The hand is the most complex part of the upper extremity in its structure. It is made up of many bones that are tightly packed together. 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. According to various sources, 30-50% of the total number of musculoskeletal injuries are various injuries and do not tend to decrease.
Therefore, the main cause of pain in the fingers is trauma. In second place in terms of prevalence are connective tissue diseases - rheumatoid arthritis, systemic scleroderma and erythema, psoriasis. Less often it is associated with pain in the joints of the fingers, gout, disruption of metabolic processes in osteoarthritis.
Symptoms
Symptoms of non-traumatic injuries that may indicate the presence of joint pathology include:
- persistent or wavy pain syndrome;
- pain when pressing and bending fingers;
- swelling and redness of the skin over the joints;
- stiffness, stiffness during movements;
- deterioration of fine motor skills;
- squeaking, squeaking and cracking during finger flexion;
- formation of subcutaneous nodules that are painless to the touch;
- thickening of the skin in the folds;
- change in the configuration of the joints;
- increase in body temperature.
Rheumatoid arthritis
Rheumatoid arthritis most often affects the fingers, both right and left hand. This systemic disease is characterized by a malfunction in the immune system in which T lymphocytes begin to attack their own cells. The cells of the synovial membrane, which surround the articular 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 in the blood vessels and tissues. They are absorbed by the cells of the immune system - neutrophils and phagocytes, releasing substances that damage the surrounding structures.
It is known that inflammation develops in rheumatoid arthritis. However, scientists have not been able to determine the cause of this process. According to recent research in this area, the culprits of connective tissue damage are cytokines - signaling immune cells. Japanese experts have concluded that the study of this type of cell will help to find an effective treatment.
With rheumatoid arthritis can damage any finger - index, middle, ring or little finger, but the lesion will always be bilateral. If one or more fingers of the left hand become ill, the same fingers of the right hand begin to ache almost immediately.
The phalanges in the joint area become swollen and red, and do not bend well, especially in the morning, due to the accumulation of fluid. Morning stiffness can last up to 1 hour. Over time, the development 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, and the pain intensifies due to the change in the position of the articular elements. 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 are similar to rheumatoid arthritis and can occur against the background of dermatological pathology - psoriasis. In most cases, skin rashes appear first, and after a while the joints of the fingers ache.
Simultaneous manifestations of skin and joint lesions are also possible, with joint pain beginning earlier in 20 out of 100 patients. It is unknown why psoriasis occurs. Presumably, this can be triggered by genetic predisposition, immune system malfunctions, and infections. The average age of patients is 40 years.
Psoriatic arthritis, like rheumatoid arthritis, can begin with general weakness and malaise, or it can present with unexpected sharp pain sensations. Not only the fingers but also the small joints of the feet, knees and shoulders can be affected. Participation in the pathological process can be both unilateral and symmetrical.
Pain syndrome manifests itself most at night and at rest. There is stiffness in the morning, pain decreases during the day and with exercise. Often there is a lesion on one side - 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 sausage-like, the tendons of the flexor muscles become inflamed, and the skin on the joints becomes purple-blue. 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 solitary or cover a large area of skin;
- characteristic flower-like pits on the skin of the hands, pigmentation on the fingers or toes;
- psoriatic plaques may be hyperemic, edematous, and pruritic;
- joint pain is persistent and does not pass during the day;
- hand mobility and functionality are significantly reduced.
The arthropathic form of psoriasis is one of the most severe forms. Deformation of the joints is usually not observed, but if this occurs, the articulation 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. Bone osteoporosis develops, joints are destroyed, so psoriatic arthritis often leads to disability.
Osteoarthritis
Osteoarthritis disrupts the formation of cartilage tissue surrounding the articular surfaces of bones. This is due to both external and internal factors - injuries, high physical activity, hereditary predisposition and metabolic disorders.
Depending on the cause, osteoarthritis can be primary or secondary, developing against the background of an endocrine or metabolic disease. Most often, osteoarthritis affects the large joints of the lower extremities - the knees, thighs and ankles - because they carry the main load when walking and standing. The upper extremities are less affected.
If the fingers ache due to long-term physical exertion, and the pain disappears after rest, the development of osteoarthritis is not excluded.
Over time, other symptoms appear:
- increased pain when squeezing the fist or squeezing the fingers;
- increase in the size of the diseased joint;
- morning stiffness that requires the fingers to "develop" for 10-15 minutes or longer;
- characteristic cracking when bending 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 of the condition. If at first the pain occurs only during tension, then it does not pass after rest.
Characteristic pineal formations appear due to the marginal growth of the bones that make up the joints. Bouchard nodules form in the proximal phalangeal joints closer to the palm. There are Heberden's nodes near the distal interphalangeal joints near the nails.
Stenotic ligamentitis
Stenotic ligamentitis affects the ligamentous-tendon apparatus of the hand and manifests itself by blocking one of the fingers in a bent or stretched position. The pathological process occurs as a result of overloading or excessive pressure on the ligament area, so the disease occurs among people engaged in handicrafts - builders, welders, seamstresses 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, accompanied by a click during extension. 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 on the palm under the finger and difficulty with bending / stretching, especially in the morning. With a long course of ligament, you can move your finger only with the help of your other hand, and after the "bump" there is pain that spreads not only to the palm, but also to the forearm.
Which doctor to consult
If you need pain in the fingers, you can first contact a narrow specialist - a traumatologist, rheumatologist, hematologist, neurologist or a therapist who will refer you to a surgeon. Clinical, radiation and laboratory research methods are used for diagnosis.
An anamnesis and physical examination are performed to find the cause of the pain, followed by an x-ray or tomography, blood and urine tests.
Treatment
How it will be treated and what to do next will depend on the results of the examination. Task 1 is to relieve pain and inflammation: for this purpose, drugs from the group of NSAIDs are prescribed - non-steroidal anti-inflammatory drugs. Nowadays, a new generation of tools, selective NSAIDs, are used more often.
Selective NSAIDs have a selective effect and are less toxic to the body, can be taken for a long time. If the pain syndrome is moderate or mild, local agents are used - 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.
If joints ache against the background of psoriatic arthritis, the same immunosuppressive drugs are prescribed. Methods such as plasmapheresis, hemosorption, and photochemotherapy are used to reduce disease activity, prolong remission periods, and shorten drug treatment.
How to treat osteoarthritis of the joints depends on the stage of the disease. By taking chondroprotectors in stages 1-2, it is possible to significantly slow down the destruction of cartilage. Physiotherapy is effective, it increases the effect of drugs and stimulates recovery processes.
Can be prescribed for the treatment of osteoarthritis:
- magnetotherapy;
- electrophoresis;
- laser;
- ultrasound;
- cryotherapy - exposure of the joints with liquid nitrogen;
- balneotherapy - baths with mineral water;
- Hirudotherapy - includes substances (hirudin, vitamins and hormones) that promote cartilage regeneration during treatment with leeches.
Therapeutic tactics for ligament stenosis are determined by the stage, the presence of stimuli 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 tire. Electrophoresis with anti-inflammatory drugs and hyaluronidase is prescribed for pain.
Treatment of the second stage begins with conservative methods. The absence of effect for several months is an indication for surgery to remove the damaged ligament. In patients in the third stage, conservative therapy is rarely performed, and 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 you have a load on hand.
Folk remedies
Folk remedies can not be the main treatment, because they are not effective enough. However, as an adjunct therapy, such medications will help relieve pain and increase the effectiveness of medications.
Mix a few bay leaves with juniper needles, add a little butter and massage your hands with the resulting ointment.
At night you can compress from crushed chalk, kefir, fermented baked milk or boiled oatmeal.
Green potatoes are used for compresses, they must be cut directly into the skin in a meat grinder or grater. Then immerse the potato gruel in boiling water and heat to 39-40 °. Then put it in a linen bag and apply to 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 soak in any herbal decoction for 15-20 minutes. Do not be afraid of burns, because paraffin melts at a temperature not exceeding 65 °. 2-3 applications per week are enough to get the effect.
Compresses with bischofite accelerate tissue healing. Due to its composition, this natural mineral relieves pain and inflammation, restores joint mobility. Regular use of bischofite maintains the tone of muscles and connective tissues.
It is recommended to apply a compress with bischofite as follows: heat the joints with a heating pad or keep them in a hot bath, then rub the bischofite, previously diluted 1: 1 with water, on the skin of the hands. The rubbing should last a few minutes, after which a cloth or gauze soaked in the solution is applied to the painful area. From above, the compress is covered with polyethylene and insulated. Compresses with bischofite are made at night, in the morning hands are washed thoroughly with warm water. The procedure is performed every day for three weeks.
Reference: One compress with bischofite can be applied to no more than three joints at a time.
The most important
To prevent or reduce the intensity of the pain that has already occurred, the brushes should be kept warm and not exposed to hypothermia. Work that requires the same type of movement is best done at intervals, 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 must be evenly distributed on both limbs. You can also keep your joints healthy with proper nutrition, which includes calcium-rich foods and omega-3 fatty acids.