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 are injured much more often than any other part of the body. Various injuries account for, 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 on 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 the following:
- 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 flexion;
- 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 at the same time 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 lining 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 of 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, 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 came to the conclusion that the study of this cell type will help to find an effective method of treatment.
With 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 get sick, then the same fingers on 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 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 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, skin rashes appear 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 provoked 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 itself with sharp pain sensations unexpectedly. Not only fingers can be affected, but also small joints of the feet, knees and shoulders. Involvement in the pathological process can be both unilateral 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 - 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 over the joints acquires 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 can be single or cover a large area of the 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;
- soreness in the joints is permanent and does not go away during the day;
- significantly reduced mobility and functionality of the hand.
Arthropathic form of psoriasis is one of the most severe. Usually, deformation of the joints is not observed, but if this occurs, then the fusion of the articular surfaces of the bones (ankylosis) is not excluded.
The danger of this disease is that large joints and the spinal column 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 cartilage tissue covering the articular surfaces of bones is disrupted. This is facilitated by both 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, arthrosis 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 fingers hurt due to prolonged physical exertion, and after rest the pain disappears, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- increased pain when clenching a fist or straining fingers;
- an increase in the diseased joint in size;
- stiffness in the morning, requiring the "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 deterioration in the condition. If at first the pain occurs only during exertion, then later 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, 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 ligamentous-tendon apparatus of the hand and is manifested by blocking one of the fingers in the flexion or extension position. The pathological process is caused by overload or excessive pressure on the ligament area, so the disease occurs among people engaged in manual labor - builders, 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 "jumping" of the finger during extension, 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 with 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 "snapping" 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 farrowing (history taking) 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 next will depend on the results of the examination. 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 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.
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 on the background of 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 therapy.
How to treat arthrosis 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 arthrosis 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 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 an orthosis or splint. For pain, anti-inflammatory drugs and electrophoresis with hyaluronidase 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 extremely rarely, in most cases surgery is performed as planned.
Reference: due to the high risk of recurrence, it is very important to change your profession 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, such drugs will help relieve pain and enhance the effect of medications.
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 in the peel in a meat grinder or on a grater. Then dip the potato gruel into hot water and warm up to 39-40 °. After that, place it in a linen bag and apply to 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 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 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 tissues.
A compress with Bischofite is recommended to be done 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 hands are thoroughly washed 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 pain that has already appeared, you need to keep the brushes warm and not expose them to hypothermia. Work that requires performing the same type of movements is best done intermittently, and when using vibrating tools, use gloves and support the working brush with the other hand. When lifting and carrying heavy loads, the weight of the load should be evenly distributed on both limbs. You can also maintain healthy joints with the help of proper nutrition, which must contain calcium-containing foods and omega-3 fatty acids.