The fist is the most complex region of the upper extremity in terms of its structure. It consists of many bones, closely grouped. The bones are connected over 30 different joints - interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, hands are injured much more often than any other part of the body. According to various sources, various injuries account for 30 to 50% of the total number of injuries to the musculoskeletal system and do not tend to decrease.
So, of all the causes of pain in the fingers, the main one is trauma. In second place in terms of frequency are connective tissue diseases - rheumatoid arthritis, systemic scleroderma and lupus erythematosus, psoriasis. Much less often, pain in the finger joints occurs due to violations of metabolic processes in gout, osteoarthritis.
Symptoms
Signs of non-traumatic injuries that may indicate the presence of joint pathology are as follows:
- pain syndrome, which is persistent or wavy;
- pain when pressing and bending fingers;
- swelling and redness of the skin over the joints;
- stiffness, stiffness during movement;
- deterioration of fine motor skills;
- creaking, creaking and cracking during bending of the fingers;
- formation of subcutaneous nodules, painless to the touch;
- thickening of the skin on the folds;
- change in joint configuration;
- increase in body temperature.
Rheumatoid arthritis
Arthritis of rheumatoid origin most often affects the fingers, both on the 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 that line 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 absorbed by cells of the immune system - neutrophils and phagocytes, releasing substances that damage surrounding structures.
It is known that this is 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 area, the culprits for connective tissue damage are cytokines - signaling immune cells. Japanese experts have concluded that studying this type of cell will help find an effective method of treatment.
Rheumatoid arthritis can affect any finger - forefinger, middle finger, ring finger or little finger, but the lesion will always be bilateral. If one or more fingers on the left hand get sick, then the same fingers on the right hand start to hurt almost immediately.
The phalanges in the area of the joints swell and redden, due to the accumulation of fluid they bend slightly, 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 tissue with a fibrous structure, which disrupts the free movement of bones in the joint.
Gradually the joints deform, due to the change in the position of the joint elements, the pain intensifies. With a long course 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 can resemble rheumatoid arthritis and appear in the background of dermatological pathology - psoriasis. In the vast majority of cases, the rash appears on the skin first, and after a while, the finger joints hurt.
Simultaneous manifestation of skin and joint lesions is also possible, in 20 out of 100 patients the joints start to hurt earlier. It is not known why psoriasis occurs. It is thought to be caused by genetic predisposition, immune system failure 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 manifest with unexpected sharp feelings of pain. Not only the toes but also the small joints of the feet, knees and shoulders can be affected. Involvement in the pathological process can be one-sided and symmetrical.
The pain syndrome is most pronounced at night and at rest. Stiffness occurs in the morning, and pain subsides during the day. Most often there is a lesion on one side - on the left or right side and, as a rule, does not hurt 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 hue. The following symptoms indicate the presence of psoriasis and psoriatic arthritis:
- red or pink scaly patches on the head, elbows, knees and thighs - may be single or cover a large area of skin;
- characteristic holes on the skin of the hands, similar to smallpox, pigmentation on the fingers or toes;
- psoriatic plaques are hyperemic, edematous, and may be itchy;
- joint pain is permanent and does not disappear during the day;
- the mobility and functionality of the hand is significantly reduced.
The arthropathic form of psoriasis is one of the most severe. Deformation of the joints is usually not observed, but if this happens, then the joining of the articular surfaces of the bones (ankylosis) is not excluded.
The danger of this disease is that the large joints and spine gradually become involved in the pathological process. Bone osteoporosis develops, joints are destroyed, and psoriatic arthritis often leads to disability.
Osteoarthritis
In arthrosis, the process of forming cartilage tissue that covers the articular surfaces of the bones is disturbed. Both external and internal factors contribute to this - injuries, high physical activity, hereditary predisposition and metabolic disorders.
Depending on the cause, osteoarthritis can be primary or secondary, and develops on the background of endocrine or metabolic diseases. Osteoarthritis most often affects the large joints of the lower extremities - the knee, hip and ankle - because they can withstand the main load when walking and standing. The upper extremities are affected much less frequently.
When the fingers hurt due to long-term physical effort, and after the rest the pain disappears, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- increased pain when clenching the fist or straining the fingers;
- increase in the size of the diseased joint;
- stiffness in the morning, which requires "development" of the fingers for 10-15 minutes or longer;
- characteristic cracking when bending fingers.
Osteoarthritis develops slowly and may not be a major concern for years or even decades. However, in some cases, there is a rapid increase in symptoms and a sharp worsening of the condition. If in the beginning the pain occurs only during exertion, later it does not disappear even after rest.
Due to the marginal growths of the bones that form the joints, characteristic pineal glands appear. Closer to the palm, in the proximal phalangeal joints, Bouchard's nodes are formed. In addition to the distal interphalangeal joints, which are located near the nail, there are Heberden's nodules.
Stenotic ligamentitis
Stenotic ligamentitis affects the ligament-tendon apparatus of the hand and is manifested by blocking one of the fingers in a flexible or extensive position. The pathological process is caused by overloading or excessive pressure on the ligament area, so the disease occurs in people who are engaged in physical work - builders, welders, tailors and kitchen workers. In children, stenotic ligamentitis is extremely rare and affects only the thumb.
The main symptom of the disease is "jumping" of the finger during the extension, followed by clicking. In the future, the "click" disappears, and the finger remains motionless, turning into a flexion or contracture of the extensor.
In the early stages, there is pain when pressing the palm at the base of the finger and difficulty with flexion / extension, especially in the morning. With a long course of ligamentitis, you can move your finger only with the help of the other hand, and after the "shooting" there is pain that spreads not only to the palm, but also to the forearm.
Which doctor to go to
For pain in the fingers, you can first consult a therapist who will refer you to a specialist - traumatologist, rheumatologist, hematologist, neurologist or surgeon. Clinical, radiation and laboratory research methods are used for diagnosis.
In order to determine the cause of the pain, a questioning is performed (taking an anamnesis) and a physical examination, after which an X-ray or tomography, blood and urine tests are prescribed.
Treatment
How to be treated and what to do next will depend on the results of the examination. Task number 1 is to alleviate pain and inflammation: NSAIDs - nonsteroidal anti-inflammatory drugs - are prescribed for this. Currently, a new generation of selective NSAIDs is being 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, 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, which reduces 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, chemosorption, and photochemotherapy are used to reduce disease activity, prolong remission, and shorten drug therapy.
How to treat arthrosis of the joints depends on the stage of the disease. In phases 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 osteoarthritis may be prescribed:
- magnetotherapy;
- electrophoresis;
- laser;
- ultrasound;
- cryotherapy - exposure of the joints with liquid nitrogen;
- balneotherapy - baths with mineral water;
- hirudotherapy - during treatment with leeches, substances that stimulate cartilage regeneration (hirudin, vitamins and hormones) enter the joint.
Therapeutic tactics of stenotic ligamentitis are determined taking into account the stage, the presence of provoking factors and the age of the patient. If the ligament damage is minimal, it is recommended to reduce the load on the hand, and if necessary, the arm is fixed with an orthosis or splint. Anti-inflammatory drugs and hyaluronidase electrophoresis are prescribed for pain.
Treatment of the second phase 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 therapy is performed extremely rarely, in most cases the operation is performed according to plan.
Reference: due to the high risk of recurrence, it is very important to change your profession if it is a hand load.
Folk remedies
Means prepared according to folk recipes cannot be the main method of treatment, because they are not effective enough. However, as an adjunct therapy, such medications will help relieve pain and improve medication performance.
Mix a few bay leaves with juniper needles, add a little butter and massage the hands with the obtained fat.
At night, you can make a wrap from crushed chalk, kefir, fermented baked milk or cooked oatmeal.
Green potatoes are used for dressings, which must be chopped directly into the crust in a meat grinder or on a grater. Then dip the mashed potatoes in hot water and heat to 39-40 °. Then put in a canvas bag and apply on sore joints for half an hour. The procedure can be done several times a day.
Paraffin applications relieve pain well, if you put your hands in melted paraffin for 10 minutes, and then keep them in any herbal decoction for 15-20 minutes. You can not be afraid of burns, because paraffin melts at a temperature not exceeding 65 °. 2-3 applications per week are enough to achieve the effect.
Bischofite compresses help speed up tissue healing. Due to its composition, this natural mineral relieves pain and inflammation, restores joint mobility. Regular use of Bischofite maintains muscle and connective tissue tone.
We recommend that you do the compression with bischofite in the following way: warm the joints with a heating pad or keep them in a warm bath, and then rub the bischofite, previously diluted 1: 1 with water, into the skin of the hands. Rubbing should continue for a few minutes, after which a cloth or gauze soaked in the solution is applied to the sore spot. The top of the compress is covered with polyethylene and insulated. Bischofite compresses are made at night, and hands are washed well with warm water in the morning. The procedure is performed every other day for three weeks.
Reference: Bischofite coating can be applied to a maximum of three joints at a time.
The most important
To prevent or reduce the intensity of pain that has already occurred, you must keep the brushes warm and not expose them to hypothermia. Work that requires the same type of movement is 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 on both extremities. You can also maintain healthy joints with the help of a proper diet, which must include foods that contain calcium and omega-3 fatty acids.