The hand is the most complex region of the upper limb in its structure. It is made up of many bones, closely grouped together. The bones are connected through 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. The various injuries represent, according to various sources, from 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 scleroderma and lupus erythematosus, psoriasis. Much less often, pain in the joints of the fingers is due to a violation 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 permanent or undulating;
- pain when pressing and bending the fingers;
- swelling and redness of the skin over the joints;
- stiffness, stiffness during movements;
- impairment of fine motor skills;
- crunches, crunches and crunches during finger flexion;
- the formation of subcutaneous nodules, painless to the touch;
- thickening of the skin in the folds;
- change in the configuration of the joints;
- increased body temperature.
Rheumatoid arthritis
Rheumatoid arthritis most often affects the fingers and, at the same time, the right and left hands. This systemic disease is characterized by a malfunction of the immune system, in which T lymphocytes begin to attack their own cells. The cells of the synovial membrane lining the joint capsule from the inside actively produce rheumatoid factors - pathological antibodies are protective protein molecules.
The rheumatoid factors then enter the bloodstream and bind to normal antibodies. As a result, immune complexes are formed that are deposited in blood vessels and tissues. They are taken up by cells of the immune system - neutrophils and phagocytes, which release 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 of connective tissue damage are cytokines, signaling immune cells. Japanese experts concluded that the study of this type of cells will help to find an effective treatment method.
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 become ill, the same fingers of the right hand begin to hurt almost immediately.
The phalanges in the area of 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 leads to the replacement of smooth cartilage tissue with a fibrous structure, which disrupts the free movement of the bones in the joint.
Gradually, the joints become deformed, due to a change in the position of the joint elements, the pain intensifies. With a prolonged course of the disease, small painless formations appear near the joints on the back of the hand - rheumatoid nodules.
Psoriasic arthritis
The symptoms of this disease can resemble rheumatoid arthritis and occur against the background of a dermatological pathology - psoriasis. In the vast majority of cases, skin rashes first appear, 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 manifest with unexpected sharp pain sensations. 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 symmetric.
The pain syndrome is more 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 an injury on one side, left or right, and, as a rule, not one, but 2-4 joints hurt (oligoarthritis).
After a long rest, the fingers swell greatly and become like sausages, the tendons of the flexor muscles swell, the skin over 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 - may be individual or cover a large area of skin;
- characteristic pits on the skin of the hands, similar to smallpox, pigmentation on the fingers or toes;
- psoriatic plaques are hyperemic, edematous, and may itch;
- joint pain is permanent and does not go away during the day;
- the mobility and functionality of the hand is significantly reduced.
The arthropathic form of psoriasis is one of the most serious. Usually, deformation of the joints is not observed, but if this occurs, fusion of the articular surfaces of the bones (ankylosis) is not excluded.
The danger of this disease is that the large joints and the spine gradually become 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 cartilage tissue covering the articular surfaces of the bones is disrupted. This is facilitated by external and internal factors: injuries, high physical activity, hereditary predisposition, and metabolic disorders.
Depending on the cause, osteoarthritis can be primary and secondary, developing in the context of an endocrine or metabolic disease. In most cases, 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 extremities are affected much less frequently.
When the fingers hurt due to prolonged physical exertion, and after resting the pain disappears, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- increased pain when clenching your fist or forcing your fingers;
- an increase in the size of the diseased joint;
- stiffness in the morning, which requires the "development" of the fingers for 10-15 minutes or more;
- characteristic crunch 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 first the pain occurs only during exertion, then it does not go away even after rest.
Due to the marginal growths of the bones that form the joints, characteristic pineal formations appear. Closer to the palm, at the proximal phalangeal joints, Bouchard's nodes form. Next to the distal interphalangeal joints, located near the nails, are Heberden's nodes.
Stenosing ligamentitis
Stenosing ligamentitis affects the ligamentous-tendinous apparatus of the hand and is manifested by the locking of one of the fingers in the position of flexion or extension. The pathological process is caused by overloading or excessive pressure on the ligament area, so the disease occurs among people who perform manual labor: bricklayers, welders, seamstresses and kitchen workers. In children, stenosing ligamentitis is extremely rare and affects only the thumb.
The main symptom of the disease is the "jump" of the finger during extension, accompanied by a click. In the future, the "click" disappears, and the finger remains immobile, turning into a flexion or extension contracture.
In the early stages, there is pain when pressing the palm of the hand at the base of the finger and difficulty with flexion/extension, especially pronounced in the morning. With a prolonged course of ligamentitis, you can move the finger only with the help of the other hand, and after the "snap" there is pain that 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 - 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 delivery (history) and 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 next will depend on the results of the test. 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 used means 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 period. 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, which reduces the intensity of the inflammatory process.
The same immunosuppressive drugs are prescribed if the joints ache on the background of psoriatic arthritis. Methods such as plasmapheresis, hemosorption, and photochemotherapy are used to reduce disease activity, prolong remission periods, and shorten the duration of drug therapy.
How to treat 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 medications and stimulates recovery processes.
For the treatment of osteoarthritis can be prescribed:
- magnet therapy;
- electrophoresis;
- To be;
- 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 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 an orthosis or splint. For pain, anti-inflammatory drugs and hyaluronidase electrophoresis are prescribed.
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 therapy is carried out very rarely, in most cases, surgery is performed as planned.
Reference: Due to the high risk of recidivism, it is very important to change professions if it is a burden on the hands.
Home remedies
Means prepared according to popular recipes cannot be the main method of treatment, since they are not effective enough. However, as an additional therapy, such drugs will help relieve pain and enhance the effect of drugs.
Mix some bay leaves with juniper needles, add a little butter and massage your hands with the resulting ointment.
In the evening, you can make a compress from crushed chalk, kefir, fermented baked milk or boiled oatmeal.
For compresses, green potatoes are used, which must be chopped directly in the peel in a meat grinder or on a grater. Then dip the potato porridge in hot water and heat up to 39-40 °. After that, put it in a linen bag and apply it 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 hold them in any herbal decoction for 15-20 minutes. You can not be afraid of burns, since 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 speed up tissue healing. Due to its composition, this natural mineral relieves pain and inflammation, restores joint mobility. Regular use of Bishofit maintains the tone of the muscles and connective tissues.
It is recommended to make a compress with Bischofite as follows: warm the joints with a heating pad or keep 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 done at night, in the morning wash your hands well with warm water. The procedure is carried out 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 the pain that has already appeared, it is necessary to keep the brushes warm and not expose them to hypothermia. Work that requires the same type of motion is best done intermittently, and when using vibrating tools, wear gloves and hold the work brush with the other hand. When lifting and carrying heavy loads, the weight of the load must be evenly distributed on both ends. You can also keep your joints healthy with the help of proper nutrition, which should contain foods that contain calcium and omega-3 fatty acids.