Finger joint pain: causes and treatment

Pain in the joints of the hand can occur from muscle fatigue, or it can be a sign of a dangerous systemic disease. Fortunately, the latter are much less common. Most 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 different. To treat hand pathology, it is important for the patient to seek help in time, 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 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 their knuckles when bending, lying, or at rest may have a variety of diagnoses.

"Split toe, " 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 independently straighten the finger from a bent position. The disease is common in 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 or thumb, hurts. In left-handed people, the left hand is affected more often.

Risk factors include:

• Excessive fatigue of the flexor muscles of the wrist. This can happen when working on a computer for long periods of time, driving long distances, carrying heavy bags, playing the guitar, repetitive open trauma to the hand, or working with tools that need to be held firmly in the hand, such as p. sh. 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

These include fractures, bone breaks, 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 is distinguished from "squeaky finger" by the following characteristics:

• Reason for submission. "Hammer finger" is the result of injury, for example, from a strong blow to the tip of an extended finger, for example, being hit by a ball during the game of basketball.
• Bend localization. The hammer toe is bent at the distal interphalangeal joint, which is the little joint of the toe closest to the nail. The "broken finger" is bent 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 hammer toe often becomes swollen, blue and deformed, especially if there is a fracture of the phalanx.

Osteoarthritis

This is a degenerative-dystrophic disease of the joints, a common pathology in patients over 40 years old, especially in women. The cartilage tissue that forms the joint is destroyed and the amount of fluid inside it decreases. As a result, the joint becomes "dry" and its mobility decreases. In the later stages, the bones forming the joint are also destroyed and "growths" - osteophytes - may appear on them. The interphalangeal joints of the fingers are usually affected. It is difficult for the patient to make 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 most often 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, including 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 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 another substance - calcium pyrophosphate. Both diseases are treated with medication, 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 they are large, they impair the range of motion in the joint.

Infectious diseases of the fingers

The most common: felon 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 vessels,
• abscesses - collections of pus,
• osteomyelitis - inflammation of the bones.

Patients with hand infections usually report minor previous 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 carpal bones, ligaments and tendons. Women suffer from this syndrome more often than men. Conditions in which the possibility of developing the disease increases: thyroid disease, pregnancy, obesity, diabetes. Continuous work with prolonged holding 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 close to them. Usually this is not just pain, but also numbness, tingling and pins and needles, and sometimes weakness in the hand.

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. First, dense cords of connective tissue form in the palmar tendons, then they shorten. Most often, the disease appears in men over 50 years old 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 pain in the joints of the hand also includes a number of rarer conditions: tremor disease, vasculitis, etc. Given this diversity, it is better not to delay 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. The onset of pain, which can be acute 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 appear gradually or acutely. Exacerbations of gout and pseudogout occur suddenly, reaching the peak of symptoms within a few hours. Trauma is also accompanied by sharp and sharp pains.
2. Time and factors for the occurrence or intensification of pain during the day.With carpal tunnel syndrome, the hand can hurt at night; with osteoarthritis, the pain is stronger after joint stress; with 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 accompanying symptoms, including:

• Characteristics of joint flexion and extension: with a "snipped finger", the joint is locked in flexion, but can be carefully transferred to an extended position, while the "hammer finger" and the contracture cannot be fully straightened. With rheumatoid arthritis, you can see thickening of the fingers at the joints and their deformation. If there is pathology of the ligaments, the joints 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, numbness, lumps, 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.
• Weakness in the hand can be observed with many diseases: this indicates nerve damage and also occurs with 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.

Diagnosing

Diagnosis begins with a consultation with a specialist, who asks in detail about complaints, the presence of accompanying and hereditary diseases. Next, the doctor should examine the patient and palpate the hand. In some cases, these manipulations are enough to establish a diagnosis. But to confirm and clarify it, additional studies are described. It can be:

• X-ray of hands in different projections- the most used and most accessible method for assessing the condition of bones and joints. It will be required if there is a suspected fracture, foreign body, developmental abnormality, tumor or cyst, 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.
• CT scan(CT). It is used to better visualize complex fractures and assess joint condition.
• Ultrasound of the soft tissues and joints of the hand. It allows you to visualize ligaments, tendons, nerve trunks and joint condition.
• 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 if carpal tunnel syndrome is suspected.
• Blood tests.Most often this is:
  1. metabolic indicators - for example, glycated hemoglobin and blood sugar in diabetes, since metabolic diseases affect the condition 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 great variety, often require consultation with specialists of several profiles. First, if there has been no real damage, you should consult a therapist; if an injury has occurred, you should consult a traumatologist.

Autoimmune diseases are treated by rheumatologists. Diagnosis and treatment of hand injuries and tumors is performed by orthopedic traumatologists and surgeons. Consultation with an endocrinologist will be necessary for metabolic disorders. If you notice weakness and numbness in the hand, 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 in 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. After that, the patient wears a special orthosis on the hand until the bone is completely restored - usually 4-10 weeks, sometimes even 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 musculoskeletal problems, systemic drug treatment is used as part of complex therapy. For pain in the joints of the hand, non-steroidal anti-inflammatory drugs may be indicated to relieve pain and inflammation. Local influence methods 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.
   • Gentle hand fixationusing orthotics or an elastic bandage. The fixation position depends on the diagnosis.
   • exercisein 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 is gaining popularity in the treatment of ligament problems. Effective and safe for the treatment of "broken finger", deforming osteoarthritis, reduces the possibility of relapse, improves the mobility of the joints and the functionality of the hand as a whole.
   • Kinesio taping.This involves attaching special straps to the hand, which helps stabilize the wrist in a comfortable position. This way he recovers faster.
   • Laser therapy.It reduces pain and helps restore cartilage, which is extremely important for osteoarthritis.
   • Magnetotherapy. Aimed at reducing pain, inflammation and swelling.

Consequences

Most patients with hand injuries and degenerative processes, finger sprains and carpal tunnel syndrome are able to restore joint function and return to their normal lifestyle. The main role in the prognosis of the disease is played by the early consultation with the doctor, the correct wearing of the bandage, 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.

Preventing

• Address 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 body.
• Take care of your hand if the risk of joint diseases increases.For example, if your work involves overloading your hands, try to ensure the most comfortable position, do not keep your hands constantly bent, rest and do some 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 the hand. Regularly perform preventive examinations with doctors.

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