Painful finger joints: causes and treatment

Pain in the joints of the hand can occur due to muscle fatigue, or it can be a sign of a dangerous systemic disease. Fortunately, the latter are much rarer. Most often, doctors are faced with injuries and problems of the ligament apparatus, which respond well to local treatment. When the joints of the hand hurt, the causes and treatment are quite different. For the treatment of 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 that cause pain in the joints of the hands, what to do, how to treat such conditions.

Pain in the small joints of the fingers: causes

Patients who feel numbness, clicking, or pain in the joints of the fingers when bending, extending, or at rest may have different diagnoses.

"Snapping finger", 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 hurts, as well as the ring finger or thumb. In left-handed people, the left hand is more often affected.

Risk factors include:

• Wrist flexor muscle fatigue. This can happen when you work at a computer for long periods of time, drive long distances, carry heavy bags, play the guitar, repeat blunt hand injuries, or work with tools that need to be held firmly in your hand, such asconstruction.
• Metabolic disorders in the body: diabetes mellitus, reduced 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 strains. A condition called hammertoe is common. This finger is bent and hurts a lot when you try to straighten it. It differs from "finger snapping" by the following characteristics:

• The reason for the occurrence. "Hammer finger" is the result of an injury, for example, from a strong blow to the tip of an outstretched finger, for example, from hitting a ball while playing basketball.
• Localization of flexion. The hammer toe is bent at the distal interphalangeal joint, which is the small joint of the finger closest to the nail. The "finger" is bent at the proximal interphalangeal joint, the second joint of the finger from the nail, or the metacarpophalangeal joint that connects the finger to the palm itself.
• The hammer toe often becomes swollen, blue and deformed, especially if a phalanx fracture occurs.

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 becomes "dry" and its mobility decreases. In the later stages, the bones that form the joint are also destroyed and "growths" - osteophytes - can 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 everyday 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 on 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 inside 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 in symptoms to gout, but it is caused by the deposition of another 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 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 joints.

Infectious diseases of the fingers

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

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

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 bones of the wrist, ligaments and tendons. Women suffer from this syndrome more often than men. Conditions in which the probability of developing the disease increases: thyroid diseases, pregnancy, obesity, diabetes. Constant work with long-term holding of the wrist in the extension 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 computers. Symptoms occur on the fingers supplied by the median nerve: the thumb, index, middle and half of the ring finger close to them. Usually it's not just pain, but numbness, tingling and pins and needles, 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, due to which the functioning of the hand is disturbed. First, dense strands of connective tissue are formed in the palmar tendons, and then they shorten. The disease occurs more often in men over 50 years of age and has a clear hereditary predisposition. As with many other hand pathologies, the risk is increased by diabetes, smoking and occupational hazards.

The list of possible diagnoses for pain in the joints of the hand includes a number of rarer conditions: vibration 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 appearance of pain, which can be acute or gradual.Diseases caused by degenerative changes and overfatigue of the ligament apparatus are characterized by a gradual onset, because the development of these processes takes time. Autoimmune diseases can manifest gradually or acutely. Exacerbations of gout and pseudogout occur suddenly, reaching the peak of symptoms within a few hours. Trauma is also associated with sharp, sharp pain.
2. Time and factors for occurrence or intensification 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: "snap finger" joint is locked in flexion, but can be carefully moved to an extended position, while "hammer finger" and contracture cannot be completely straightened. With rheumatoid arthritis, you can see the thickening of the fingers in the joints and their deformation. If there is pathology of the ligaments, knots in their composition can be felt.
• 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, tingling, tingling, and reduced sensitivity to heat, cold, and touch may occur.
• With vasculitis - inflammation of blood vessels - fingers often turn white or blue.
• Weakness in the hand can be observed in many diseases: it indicates nerve damage, and it also occurs in injuries.
• General symptoms such as weakness, fever and problems in other organs for which you do not know the cause indicate the systemic nature of the disease. In these cases, it is better to consult a doctor immediately.

Diagnostics

The diagnosis begins with a consultation with a specialist, who asks in detail about complaints, the presence of accompanying and hereditary diseases. After that, the doctor must examine the patient and palpate the hand. In some cases, these manipulations are enough to make a diagnosis. But in order to confirm and clarify this, additional studies are prescribed. It can be:

• X-ray of hands in various projections- the most commonly used and accessible method for assessing the condition of bones and joints. This will be necessary if there is a suspicion of a fracture, foreign body, developmental anomaly, tumor or cyst, as well as rheumatoid arthritis and osteoarthritis. Osteoarthritis on an X-ray is manifested by the reduction of the joint cavity, as well as the presence of bone growths - osteophytes.
• CT scanner(CT). It is used for better visualization of complex fractures and assessment of joint conditions.
• Ultrasound of soft tissues and joints of the hand. It allows you to visualize ligaments, tendons, nerve trees and joint conditions.
• 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 evaluate 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, because 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 hand, due to their enormous variety, often require consultation with specialists of several profiles. Initially, if there was no actual injury, you should contact a therapist, and if there was an injury, you should contact a traumatologist.

Autoimmune diseases are treated by rheumatologists. Diagnosis and treatment of hand injuries and tumors are carried out by orthopedic traumatologists and surgeons. Consultation with an endocrinologist will be necessary due to metabolic disorders. If you notice weakness and numbness in your hand, you should contact a neurologist.

How to relieve pain in the joints of the fingers

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 such patients are prescribed antibiotics and debridement. Closed fractures can be treated conservatively. They begin with rigid fixation of the fracture site: 7-10 days for non-displaced fractures and 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 longer.

2. Conservative treatmentfor autoimmune diseases that affect the joints of the hand, it is special - it is based on drugs that suppress the immune response and is prescribed by a rheumatologist. In 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 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 fixation of the handusing orthotics or an elastic bandage. The fixation position depends on the diagnosis.
   • Exerciseson the muscles of the hand, which the expert 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 become increasingly popular in the treatment of ligament problems. Effective and safe for the treatment of "finger cracking", deforming osteoarthritis, reduces the likelihood of recurrence, improves joint mobility and the functionality of the hand as a whole.
   • Kinesio taping.This involves gluing special tapes to the arm, which helps stabilize the joint in a comfortable position. That way he recovers faster.
   • Laser therapy.It reduces pain and helps restore cartilage, which is extremely important for osteoarthritis.
   • Magnetotherapy. It is intended to reduce pain, inflammation and swelling.

Consequences

Most patients with hand injuries and degenerative processes, finger cracking and carpal tunnel syndrome can restore joint function and return to their normal lifestyle. Early consultation with a doctor, proper wearing of bandages, orthotics, if indicated, and compliance with prescribed recommendations play a leading role in the prognosis of the disease. If the joints of the hand are not treated for a long time, deformations are possible that cannot be completely removed. 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

• Get rid of 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, especially if you have already been diagnosed with diabetes. Patients with gout are recommended a special diet, and some are prescribed anti-gout medications. It will be useful to have your thyroid checked periodically. A decrease in its function negatively affects the immune system and the whole body.
• Take care of your hand if the risk of joint disease is increased.For example, if your work involves overloading your hands, try to ensure the most comfortable position, do not keep your arms constantly bent, give them a break and warm up a little. Play sports in special gloves, monitor the condition of the skin and nails so that the infection does not penetrate the tissues of your hand. Have regular preventive check-ups with a doctor.

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