Pain in the joints of the fingers: causes and treatment

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

Pain in the small joints of the fingers: causes

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

"Snapping finger" also known as stenosing ligamentitis or Knott's disease

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

Risk factors include:

• Overfatigue of the wrist flexor muscles. This can happen with prolonged computer work, driving long distances, carrying heavy bags, playing the guitar, repetitive blunt trauma to the hand, or working with tools that need to be held firmly in the hand, such asconstruction.
• Metabolic disorders in the body: diabetes mellitus, decreased function of the thyroid gland - 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, ligament and muscle tears and sprains. A condition called hammertoe is common. This finger is bent and hurts a lot when you try to straighten it. It differs from the "clicking finger" by the following characteristics:

• Cause of appearance. A "hammer toe" results from an injury, such as a hard blow to the tip of an outstretched toe, such as being hit by a ball during a basketball game.
• Localization of flexion. The mallet finger is bent at the distal interphalangeal joint, which is the small joint of the finger closest to the nail. The "snapping finger" is bent at the proximal interphalangeal joint, the second joint of the finger after the nail, or metacarpophalangeal joint, which connects the finger and the palm itself.
• The hammer toe is often swollen, bruised and deformed, especially if there is a phalanx fracture.

Osteoarthritis

This is a degenerative-dystrophic disease of the joints, a common pathology in patients over 40 years old, especially women. The cartilage tissue that forms the joint is destroyed and the amount of fluid in it decreases. As a result, the joint dries up and its mobility decreases. In the later stages, the bones that form the joint are also destroyed and "growths" - osteophytes - can appear on them. Usually the interphalangeal joints of the fingers are affected. It is difficult for the patient to make a fist or hold heavy objects, which significantly interferes with everyday life.

Rheumatoid and psoriatic arthritis

These are autoimmune diseases. The metacarpophalangeal and proximal interphalangeal joints are most commonly affected. Because these diseases are systemic, meaning they cause changes throughout the body, the joints usually become painful and swollen in both hands. In addition, such patients often have other symptoms: weakness, fever, loss of appetite. Severe rheumatoid arthritis can have extra-articular manifestations involving 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 made inside the body and also come from food. Gout crystals can appear not only in the joints, but also under the skin and in the 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 drugs, although the drugs are slightly different.

Tumors and cysts

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

Infectious diseases of the fingers

The most common: felon and its variety - paronychia. This is an infection of the tissues around the nail. Other infections include:

• cellulitis - inflammation of the subcutaneous tissue,
• lymphangitis - inflammation of the lymphatic vessels,
• abscesses - collection of pus,
• osteomyelitis - inflammation of the bone.

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

Carpal tunnel syndrome

It is caused by compression of the median nerve in the carpal tunnel formed by the wrist bones, ligaments and tendons. Women suffer from this syndrome more often than men. Conditions in which the probability of developing the disease increases: thyroid disease, pregnancy, obesity, diabetes. Constant work with prolonged retention of the wrist in an extended position often becomes a provoking factor. This is especially true for people whose occupations involve assembling small parts, such as tailors or surgeons, or working on a computer. Symptoms appear in the fingers that are supplied by the median nerve: the thumb, index, middle and half of the ring finger near them. Usually it's not just pain, but numbness, tingling and numbness, and sometimes weakness in the arm.

Dupuytren's contracture or palmar fibromatosis

With this disease, it is impossible to fully straighten the fingers, they are in a forced half-bent position, as a result of which the functioning of the hand is impaired. Dense connective tissue bundles are first formed in the palmar tendons, then shortened. More often, the disease manifests itself in men over the age of 50 and there is a pronounced hereditary predisposition. As with many other hand pathologies, the risk increases due to diabetes, smoking and occupational risks.

The list of possible diagnoses for pain in the joints of the hand also includes a number of rarer conditions: vibration disease, vasculitis, etc. Given this variety, it is better not to delay in contacting a specialist.

Symptoms

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

1. Onset of pain, which can be sharp or gradual.Diseases caused by degenerative changes and overfatigue of the ligament apparatus are characterized by a gradual onset, since the development of these processes takes time. Autoimmune diseases can appear gradually or acutely. Gout and pseudogout flare-ups occur suddenly, with symptoms peaking within a few hours. Trauma is also associated with sharp, sharp pain.
2. Time and factors for onset or exacerbation of pain during the day.With carpal tunnel syndrome, the hand may hurt at night; in osteoarthritis, the pain is stronger after loading the joints; in rheumatoid arthritis, the pain is most pronounced in the first 30 minutes after waking up or prolonged inactivity.

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

• Features of joint flexion and extension: with a "snapping finger" the joint is locked in flexion but can be gently moved into an extended position until the "hammer finger" and contracture cannot be fully straightened. In rheumatoid arthritis, you can see thickening of the fingers in the joints and their deformation. If there is a pathology of the ligaments, knots can be felt in their composition.
• Stiffness and limitation of joint movements.
• 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, tingling, goosebumps, tingling, and reduced sensitivity to heat, cold, and touch may occur.
• With vasculitis - inflammation of the blood vessels - the fingers often turn white or blue.
• Weakness in the hand can be observed in many diseases: this indicates nerve damage and also in injuries.
• General symptoms such as weakness, fever and problems in other organs for which you do not know the cause indicate a systemic nature of the disease. In these cases, it is better to consult a doctor immediately.

Diagnosis

The diagnosis begins with a consultation with a specialist, who inquires in detail about complaints, the presence of accompanying and hereditary diseases. The doctor should then examine the patient and palpate the hand. In some cases, these manipulations are sufficient to establish a diagnosis. But to confirm and clarify it, additional studies are prescribed. Can not be:

• X-ray of hands in different projections- the most frequently used and accessible method for assessing the condition of bones and joints. It will be required if a fracture, foreign body, developmental abnormality, tumor or cyst is suspected, as well as rheumatoid arthritis and osteoarthritis. Osteoarthritis on an X-ray is manifested by a reduction in the joint cavity, as well as the presence of bone growths - osteophytes.
• CT(CT). It is used for better visualization of complex fractures and assessment of joint condition.
• Ultrasound of the soft tissues and joints of the hand. It allows you to visualize ligaments, tendons, nerve trunks and the condition of joints.
• MRI. The method provides clear layer-by-layer images of all hand structures. The main indications for use are ligament and tendon injuries.
• Electroneuromyography. This method is necessary to assess the conduction of nerve impulses. It is used when carpal tunnel syndrome is suspected.
• Blood tests.Most often it 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 to cyclic citrullinated peptide.

Which doctor should I contact?

Diseases of the structures of the hands, due to their huge variety, often require consultation with specialists of various profiles. Initially, if there was no actual injury, you should consult a therapist, if an injury occurred, you should consult a traumatologist.

Autoimmune diseases are treated by rheumatologists. Diagnosis and treatment of hand injuries and tumors are performed by orthopedic traumatologists and surgeons. In case of metabolic disorders, consultation with an endocrinologist will be necessary. If weakness and numbness of the hand are noticed, you should consult a neurologist.

How to relieve pain in the joints of the fingers

Treatment can be surgical or conservative.

1. Surgical treatmentnecessary for purulent processes of the hand, as well as for complex injuries. Open wounds also require surgical treatment. Any wound is a source of infection and such patients are prescribed antibiotics and debridement. Closed fractures can be treated conservatively. They begin with rigid fixation of the fracture site: for 7-10 days for non-displaced fractures and for 3 weeks for displaced fractures. The patient then wears a special arm brace until the bone is fully healed - usually 4-10 weeks, sometimes longer.

2. Conservative treatmentfor autoimmune diseases affecting the joints of the hand, it is special - it is based on drugs that suppress the immune response and is prescribed by a rheumatologist. For problems with the musculoskeletal system, systemic drug treatment is used as part of complex therapy. For pain in the joints of the hand, nonsteroidal anti-inflammatory drugs 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 should be used according to strict indications.
   • Soft arm fixationusing orthoses or an elastic bandage. The fixation position depends on the diagnosis.
   • Exerciseson the muscles of the hand, which a specialist will help you choose depending 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 gained popularity in the treatment of relationship problems. Effective and safe for the treatment of "clicking finger", deforming osteoarthritis, reduces the likelihood of relapse, improves joint mobility and the functionality of the hand in general.
   • Kinesio taping.This involves taping special tapes to the arm, which helps stabilize the joint in a comfortable position. So it recovers faster.
   • Laser therapy.It reduces pain and helps restore cartilage, which is extremely important in osteoarthritis.
   • Magnetotherapy.Aimed at reducing pain, inflammation and swelling.

Consequences

Most patients with hand injuries and degenerative processes, finger snapping and carpal tunnel syndrome manage to restore joint function and return to their normal lifestyle. A leading role in the prognosis of the disease is played by early consultation with a doctor, the correct wearing of a bandage, an orthosis, if indicated, and compliance with the prescribed recommendations. If the joints of the hand are not treated for a long time, deformations are possible that cannot be completely eliminated. Contact a specialist as soon as you have complaints about the condition of your hand and he will choose the necessary therapy for you.

Prevention

• Note the common risk factors.The risk of musculoskeletal problems with the hand increases with metabolic disorders, smoking and hormonal disorders. It is important to maintain normal blood sugar, 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 whole organism.
• Take care of your hands if the risk of joint diseases is increased.For example, if your work involves overloading the hands, 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 in special gloves, monitor the condition of your skin and nails so that the infection does not penetrate the tissues of your hand. Have regular check-ups with doctors.

Follow the recommendations listed and it will help reduce the risk of problems with your hands.