The hand is the most complex region of the upper limb in its structure. It consists of many bones, tightly grouped together. The bones are connected by 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, the hands are injured much more often than any other part of the body. Various injuries represent, according to various sources, 30 to 50% of the total number of injuries of the musculoskeletal system and do not tend to decrease.
Therefore, of all the causes of pain in the fingers of the hands, the main one is trauma. In second place in terms of prevalence are connective tissue diseases - rheumatoid arthritis, systemic sclerosis 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 include:
- painful, permanent or undulating syndrome;
- pain when pressing and bending the fingers;
- swelling and redness of the skin in the joints;
- stiffness, stiffness when moving;
- deterioration of fine motor skills;
- squeaks, crackles and crackles when flexing the fingers;
- the formation of subcutaneous nodules, painless to the touch;
- thickening of the skin at the folds;
- change in joint configuration;
- increase in body temperature.
Rheumatoid arthritis
Rheumatoid arthritis most often affects the fingers, and the right and left hands simultaneously. This systemic disease is characterized by a malfunction of the immune system, in which T cells begin to attack their own cells. Synovial membrane cells lining the joint capsule from the inside actively produce rheumatoid factors: 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 settle on blood vessels and tissues. They are taken up by cells of the immune system - neutrophils and phagocytes, releasing substances that damage surrounding structures.
This is known to be how inflammation develops in rheumatoid arthritis. However, scientists have not been able to determine the cause of this process. According to the latest research in this field, the culprits of connective tissue damage are cytokines - signaling immune cells. Japanese experts have come to the conclusion that studying this type of cell will help find an effective method of treatment.
With rheumatoid arthritis, any finger can hurt - index, middle, ring or little finger, but the injury will always be bilateral. If one or more fingers of the left hand get sick, the same fingers of the right hand begin to hurt almost immediately.
The phalanges at the 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 results in the replacement of smooth cartilage tissue with a fibrous structure, which disrupts the free movement of bone in the joint.
Gradually, the joints become deformed, due to a change in the position of the articular elements, the pain intensifies. With a long course of the disease, small painless formations appear near the joints on the back of the hand - rheumatoid nodules.
Psoriatic arthritis
Symptoms of this disease can resemble rheumatoid arthritis and occur against the background of a dermatological pathology - psoriasis. In the vast majority of cases, rashes appear first, and after a while the finger joints hurt.
Simultaneous manifestation of skin and joint damage 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 genetic predisposition, immune system dysfunction, and infections. The average age of patients is 40 years old.
Psoriatic arthritis can begin, like rheumatoid arthritis, with general weakness and malaise, or it can manifest as sharp painful sensations unexpectedly. Not only the fingers can be affected, but also the small joints of the feet, knees and shoulders. Involvement in the pathological process can be both unilateral and symmetrical.
The pain syndrome is more pronounced at night and at rest. In the morning there is stiffness, during the day and with movement the pain subsides. Most often there is a lesion on one side - on the left or on the 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 become like sausages, the tendons of the flexor muscles become inflamed, the skin above the joints acquires a purple-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 - these may be single or cover a large area of skin;
- characteristic pitting on the skin of the hands, similar to smallpox, pigmentation on the fingers or toes;
- psoriatic plaques are hyperemic, edematous and may itch;
- pain in the joints is permanent and does not go away during the day;
- mobility and functionality of the hand are significantly reduced.
The arthropathic form of psoriasis is one of the most severe. Usually, the 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 disability.
Osteoarthritis
With arthrosis, the process of formation of the cartilaginous tissue covering the articular surfaces of the bones is disturbed. This is facilitated by external and internal factors - injuries, high physical activity, hereditary predisposition and metabolic disorders.
Depending on the cause, arthrosis can be primary and secondary, developing on the background of an endocrine or metabolic disease. Most often, osteoarthritis affects the large joints of the lower extremities - knee, hip and ankle - because they bear the main load when walking and standing. The upper limbs are much less affected.
When the fingers hurt due to prolonged physical exertion, and after rest the pain subsides, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- increased pain when clenching the fist or stretching the fingers;
- an increase in the size of the diseased joint;
- stiffness in the morning, requiring the "development" of the fingers for 10-15 minutes or more;
- characteristic crackle 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 at the beginning the pain only occurs during the effort, it does not disappear later even after rest.
Due to the marginal outgrowths of the bones that form the joints, characteristic pineal formations appear. Closer to the palm, in the proximal phalangeal joints, Bouchard's nodules are formed. Next to the distal interphalangeal joints, located near the nails, are Heberden's nodules.
Stenosing ligamentitis
Stenosing ligamentitis affects the ligamento-tendinous apparatus of the hand and is manifested by the locking of one of the fingers in a position of flexion or extension. The pathological process is caused by overload or excessive pressure on the ligament area, so the disease occurs in people engaged in manual labor - builders, welders, seamstresses and kitchen workers. In children, stenosing ligamentitis is extremely rare and only affects the thumb.
The main symptom of the disease is the "jumping" of the finger when extending, accompanied by a click. 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 at the base of the finger and difficulty in flexion/extension, especially pronounced in the morning. With a long course of ligamentitis, you can move your finger only with the help of the other hand, and after "slamming" there is pain, which spreads not only to the palm, but also to the'forearm.
Which doctor to contact
For pain in the fingers, you can first contact a therapist who, if necessary, will refer you to a narrow specialist - traumatologist, rheumatologist, hematologist, neurologist or surgeon. Clinical, radiological and laboratory research methods are used for diagnosis.
To determine the cause of the pain, a farrowing (taking a history) and physical examination are performed, after which an X-ray or CT scan, blood and urine tests are prescribed.
Processing
How to be treated and what to do next will depend on the results of the examination. Task number 1 is to relieve pain and inflammation: for this, drugs from the group of NSAIDs are prescribed - nonsteroidal anti-inflammatory drugs. Currently, means of a new generation, NSAIDs of selective action, 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, topical agents are used - anti-inflammatory ointments and gels.
The 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 hurt on 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 treatment.
Treatment for osteoarthritis of the joints depends on the stage of the disease. At 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 drugs and stimulates recovery processes.
For the treatment of arthrosis can be prescribed:
- magnetic therapy;
- electrophoresis;
- laser;
- ultrasound;
- cryotherapy - exposure of joints to liquid nitrogen;
- balneotherapy - mineral water baths;
- hirudotherapy - during treatment with leeches, substances that promote cartilage regeneration (hirudin, vitamins and hormones) enter the joint.
Therapeutic tactics of stenosing ligamentitis is determined taking into account the stage, the presence of provoking 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, the hand is fixed with a brace or splint. For pain, anti-inflammatory drugs and electrophoresis with hyaluronidase are prescribed.
The treatment of the second stage begins with conservative methods. The lack of effect for several months is an indication for surgery to cut the damaged ligament. In patients with the third stage, conservative treatment is extremely rare, 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 involves a load on the hands.
Folk 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, these drugs will help relieve pain and improve 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 must be chopped directly into the skin in a meat grinder or on a grater. Then dip the potato porridge in hot water and warm it to 39-40 °. After that, place it in a linen bag and apply it on the painful 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, then hold them in any herbal decoction for 15-20 minutes. You can not be afraid of burns, because paraffin melts at a temperature of no more than 65 °. To achieve the effect, 2-3 applications per week are enough.
Compresses with Bischofite help to accelerate tissue healing. By its composition, this natural mineral relieves pain and inflammation, restores joint mobility. Regular use of Bishofit maintains the tone of muscles and connective tissues.
It is recommended to make a compress with Bischofite 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 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 made at night, in the morning the hands are thoroughly washed 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.
Most important
To prevent or reduce the intensity of the pain that has already arisen, you need to keep the brushes warm and not expose them to hypothermia. Jobs that require performing the same type of movements are best done intermittently, and when using vibrating tools, use gloves and support the work brush with the 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 proper nutrition, which should contain foods containing calcium and omega-3 fatty acids.