The hand is the most complex region of the upper limb in its structure. It consists of many bones, which are closely grouped together. The bones are attached by 30 different joints – the interphalangeal, metacarpophalangeal, carpometacarpal and radiocarpal.
According to statistics, the hands are injured much more often than any other part of the body. According to various sources, various injuries account for from 30 to 50% of the total number of injuries of the musculoskeletal system and are no less.
Therefore, among all the causes of pain in the fingers of the hands, the main reason is trauma. In second place in terms of prevalence are connective tissue diseases - rheumatoid arthritis, systemic scleroderma and lupus erythematosus, psoriasis. Very rarely, pain in the joints of the fingers gout, Osteoarthritis occurs due to a violation of metabolic processes.
Symptoms
Signs of non-traumatic injuries that may indicate the presence of joint deformity are the following:
- pain syndrome, which is permanent or wavy;
- pain when pressing and bending the fingers;
- swelling and redness of the skin on the joints;
- stiffness, stiffness during movements;
- deterioration of fine motor skills;
- creaking, crunching and cracking 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 rheumatic origin most often affects the fingers, as well as 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. Joint capsule from insideThe cells of the synovial membrane lining actively produce rheumatoid factor: pathogenic antibodies are protective protein molecules.
Subsequently, 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 the cells of the immune system - neutrophils and phagocytes, suchRelease 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 on thisconcluded that the study of this type of cell would help in finding an effective method of treatment.
With rheumatoid arthritis, any finger can hurt - the index, middle, ring finger or little finger, but the lesion will always be bilateral. If one or more fingers of the left hand become ill, the same fingers on the right hand almost immediatelyIt just starts hurting.
The phalanges in the joint area swell and become red, 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 symptoms of arthritisProgression replaces the smooth cartilage tissue with a fibrous structure, which impedes the free movement of bones in the joint.
Gradually, the joints are deformed, the pain intensifies due to a change in the position of the articular elements. With a long course of the disease, small painless forms appear near the joints on the back of the hand - rheumatoid nodules.
psoriatic arthritis
Symptoms of this disease can be similar to rheumatoid arthritis and occur against the background of a dermatological pathology - psoriasis. In most cases, skin rashes first appear, and after a while there is pain in the joints of the fingers.
It is also possible for skin and joint lesions to appear simultaneously, in 20 out of a hundred patients, the joints first begin to hurt. Why psoriasis occurs is unknown. Presumably, it is a genetic predisposition, immune system malfunction and infectionCan be provoked. 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 unexpectedly sharp pain sensations. Not only the fingers can be affected, but also the small joints of the feet, knees, and shoulders. May be affected. Participation in the pathological process can be both unilateral and symmetric.
The pain syndrome is most pronounced at night and at rest. There is stiffness in the morning, pain subsides during the day and with movements. 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-arthritic).
After prolonged rest, the fingers swell and become sausage-like, the tendons of the flexor muscles become inflamed, the skin over the joints becomes purple-blue in color. The following symptoms indicate the presence of psoriasis and psoriatic arthritis. indicate:
- red or pink scaly spots on the head, elbows, knees, and thighs - they may be single or cover a large area of skin;
- Distinctive pits on the skin of the hands, similar to smallpox, pigmentation on the fingers or toes;
- Psoriatic plaques can be hyperemic, edematous and itchy;
- 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 severe. Usually, deformity of the joints is not observed, but if it occurs, 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 gradually become involved in the disease 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 endocrine or metabolic disease. Most often, arthrosis affects the large joints of the lower extremities – knees, hips and ankles – as they interfere with walking andCarry the main load when standing. The upper extremities are affected much less often.
When pain occurs in the fingers due to prolonged physical exertion, and the pain disappears after rest, the development of arthrosis is not excluded.
Over time, other symptoms appear:
- The pain worsens when clenching the fist or straining the fingers;
- an increase in the size of the diseased joint;
- morning stiffness, requiring "development" of the fingers for 10-15 minutes or more;
- Characteristic cracking when bending the fingers.
Osteoarthritis develops slowly and may not cause much concern for many 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. If it occurs, it does not go away even after taking rest later.
Due to the marginal growth of the bones that form the joints, distinctive pineal structures are visible. 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 a position of flexion or extension. The pathological process is caused by overload or excessive pressure on the ligament area, so this disease is caused by physical exertion. - 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 with a click. In the future, the "snap" disappears, and the finger remains motionless, turning into a flexion or extensor contraction.
In the early stages, there is pain when pressing on the palm at the base of the finger and difficulty in flexion/extension, especially evident in the morning. With a long course of ligamentitis, you can only move your finger with the other hand. And the "snapping" is followed by pain that extends not only to the palm, but also to the forearm.
which doctor to contact
For pain in the fingers, you can first contact a doctor, who, if necessary, will refer you to a narrow specialist - a traumatologist, rheumatologist, hematologist, neurologist or surgeon. For diagnosis, diagnostic, radiation and laboratory. research methods are used.
To find out the cause of the pain, a farrowing (history taking) and a physical examination are done, after which an X-ray or tomography, blood and urine tests are prescribed.
Treatment
How to treat 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 of the NSAID group are prescribed - non-steroidal anti-inflammatory drugs. Currently, of the new generation. More and more often used means, NSAIDs of selective action.
Selective NSAIDs act selectively and have a less toxic effect on the body, they can be taken for a longer period. If the pain syndrome is moderate or mild, then 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.
If there is joint pain on the background of psoriatic arthritis, the same immunosuppressive drugs are prescribed. Methods such as plasmapheresis, hemosorption and photochemotherapy are used to reduce disease activity, prolong the period of remission and reduce the duration of drug therapy. is done for.
How to treat arthrosis of the joints depends on the stage of the disease. In 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 accelerates recovery processes. stimulates.
For the treatment of arthrosis can be prescribed:
- magnet therapy;
- electrophoresis;
- Laser;
- ultrasound;
- cryotherapy - exposure of joints with liquid nitrogen;
- balneotherapy - baths with mineral water;
- Hirudotherapy - during the treatment of leeches, substances that promote cartilage regeneration (hirudin, vitamins and hormones) enter the joint.
Therapeutic strategy to prevent 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 arm, if necessary. If so, the arm 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 of the third stage, conservative therapy is performed extremely rarely, planning in most casesThe surgery is done accordingly.
Context: Due to the high risk of recurrence, it is very important to change your profession if weight is involved on your hands.
folk remedies
Means prepared according to folk recipes may not be the main method of treatment, as they are not effective enough. However, as an additional therapy, such drugs will help relieve pain and enhance 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 cut into peels directly in a meat grinder or on a grater. Then immerse the potato pulp in hot water and heat to 39-40 degrees. After that, put it on a linen. Place in a bag and apply on sore joints for half an hour. The procedure can be done several times a day.
If you keep your hands in melted paraffin for 10 minutes, and then in any herbal decoction for 15-20 minutes, then the application of paraffin relieves pain well. You are not afraid of burnscan, because paraffin melts at a temperature not exceeding 65 °. To obtain 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 mobility of joints. Regular use of Bischofite maintains the tone of muscles and connective tissues. Lives.
A compress with bishophyte is recommended to be done as follows: warm the joints with a heating pad or put them in a hot bath, then dilute bischofite into the skin of the hands first 1: 1 with water. Rubbing continuing for several minutesshould, after which a cloth or gauze soaked in the solution is applied to the wound area. From above, the compress is covered with polyethylene and insulated. Compresses are made with bishophyte at night, in the morning the hands are thoroughly moistened with warm water. Kind of washed off. The procedure is carried out every other day for three weeks.
Context: A compress with bischophyte cannot be placed on more than three joints at once.
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 the same type of movement, that is best done intermittently, and when using vibrating tools, use gloves and support the working brush with the other hand. You can also maintain healthy joints with the help of proper nutrition, which should contain calcium-rich foods and omega-3 fatty acids.