Structurally, the hand is the most complex region of the upper extremity. It consists of many bones that are closely strung together. Bones are connected by 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, hands are injured much more often than any other part of the body. Miscellaneous injuries account for 30-50% of the total number of musculoskeletal injuries according to various sources and are not tending 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 due to a violation of metabolic processes in gout, arthrosis.
symptoms
Signs of non-traumatic injuries that may indicate the presence of joint pathology are the following:
- pain syndrome that is permanent or wavy;
- pain when pressing and bending fingers;
- swelling and redness of the skin over the joints;
- stiffness, stiffness in movements;
- deterioration of fine motor skills;
- creaking, crunching and cracking when bending fingers;
- the formation of subcutaneous nodules that are painless to the touch;
- thickening of the skin at the folds;
- changing the configuration of the joints;
- increase in body temperature.
Rheumatoid arthritis
Arthritis of rheumatoid origin most often affects the fingers, and at the same time the right and left hands. This systemic disease is characterized by a malfunction in the immune system, in which T lymphocytes begin attacking their own cells. The cells of the synovial membrane, which line the inside of the joint capsule, actively produce rheumatoid factors: pathological antibodies are protective protein molecules.
Next, rheumatoid factors enter the bloodstream and bind to normal antibodies. As a result, immune complexes are formed, which settle on 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 occurs in rheumatoid arthritis. However, scientists could not determine the cause of this process. According to the latest research in this area, cytokines - signaling cells of the immune system - are to blame for connective tissue damage. Japanese experts came 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 ache—index, middle, ring, or pinky, but the lesion will always be bilateral. If one or more fingers on the left hand become ill, the same fingers on the right hand begin to hurt almost immediately.
The joints of the fingers 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 progression of arthritis leads to the replacement of smooth cartilage with a fibrous structure, interfering with the free movement of bones in the joint.
Gradually, the joints deform, 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 hands - rheumatic nodules.
psoriatic arthritis
The symptoms of this disease can resemble rheumatoid arthritis and appear against the background of a dermatological pathology - psoriasis. In the vast majority of cases, rashes appear first, and after a while the joints of the fingers begin to hurt.
Simultaneous manifestation of skin and joint lesions is also possible; joint pain begins earlier in 20 out of 100 patients. Why psoriasis occurs is unknown. It can probably be caused by a genetic predisposition, a malfunction of the immune system and infections. The average age of the patients is 40 years.
Psoriatic arthritis, like rheumatoid arthritis, can begin with general weakness and malaise or unexpectedly manifest with intense pain sensations. Not only fingers can be affected, but also small foot, knee and shoulder joints. Involvement in the pathological process can be both unilateral and symmetric.
Pain syndrome is most pronounced at night and at rest. Stiffness in the morning, during the day and when moving, the pain subsides. Most often there is a lesion on one side - left or right, and usually it hurts not one, but 2-4 joints (oligoarthritis).
After a long rest, the fingers become very swollen and become like sausages, the tendons of the flexor muscles become inflamed, the skin over the joints acquires a purplish-bluish tint. The following symptoms indicate the presence of psoriasis and psoriatic arthritis:
- red or pink scaly patches 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 smallpox, pigmentation on the fingers or toes;
- Psoriasis plaques are hyperemic, edematous, and may be itchy;
- Pain in the joints is permanent and does not go away throughout the day;
- the mobility and functionality of the hand is significantly restricted.
Arthropathic form of psoriasis is one of the most severe. Usually, deformation of the joints is not observed, but if this occurs, the fusion of the articular surfaces of the bones (ankylosis) is not excluded.
The danger of this disease is that large joints and the spine are gradually involved in the pathological process. Bone osteoporosis develops, joints are destroyed, so psoriatic arthritis often leads to disabilities.
arthrosis
With arthrosis, the process of formation of cartilaginous tissue covering the articular surfaces of the bones is disturbed. This is facilitated by both external and internal factors - injuries, high physical activity, hereditary predisposition and metabolic disorders.
Depending on the cause, arthrosis can be primary and secondary, developing against the background of an endocrine or metabolic disease. Osteoarthritis most commonly affects the large joints of the lower extremities — knees, hips, and ankles — because they bear the brunt of walking and standing. The upper extremities are affected much less frequently.
If the fingers hurt from prolonged physical exertion, and the pain goes away after rest, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- increased pain when clenching your fist or straining your fingers;
- an enlargement 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 sharp deterioration in the condition. If the pain initially only occurs under stress, it will not go away later, even after rest.
Due to the marginal growth of the bones that form the joints, characteristic pineal formations appear. Bouchard nodules form closer to the palm, in the proximal phalangeal joints. Adjacent to the distal interphalangeal joints, near the nails, are Heberden's nodules.
Stenosing ligamentitis
A stenosing ligamentitis affects the ligament-tendon apparatus of the hand and is manifested by a locking of a finger in a flexed or extended position. The pathological process is caused by overload or excessive pressure on the ligament area, so the disease occurs in people who perform manual labor - builders, 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 "jumping" of the finger when stretched, accompanied by a click. In the future, the "snapping" disappears, and the finger remains motionless, turning into a flexion or extension contracture.
In the early stages, there is pain when pressing the palm of the hand at the base of the fingers and difficulty bending/stretching, especially in the morning. With a long ligamentitis, you can move your finger only with the help of the other hand, and after "snapping" there is pain that spreads not only to the palm, but also to the forearm.
Which doctor to contact
If there is 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 (anamnesis) and a physical examination are performed, after which an X-ray or tomography, blood and urine tests are prescribed.
treatment
How to treat and what to do next depends on the results of the investigation. Task number 1 is to relieve pain and inflammation: for this, drugs from the NSAID group are prescribed - nonsteroidal anti-inflammatory drugs. Currently, means of a new generation, NSAIDs with a selective effect, are used more and more often.
Selective NSAIDs act selectively and have less toxic effects on the body, they can be taken for a long time. If the pain syndrome is moderate or mild, then topical agents are used - anti-inflammatory ointments and gels.
Rheumatoid arthritis treatment 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 if the joints hurt against the background of psoriatic arthritis. Methods such as plasmapheresis, hemosorption, and photochemotherapy are used to reduce disease activity, prolong periods of remission, 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 slow down the cartilage destruction by taking chondroprotectors. Physiotherapy is effective, which enhances the effect of drugs and stimulates recovery processes.
For the treatment of osteoarthritis can be prescribed:
- magnetotherapy;
- electrophoresis;
- Laser;
- Ultrasonic;
- 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. With minimal damage to the ligaments, 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.
Treatment of the second stage begins with conservative methods. If there is no effect over several months, this is an indication for an operation to cut the damaged ligament. In patients with the third stage, conservative therapy is carried out extremely rarely, in most cases surgery is performed as planned.
Note: Due to the high risk of recurrence, a career change is very important when the hands are strained.
home remedies
Means prepared according to folk recipes cannot be the main method of treatment, since they are not effective enough. However, as an additional therapy, such drugs help to relieve pain and enhance the effect of drugs.
Mix a few bay leaves with juniper needles, add a little butter and massage your hands with the resulting ointment.
At night, you can make a compress of crushed chalk, kefir, fermented baked milk or boiled oatmeal.
For compresses, green potatoes are used, which need to be chopped in a meat grinder or on a grater right in the peel. Then dip the mashed potatoes in hot water and heat to 39-40°. After that, put in a linen bag and apply to the sore joints for half an hour. The procedure can be carried out several times a day.
Paraffin applications relieve pain well if you put your hands in melted paraffin for 10 minutes, and then hold them in any herbal decoction for 15-20 minutes. You can not fear burns, because paraffin melts at a temperature not higher than 65 °. To achieve the effect, 2-3 applications per week are enough.
Compresses with bishopite help accelerate tissue healing. Due to its composition, this natural mineral reduces pain and inflammation and restores joint mobility. Regular use of Bishofit maintains the tone of muscles and connective tissue.
A compress with Bischofite is recommended 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 be continued 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. Compresses with bishopite are made at night, in the morning hands are thoroughly washed with warm water. The procedure is carried out every other day for three weeks.
Note: A compress with bischophite can be placed on no more than three joints at a time.
The most important
To prevent or reduce the intensity of pain that has already appeared, you need to keep the brushes warm and not subject them to hypothermia. Works that require the same type of movements to be performed are best done intermittently, and when using vibrating tools, use gloves and support the working brush with your other hand. When lifting and carrying heavy loads, the weight of the load should be evenly distributed over both limbs. You can also maintain healthy joints with the help of the right diet, which must include calcium-rich foods and omega-3 fatty acids.