The hand is the most complex area of the upper extremity structure. It consists of many bones that are tightly grouped together. Bones are connected by 30 different joints - the interphalangeal, metacarpophalangeal, carpal, and radiocarpal joints.
Statistically, hands are more prone to injury than other parts of the body. According to various sources, various injuries account for 30% to 50% of total musculoskeletal system injuries and do not tend to decrease.
Therefore, of all the causes of finger pain on the hand, the most important one is trauma. In second place in terms of prevalence are connective tissue diseases - rheumatoid arthritis, systemic scleroderma and lupus erythematosus, psoriasis. More rarely, finger joint pain is due to disruption of metabolic processes in gout, osteoarthritis.
symptom
Signs of non-traumatic injury that may indicate the presence of joint pathology include:
- pain syndromes that are permanent or fluctuating;
- pain when pressing and bending the fingers;
- swelling and redness of the skin at the joints;
- stiffness, stiffness during motion;
- Deterioration of fine motor skills;
- Squeaking, creaking, and crackling sounds when the fingers are flexed;
- Formation of subcutaneous nodules, painless to the touch;
- thickening of the skin in the folds;
- Changes in joint configuration;
- Elevated body temperature.
Rheumatoid Arthritis
Rheumatoid arthritis most commonly affects the fingers, but also the left and right hands. This systemic disease is characterized by a malfunctioning immune system in which T lymphocytes start attacking their own cells. The synovial cells lining the joint capsule actively produce rheumatoid factor from within: pathological antibodies are protective protein molecules.
Next, rheumatoid factor enters the blood and binds to normal antibodies. As a result, immune complexes are formed that deposit on blood vessels and tissues. They are taken up by cells of the immune system - neutrophils and phagocytes, which release substances that damage surrounding structures.
As we all know, this is how inflammation develops in rheumatoid arthritis. However, scientists have not been able to pinpoint the cause of this process. According to the latest research in the field, the main culprits of connective tissue damage are cytokines - signaling immune cells. Japanese experts concluded that research on this cell type will help to find an effective treatment.
With rheumatoid arthritis, any finger can be injured - index, middle, ring, or little finger, but lesions are always bilateral. If one or more fingers of the left hand become ill, the same finger of the right hand will start to hurt almost immediately.
The phalanges in the joint area are swollen and red, and they don't bend well due to fluid buildup, especially in the morning. Morning stiffness can last up to 1 hour. Over time, the progression of arthritis causes smooth cartilage tissue to be replaced by fibrous structures, disrupting the free movement of bone in the joint.
Due to the change in the position of the joint elements, the joint gradually deforms and the pain increases. With the long-term progression of the disease, small painless formations - rheumatoid nodules - appear near the joints on the back of the hand.
psoriatic arthritis
The symptoms of this disease may resemble those of rheumatoid arthritis and occur against the background of dermatological pathology - psoriasis. In the vast majority of cases, the rash appears first, and then the finger joints are injured.
Simultaneous manifestations of skin and joint lesions are also possible; in 20 out of 100 patients, joint pain started earlier. The cause of psoriasis is unknown. It has been speculated that it may be caused by genetic susceptibility, immune system malfunction, and infection. The average age of the patients was 40 years.
Psoriatic arthritis can start with generalized weakness and discomfort just like rheumatoid arthritis, or it can be unexpectedly severe and painful. Not only the fingers can be affected, but also the small joints of the feet, knees and shoulders. Participation in pathological processes can be unilateral or symmetrical.
The pain syndrome is most pronounced at night and at rest. There is stiffness in the morning, pain subsides during the day and with movement. Most of the time, there is a lesion on one side - left or right, and usually does not hurt one, but 2-4 joints (oligoarthritis).
After a long rest, the fingers became very swollen and became sausage-like, the flexor tendons became inflamed, and the skin on the joints turned purplish-blue. The following symptoms indicate the presence of psoriasis and psoriatic arthritis:
- red or pink scaly patches on the head, elbows, knees, and thighs—they can be solitary or cover large areas of skin;
- characteristic pits on the skin of the hands, similar to smallpox, and pigmentation on the fingers or toes;
- Psoriatic plaques are congested, edematous, and may itch;
- Joint soreness is permanent and does not go away during the day;
- The mobility and functionality of the hand is significantly reduced.
The arthropathy form of psoriasis is the most serious one. Usually, deformation of the joint is not observed, but if this occurs, fusion (ankylosis) of the articular surfaces of the bones is not excluded.
The danger of this disease lies in the progressive involvement of the large joints and the spine in the pathological process. Osteoporosis develops and joints are destroyed, so psoriatic arthritis often leads to disability.
Osteoarthritis
With arthropathy, the process of forming cartilage tissue that covers the joint surfaces of bones is disrupted. This is caused by external and internal factors - injury, high-intensity physical activity, genetic predisposition, and metabolic disorders.
Depending on the etiology, arthropathy can be primary and secondary, developing in the context of endocrine or metabolic diseases. Most often, arthropathy affects the large joints of the lower extremities -- the knees, hips, and ankles -- because they carry the main load when walking and standing. The upper extremities are affected much less frequently.
When the fingers are injured due to prolonged physical exertion and the pain disappears after rest, the development of arthropathy is not excluded.
Over time, other symptoms develop:
- Pain that gets worse when you make a fist or squeeze your fingers;
- An increase in the size of the affected joint;
- stiffness in the morning, requiring fingers to "grow" for 10-15 minutes or more;
- The characteristic crackling sound when you bend your fingers.
Osteoarthritis develops slowly and may not receive much attention for years or even decades. In some cases, however, symptoms increase rapidly and the condition worsens dramatically. If the pain occurs only with exertion at first, it will not go away even after rest.
The typical pineal structure appears due to the growth of the edges of the bones that form the joint. Close to the palm, in the proximal knuckles, Bouchard's nodules form. Next to the distal interphalangeal joint near the nail is the Heberden's tubercle.
stenotic ligamentitis
Stenotic ligamentitis affects the ligamentous tendon apparatus of the hand, manifesting as a blockage of one finger in a flexed or extended position. The pathological process is caused by overloading or excessive stress in the area of the ligament, so the disease occurs in people who perform manual labor - construction workers, welders, tailors and kitchen workers. In children, stenotic ligamentitis is extremely rare and affects only the thumb.
The main symptom of the disease is the "jumping" of the fingers during extension, accompanied by a clicking sound. Later, the "pop" sound disappeared, and the fingers remained motionless, becoming flexion or extensor contractures.
In the early stage, there is pain when the base of the finger presses the palm, and it is difficult to bend and stretch, especially in the morning. Ligamentitis has a long course and can only move the fingers with the help of the other hand. After the "pop", the pain spreads not only to the palm, but also to the forearm.
which doctor to contact
For finger pain, you can first contact a therapist who, if necessary, will refer you to a specialist - traumatologist, rheumatologist, haematologist, neurologist or surgeon. Clinical, radiological and laboratory research methods are used for diagnosis.
To find the cause of the pain, labor (history) and physical exam are done, followed by X-rays or tomography, blood and urine tests.
treat
How to treat and what to do next will depend on the results of the test. The 1st task is to relieve pain and inflammation: for this, drugs of the NSAID group - non-steroidal anti-inflammatory drugs - are prescribed. Currently, a new generation of selectively acting NSAIDs is increasingly used.
Selective NSAIDs have selective effects, have less toxic effects on the body, and can be taken for a long time. If the pain syndrome is moderate or mild, topical medications - anti-inflammatory creams and gels are used.
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 context of psoriatic arthritis. Methods such as plasma exchange, blood adsorption, and photochemotherapy are used to reduce disease activity, prolong remission and shorten the duration of drug therapy.
How arthropathy of the joints is treated depends on the stage of the disease. During stages 1-2, cartilage destruction can be significantly slowed by taking chondroprotective agents. Physical therapy is effective, it enhances the effects of medications and stimulates the recovery process.
For the treatment of arthropathy, it is possible to prescribe:
- magnetic therapy;
- electrophoresis;
- laser;
- Ultrasound;
- cryotherapy - contacting the joint with liquid nitrogen;
- Balneotherapy - bathing with mineral water;
- Leech Therapy - During leech therapy, substances that promote cartilage regeneration (hirudin, vitamins and hormones) enter the joints.
Treatment strategies for stenotic ligamentitis are determined taking into account the stage, the presence of predisposing factors, and the patient's age. If the ligament damage is minor, it is recommended to relieve the load on the hand and immobilize the hand with orthoses or splints if necessary. For pain, anti-inflammatory drugs and hyaluronidase electrophoresis are prescribed.
The second stage of treatment begins with a conservative approach. Months of inefficiency suggest the need for surgery to remove the damaged ligament. In stage III patients, conservative treatment is rarely performed and, in most cases, surgery proceeds as planned.
Reference: Due to the high risk of relapse, it is very important to change your career if it involves the burden on your hands.
folk remedies
Methods prepared according to folk remedies cannot be the main treatment because they are not effective enough. However, as an add-on therapy, these medications will help relieve pain and enhance the effects of the medication.
Mix a few bay leaves with juniper needles, add a little butter, and massage your hands with the resulting salve.
In the evening, you can make a zip with crushed chalk, kefir, fermented toasted milk, or boiled oatmeal.
For compression, use green potatoes, which must be chopped directly in the peel in a meat grinder or grater. The potato porridge is then dipped in hot water and heated to 39-40°. After that, put it in a linen bag and apply it to the joint pain for half an hour. This procedure can be performed several times a day.
Paraffin application is great for pain relief if you put your hands in melted paraffin for 10 minutes and then put them in any herbal decoction for 15-20 minutes. You can't be afraid of burns, because paraffin melts at temperatures up to 65°. To achieve results, it is sufficient to apply 2-3 times a week.
Bischofite Compression helps accelerate tissue healing. Thanks to its composition, this natural mineral relieves pain and inflammation and restores joint mobility. Regular use of Bishofit maintains muscle and connective tissue tone.
Bischofite is recommended for compression by heating the joint with a heating pad or placing it in a warm water bath, then rubbing Bischofite previously diluted 1: 1 with water into the skin of the hand. The rubbing should last a few minutes, and then apply a cloth or gauze soaked in the solution to the sore spot. Viewed from above, the compress is covered with polyethylene and insulated. Compress with Bischofite at night and wash hands thoroughly with lukewarm water in the morning. The procedure is performed every other day for three weeks.
Reference: A compress with Bischofite can be placed on no more than three joints at the same time.
the most important
To prevent or reduce the intensity of pain that has already occurred, you need to keep your brushes warm and not expose them to low temperatures. Work that requires the same type of motion is best done intermittently, wearing gloves and supporting the work brush with the other hand when using vibrating tools. When lifting and carrying heavy objects, the weight of the load should be evenly distributed over both legs. You can also maintain healthy joints with the help of proper nutrition, which must contain calcium-rich foods and omega-3 fatty acids.