The hand is the most complex region of the upper limb in its structure. It consists of many bones, closely grouped together. Bones are connected through 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, the hands get injured much more often than any other part of the body. According to various sources, different injuries make up from 30 to 50% of the total number of injuries in the musculoskeletal system and do not tend to decrease.
Therefore, the most important of all the causes of pain in the fingers of the hands 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 arthritis, osteoarthritis.
Symptoms
Signs of non-traumatic injury that may indicate the presence of joint pathology are as follows:
- pain syndrome, which is permanent or undulating;
- pain when pressing and bending the fingers;
- swelling and redness of the skin over the joints;
- stiffness, stiffness during movements;
- deterioration of fine motor skills;
- creaking, crunching and crackling during finger bending;
- the formation of subcutaneous nodules, painless to the touch;
- thickening of the skin at the folds;
- change in the configuration of the joints;
- 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 of the immune system in which T lymphocytes begin to attack their own cells. The cells in the synovial membrane that line the joint capsule from the inside 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 that settle on blood vessels and tissues. They are absorbed by cells in the immune system - neutrophils and phagocytes, releasing substances that damage the surrounding structures.
It is known that this is how inflammation develops in rheumatoid arthritis. However, researchers have not been able to determine the cause of this process. According to the latest research in this area, the culprits behind connective tissue damage are cytokines - signaling immune cells. Japanese experts came to the conclusion that the study of this cell type will help find an effective treatment method.
In rheumatoid arthritis, any finger can hurt - index, middle, ring or little finger, but the lesion will always be bilateral. If one or more fingers on the left hand become ill, then the same fingers on the right hand begin to hurt almost immediately.
The phalanges of the joints swell and blush, due to accumulation of fluid, they do not bend well, especially in the morning. 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 interferes with the free movement of bones in the joint.
Gradually the joints are deformed, due to a change in the position of the articular elements the pain intensifies. With a long course of disease, small painless formations occur near the joints on the back of the hand - rheumatoid nodules.
Psoriatic arthritis
Symptoms of this disease may resemble rheumatoid arthritis and occur on the background of a dermatological pathology - psoriasis. In the vast majority of cases, skin rashes occur 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 begin to hurt earlier. Why psoriasis occurs is unknown. Presumably, it can be caused by a genetic predisposition, a malfunction of the immune system and infections. The average age of patients is 40 years.
Psoriatic arthritis can begin, like rheumatoid arthritis, with general weakness and malaise, or it can unexpectedly manifest itself with sharp pain sensations. Not only fingers can be affected, but also small joints in the feet, knees and shoulders. Involvement in the pathological process can be both 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 movements the pain subsides. Most often there is a lesion on one side - left or right, and usually it does not hurt in one, but 2-4 joints (oligo-arthritis).
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 gets a purple-bluish tint. 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 the skin;
- characteristic pits on the skin of the hands resembling cups, pigmentation on the fingers or toes;
- psoriatic plaques are hyperemic, edematous and may itch;
- soreness in the joints is permanent and does not disappear during the day;
- hand mobility and functionality are significantly reduced.
Arthropathic form of psoriasis is one of the most severe. Usually, deformation of the joints is not observed, but if this happens, the fusion of the articular surfaces of the bones (ankylosis) is not ruled out.
The danger of this disease is that large joints and the spine are gradually involved in the pathological process. Osteoporosis develops, joints are destroyed, so psoriatic arthritis often leads to disability.
Osteoarthritis
With osteoarthritis, the process of forming cartilage tissue that covers the articular surfaces of bones is disrupted. This is facilitated by both external and internal factors - injuries, high physical activity, hereditary disposition and metabolic disorders.
Depending on the cause, osteoarthritis can be primary and secondary and develop on the background of an endocrine or metabolic disease. Osteoarthritis most often affects the large joints of the lower extremities - 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 ache 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 clenching a fist or tightening fingers;
- an increase in the diseased joint in size;
- stiffness in the morning that requires "development" of the fingers for 10-15 minutes or longer;
- 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 worsening of the condition. If at first the pain occurs only during exertion, it later does not disappear even after rest.
Due to the marginal growths of the bones that form the joints, characteristic pineal formations occur. Closer to the palm, in the proximal phalangeal joints, Bouchard's nodules form. Next to the distal interphalangeal joints located near the nails are the nodules of the Heberden.
Stenosing ligamentitis
Stenosing ligamentitis affects the ligamentous tendon apparatus of the hand and manifests itself by blocking one of the fingers in the flexion or extension position. The pathological process is caused by congestion or excessive pressure on the ligament area, so the disease occurs among people involved in manual labor - builders, welders, seamstresses 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 finger during extension, accompanied by a click. In the future, the "snap" disappears and the finger remains motionless and becomes a flexion or extensor contracture.
In the early stages, there is pain when pressing on the palm of the hand at the base of the finger and difficulty with flexion / extension, especially pronounced in the morning. With a long course of ligamentitis, you can only move your finger using 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
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.
To find out the cause of the pain, a farrowing (anamnesis) and a physical examination are performed, after which an X-ray or tomography, blood and urine tests are prescribed.
Treatment
How to be treated and what to do then depends on the results of the study. Task number 1 is to relieve pain and inflammation: for this, drugs from the NSAID group are prescribed - non-steroidal anti-inflammatory drugs. Currently, more and more often used drugs of a new generation, NSAIDs of selective action.
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, topical 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.
The same immunosuppressive drugs are prescribed if the joints ache due to psoriatic arthritis. Methods such as plasmapheresis, hemosorption and photochemotherapy are used to reduce the activity of the disease, prolong periods of remission and shorten the duration of drug treatment.
How to treat osteoarthritis of the joints depends on the stage of the disease. In stages 1-2, it is possible to slow down the destruction of cartilage significantly by taking chondroprotectors. Physiotherapy is effective, which increases 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 - 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 provocative factors 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 fix the hand with an orthosis or splint. For pain, anti-inflammatory drugs and electrophoresis with hyaluronidase are prescribed.
Second phase treatment begins with conservative methods. The lack of effect for several months is an indication for surgery to cut the damaged ligament. In patients with third stage, conservative therapy is performed extremely rarely, in most cases surgery is performed as planned.
Reference: due to the high risk of recurrence, it is very important to change professions if it causes a strain on the hands.
Folk remedies
Remedies prepared according to folk recipes may not be the main method of treatment as they are not effective enough. But as an additional therapy, such drugs will help relieve pain and improve the effect of medication.
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, use green potatoes, which must be chopped directly into the peel in a meat mincer or on a grater. Then dip the potato puree in hot water and heat up to 39-40 °. Then put it 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 hold them in any herbal decoction for 15-20 minutes. You can not be afraid of burns, as paraffin melts at a temperature of not more than 65 °. To achieve the effect, 2-3 applications per week are enough.
Compresses with Bischofite help accelerate tissue healing. Due to its composition, this natural mineral relieves pain and inflammation, restores joint mobility. Regular use of Bishofit maintains the tone of muscles and connective tissue.
A compression with Bischofite is recommended to be performed as follows: heat the joints with a heating pad or keep them in a hot bath, and then rub Bischofite, previously diluted with water 1: 1, into the skin of the hands. The rubbing should continue for several 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 Bischofite are performed at night, in the morning wash your hands thoroughly with warm water. The procedure is performed every other day for three weeks.
Reference: a compress with Bischofite can be placed simultaneously on no more than three joints.
The most important
To prevent or reduce the intensity of pain that has already appeared, keep the brushes warm and do not expose them to hypothermia. Work that requires performing the same type of movement is best performed at intervals, and when using vibrating tools, wear gloves and support the workbrush with the other hand. When lifting and transporting heavy loads, the weight of the load must be evenly distributed on both limbs. You can also maintain healthy joints using proper nutrition, which should include calcium-containing foods and omega-3 fatty acids.