Pain in the joints of the fingers: causes and treatment.

Pain in the joints of the hand may be due to muscle fatigue or may be a sign of a dangerous systemic disease. Fortunately, the latter are much less common. Very often, doctors are faced with injuries and problems of the ligamentous apparatus, which respond well to local treatment. When the joints of the hand hurt, the causes and treatment are quite varied. To treat hand pathology, it is important for the patient to seek help in a timely manner, especially if the fingers are deformed: the longer they are in a forced position, the more difficult it will be to restore their function. In the article we will talk about possible diagnoses due to which the joints of the hands hurt, what to do and how to treat such conditions.

Pain in the small joints of the fingers: causes.

Patients who experience numbness, clicking, or pain in their finger joints when flexing, extending, or at rest may have a variety of diagnoses.

"Finger snapping, " also known as stenosing ligamentitis or Knott's disease

One of the most common causes of hand pain. This is a benign pathology in which it is very difficult to straighten the finger on its own from a bent position. The disease is common among both women and men and is associated with damage to the annular ligament of the hand. There is a feeling as if the finger is "stuck" in one position. Usually the joint of the middle finger of the right hand, as well as the ring finger or thumb, hurts. In left-handers, the left hand is most often affected.

Risk factors include:

• Overfatigue of the wrist flexor muscles. This can happen when working at a computer for long periods of time, driving long distances, carrying heavy bags, playing guitar, experiencing repeated blunt force trauma to the hand, or working with tools that must be held firmly in the hand. hand, as in construction.
• Metabolic disorders in the body: diabetes mellitus, decreased thyroid function - hypothyroidism.
• Smoking: Nicotine damages small blood vessels and nerves.
• Previous injury to the palm or base of the finger.

hand injury

This includes fractures, bone cracks, joint dislocations, tears and sprains of ligaments and muscles. A condition called hammertoe is common. This finger is bent and hurts a lot when you try to straighten it. It is distinguished from "snapping finger" by the following characteristics:

• Reason for appearance. "Hammerfinger" is a consequence of an injury, for example, from a strong blow to the tip of an extended finger, for example, from a hit with a ball while playing basketball.
• Location of flexion. The hammertoe bends at the distal interphalangeal joint, which is the small joint of the finger closest to the nail. The "snap finger" bends at the proximal interphalangeal joint, the second joint of the finger from the nail, or the metacarpophalangeal joint, which connects the finger and the palm itself.
• The hammertoe often swells, turns blue and becomes deformed, especially if there is a fracture of the phalanx.

Osteoarthritis

It is a degenerative-dystrophic disease of the joints, a common pathology in patients over 40 years of age, especially women. The cartilage tissue that makes up the joint is destroyed and the amount of fluid inside decreases. As a result, the joint "drys out" and its mobility decreases. In later stages, the bones that make up the joint are also destroyed and "growths" (osteophytes) may appear. The interphalangeal joints of the fingers are often affected. The patient finds it difficult to clench a fist or hold heavy objects, which significantly interferes with daily life.

Rheumatoid and psoriatic arthritis

These are autoimmune diseases. The metacarpophalangeal and proximal interphalangeal joints are the most affected. Because these diseases are systemic, meaning they cause changes throughout the body, the joints in both hands usually become painful and swollen. In addition, these patients usually present other symptoms: weakness, fever, loss of appetite. Severe rheumatoid arthritis can have extra-articular manifestations that affect the heart, lungs, eyes, blood vessels, and other organs. Despite its name, psoriatic arthritis can occur in the absence of symptoms of the skin disease psoriasis.

Gout and pseudogout

Metabolic disorders in which hard crystals are deposited in the joints. In gout, uric acid, a product of purine metabolism, is deposited in the form of crystals. Purines are formed within the body and also come from food. Gout crystals can appear not only inside the joints, but also under the skin and on tendons. The body reacts to them with severe inflammation. Pseudogout is similar to gout in its symptoms, but is caused by the deposition of a different substance: calcium pyrophosphate. Both diseases are treated with medications, although the medications are slightly different.

Tumors and cysts

This is a very rare pathology, the vast majority of hand tumors are benign. Cysts can appear in bone tissue and joints. They cause pain and, when large, affect the range of motion of the joints.

Infectious diseases of the fingers.

The most common: the offender and its variety: paronychia. This is an infection of the periungual tissues. Other infections include:

• cellulite: inflammation of the subcutaneous tissue,
• lymphangitis: inflammation of the lymphatic vessel,
• abscesses - collections of pus,
• osteomyelitis: inflammation of the bone.

Patients with hand infections often report previous minor trauma. The risk of these diseases increases if a person has a weakened immune system.

Carpal tunnel syndrome

Caused by compression of the median nerve in the carpal tunnel, formed by the bones, ligaments and tendons of the wrist. Women suffer from this syndrome more frequently than men. Conditions in which the likelihood of developing the disease increases: thyroid disease, pregnancy, obesity, diabetes. Constant work with prolonged holding of the wrist in an extended position often becomes a provoking factor. This is especially true for people whose professions involve assembling small parts, such as tailors or surgeons, or working on a computer. Symptoms appear in the fingers innervated by the median nerve: thumb, index, middle, and half of the ring finger close to them. Usually this is not only pain, but also numbness, tingling, tingling, and sometimes weakness in the hand.

Dupuytren's contracture or palmar fibromatosis

With this disease, it is impossible to completely straighten the fingers, they are in a forced half-bent position, as a result of which the functioning of the hand is impaired. First, dense cords of connective tissue form in the palmar tendons and then shorten. More often, the disease appears in men over 50 years of age and has a clear hereditary predisposition. As with many other hand pathologies, the risk increases due to diabetes, smoking and occupational hazards.

The list of possible diagnoses for hand joint pain also includes a number of rarer conditions: vibration diseases, vasculitis, etc. Given this diversity, it is better not to delay contacting a specialist.

Symptoms

The symptoms depend on the disease and the causes that caused it. The main sign of problems in the joints of the hand and its other structures is pain, but it is important to evaluate all its characteristics:

1. The onset of pain, which can be sharp or gradual.Diseases caused by degenerative changes and excessive fatigue of the ligamentous apparatus are characterized by a gradual onset, since the development of these processes takes time. Autoimmune diseases can manifest gradually or acutely. Exacerbations of gout and pseudogout occur suddenly and reach the peak of symptoms within a few hours. Trauma is also associated with sharp, sharp pain.
2. Time and factors of appearance or intensification of pain during the day.In carpal tunnel syndrome, the hand may hurt at night; In osteoarthritis, pain is more intense after stress is applied to the joints; In rheumatoid arthritis, pain is most pronounced in the first 30 minutes after waking up or after prolonged inactivity.

In addition to pain, patients may notice other associated symptoms, including:

• Features of flexion and extension of joints: with a "snap finger" the joint is locked in flexion, but can be carefully transferred to an extended position, while "hammer finger" and contracture cannot be straightened completely. With rheumatoid arthritis, thickening of the fingers in the joints and their deformation can be observed. If there is pathology of the ligaments, nodules can be felt in their composition.
• Stiffness and limitation of movement in the joints.
• With gout and autoimmune arthritis, the patient will notice redness and swelling, the joint will be hot to the touch; These are symptoms of inflammation.
• If the nerves are damaged, numbness, goosebumps, tingling, and decreased sensitivity to heat, cold, and touch may occur.
• With vasculitis (inflammation of the blood vessels), the fingers often turn white or blue.
• In many diseases, weakness in the hand can be observed: this indicates damage to the nerves, and also occurs with injuries.
• General symptoms such as weakness, fever, and problems in other organs whose cause is unknown indicate a systemic nature of the disease. In these cases, it is better to immediately consult a doctor.

Diagnosis

Diagnosis begins with a consultation with a specialist, who asks in detail about the complaints, the presence of concomitant and hereditary diseases. Afterwards, the doctor must examine the patient and palpate the hand. In some cases, these manipulations are enough to make a diagnosis. But to confirm and clarify it, additional studies are prescribed. Could be:

• X-ray of hands in various projections.- the most used and accessible method for assessing the condition of bones and joints. It will be necessary if a fracture, foreign body, developmental anomaly, tumor or cyst is suspected, as well as rheumatoid arthritis and osteoarthritis. Osteoarthritis on an x-ray is manifested by a decrease in the joint cavity, as well as the presence of bone growths - osteophytes.
• computed tomography(CONNECTICUT). It is used to better visualize complex fractures and evaluate the condition of the joints.
• Ultrasound of soft tissues and joints of the hand. . It allows you to visualize ligaments, tendons, nerve trunks and the state of the joints.
• magnetic resonance. The method provides clear layer-by-layer images of all structures in the hand. The main indications for use are ligament and tendon injuries.
• Electroneuromyography. This method is necessary to evaluate the conduction of nerve impulses. It is used if carpal tunnel syndrome is suspected.
• Blood test.Most often this is:
  1. metabolic indicators, for example, glycated hemoglobin and blood sugar in diabetes, since metabolic diseases affect the state of nerves, small vessels and ligaments.
  2. tests for the diagnosis of autoimmune diseases: erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, antibodies against cyclic citrullinated peptide.

Which doctor should I contact?

Diseases of the structures of the hand, due to their enormous diversity, usually require consultation with specialists of various profiles. Initially, if there was no actual injury, a therapist should be consulted; If an injury occurred, a traumatologist should be consulted.

Autoimmune diseases are treated by rheumatologists. The diagnosis and treatment of hand injuries and tumors is carried out by traumatologists and orthopedic surgeons. Consultation with an endocrinologist will be necessary in case of metabolic disorders. If weakness and numbness in the hand is noted, a neurologist should be consulted.

How to relieve pain in finger joints

Treatment can be surgical or conservative.

1. Surgical treatmentNecessary for purulent processes on the hand, as well as for complex injuries. Open wounds also require surgical treatment. Any wound is a source of infection and these patients are prescribed antibiotics and debridement. Closed fractures can be treated conservatively. They begin with rigid fixation of the fracture site: for 7 to 10 days for non-displaced fractures and for 3 weeks for displaced fractures. After this, the patient wears a special orthosis on the hand until the bone is completely restored, usually 4 to 10 weeks, sometimes longer.

2. Conservative treatmentfor autoimmune diseases that affect the joints of the hand, it is special: it is based on medications that inhibit the immune response and is prescribed by a rheumatologist. For musculoskeletal problems, systemic drug treatment is used as part of complex therapy. For hand joint pain, nonsteroidal anti-inflammatory medications may be indicated to relieve pain and inflammation. Local methods of influence give a good effect:

   • Injectionscorticosteroids in the joints of the hand, in the tendons. They effectively relieve inflammation, but have side effects, so they must be used according to strict indications.
   • Soft hand fixation.using orthoses or an elastic bandage. The fixation position depends on the diagnosis.
   • Exercisesabout the muscles of the hand, which a specialist will help you choose based on the pathology.
   • Acupuncture.The method involves inserting sterile needles into biologically active points, which relieves pain and improves joint mobility.
   • Shock wave therapy.In recent years it has been gaining popularity in the treatment of ligament problems. Effective and safe for the treatment of "finger snapping", which deforms osteoarthritis, reduces the likelihood of relapse, improves joint mobility and the functionality of the hand as a whole.
   • Kinesio tape.This involves gluing special tapes to the hand, which helps stabilize the joint in a comfortable position. This way you recover faster.
   • Laser therapy.It reduces pain and helps in cartilage restoration, which is extremely important for osteoarthritis.
   • Magnetotherapy. Aimed at reducing pain, inflammation and swelling.

Consequences

Most patients with hand injuries and degenerative processes, finger snapping, and carpal tunnel syndrome can restore joint function and return to their normal lifestyle. The main role in the prognosis of the disease is played by early consultation with a doctor, the correct use of bandages, orthoses, if indicated, and compliance with the prescribed recommendations. If the joints of the hand are left untreated for a long time, deformations may occur that cannot be completely eliminated. Contact a specialist as soon as you have complaints about the condition of your hand and he will select the necessary therapy for you.

Prevention

• Address common risk factors.The risk of musculoskeletal problems in the hand increases with metabolic disorders, smoking and hormonal disorders. It is important to maintain normal blood sugar levels, especially if you have already been diagnosed with diabetes. A special diet is recommended for gout patients, and some are prescribed anti-gout medications. It will be useful to periodically check the condition of the thyroid gland. A decrease in its function negatively affects the immune system and the entire body.
• Take care of your hand if you increase your risk of joint disease.For example, if your job involves working your hands too much, try to ensure the most comfortable position, do not keep your hands constantly bent, give them a break and do a little warm-up. Play sports with special gloves, monitor the condition of your skin and nails so that the infection does not penetrate the tissues of your hand. Periodically undergo preventive examinations with doctors.

Follow the listed recommendations and this will help reduce the risk of hand problems.