Osteoporosis of the bone develops, joints are destroyed, so psoriatic arthritis often leads to disability.
Osteoarthritis
Arthrosis disrupts the process of cartilage formation that covers the articular surfaces of bones. This is facilitated by both external and internal factors - injuries, high physical activity, hereditary predisposition and metabolic disorders.
Depending on the underlying cause, osteoarthritis can be primary or secondary, developed in the setting of endocrine or metabolic disease. Most often arthrosis affects the large joints of the lower extremities - the knee, thigh and ankle - as they carry the main load when walking and standing. The upper limbs are more rarely injured.
When the fingers ache due to prolonged physical exertion and the pain disappears after rest, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- Increased pain when pressing a fist or straining fingers;
- Increase in the size of the diseased joint;
- Morning firmness that requires fingers to "develop" for 10-15 minutes or more;
- Characteristic crunching 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 in the condition. If at first the pain appears only during the effort, then it does not disappear even after rest.
Due to the marginal formations of the bones that form the joints, characteristic pine formations appear. Closer to the wrist, buccal nodules form in the proximal phalangeal joints. Adjacent to the distal interphalangeal joints, located near the nails, are the Heberden nodes.
Stenotic ligamentitis
Stenotic ligamentitis damages the ligament-tendon apparatus of the hand and manifests itself in a state of flexibility or extension by blocking one finger. The pathological process is caused by overloading or excessive pressure on the ligaments, so the disease manifests itself in people engaged in manual labor - builders, welders, tailors and kitchen workers. Stenotic ligamentitis is very rare in children and affects only the thumb.
The main symptom of the disease is a "jump" of the finger during extension, accompanied by a click. In the future, the "piece" disappears, and the finger remains motionless, turning into flexibility or extensor contracture.
In the early stages, there is pain when pressing the wrist at the base of the finger and difficulty in flexibility / extension, especially in the morning. During a long course of ligamentitis, the finger can be moved only with the help of the other hand, and after the "break" there is pain, which extends not only to the wrist, but also to the forearm.
Which doctor should I go to
In case of 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.
Birth (history taking) and physical examination are performed to determine the cause of the pain, after which an X-ray or tomography, blood and urine tests are prescribed.
Treatment
How to treat and what to do next, it depends on the results of the examination. Task number 1 is to relieve pain and inflammation: for this non-steroidal anti-inflammatory drugs are prescribed - non-steroidal anti-inflammatory drugs. Nowadays, a new generation of non-steroidal anti-inflammatory drugs of selective action is being used more and more often.
Selective nonsteroidal anti-inflammatory drugs are selective and have a less toxic effect on the body, they can be taken for a long time. If the pain syndrome is mild or mild, use topical remedies - anti-inflammatory ointments and gels.
Treatment of rheumatoid arthritis includes basic and biological products, steroid hormones. These drugs suppress the immune system, thereby reducing the intensity of the inflammatory process.
The same immunosuppressive drugs are prescribed in case of joint pain in the background of psoriatic arthritis. Methods such as plasmapheresis, hemosorption, and photochemotherapy are used to reduce disease activity, prolong remission, and reduce 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 slow down the destruction of cartilage 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 of the joints to liquid nitrogen;
- Balneotherapy - baths with mineral water;
- Hirudotherapy - In the treatment of puppies, the joint contains substances that promote cartilage regeneration (hirudin, vitamins and hormones).
Therapeutic tactics for stenotic ligamentitis are determined by the stage, the presence of provoking factors, and the age of the patient. If ligament damage is minimal, it is recommended to reduce the hand load, if necessary, fix the hand with an orthosis or skeleton. Anti-inflammatory drugs and electrophoresis with hyaluronidase are prescribed for pain.
The second stage of treatment begins with conservative methods. The lack of effect for several months is indicative of a damaged ligament resection operation. In patients with stage III, conservative therapy is performed extremely rarely, in most cases surgery is performed as planned.
Hint: Because of the high risk of recurrence, it is very important to change professions if it involves loading on the hands.
Folk remedies
Folk remedies can not be the main method of treatment because they are not effective enough. However, as adjunctive therapy, such drugs will help relieve pain and effect medication.
Mix a few bay leaves with juniper needles, add a little butter and rub the obtained ointment on your hands.
At night you can make a compress of crushed chalk, kefir, fermented baked milk or boiled oatmeal.
Green potatoes are used for compresses, which must be cut directly into the crust in a meat grinder or grinder. Then pour the grilled potatoes in hot water and heat to 39-40 °. Then place in a linen bag and apply on sore joints for half an hour. The procedure can be done several times a day.
Paraffin tinctures relieve pain well if you put your hands in melted paraffin for 10 minutes and then soak them in any herbal extract for 15-20 minutes. Do not be afraid to burn, because the paraffin melts at a temperature of not more than 65 °. 2-3 applications per week are enough to achieve the effect.
Bischofite compresses help to accelerate tissue healing. Due to its composition, this natural mineral relieves pain and inflammation, restores joint movement. Regular use of Bishofit maintains muscle and connective tissue tone.
It is recommended to compress with bischofite as follows: warm the joints with a heating pad or place in a warm bath, then rub the bischofite diluted 1: 1 with water in the skin of the hands. Grinding should be continued for a few minutes, after which apply a cloth or gauze soaked in the solution to the sore spot. The top compress is covered with polyethylene and insulated. Bishofit compresses are done at night, in the morning wash your hands thoroughly with warm water. The procedure is performed every other day for three weeks.
Hint: A compress with a bishop can stand on no more than three joints.
ᲧMost important
To prevent or reduce the intensity of the pain that has already arisen, you should keep the brushes warm and not expose them to hypothermia. Work that requires the same type of movement is best done periodically, while 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 should be evenly distributed on both limbs. You can also maintain healthy joints with proper nutrition, which should definitely include calcium-rich foods and omega-3 fatty acids.