Painful finger joints: causes and treatment

Pain in the joints of the hand can result from muscle fatigue or be a sign of a dangerous systemic disease. Fortunately, these are much less common. Most often, doctors are faced with injuries and problems of the ligamentous apparatus, which respond well to local treatment. When hand joints hurt, the causes and treatments are very varied. To treat hand pathology, it is important that the patient seeks 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 why 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.

"Snap fingers, " 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. It feels like 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 more often affected.

Risk factors include:

• Excessive fatigue of the wrist flexor muscles. This can occur when working at a computer for long periods of time, driving long distances, carrying heavy bags, playing guitar, experiencing repeated blunt trauma to the hand, or working with tools that must be held firmly inthe 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, ruptures 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 "finger snap" by the following characteristics:

• Reason for appearance. "Hammer finger" is a consequence of an injury, for example from a strong blow to the tip of an extended finger, for example from being hit by a ball while playing basketball.
• Location of flexion. The hammer finger is bent at the distal interphalangeal joint, which is the small joint of the finger closest to the nail. The "pressure 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 malleus finger often becomes swollen, blued, and deformed, especially when 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 old, particularly women. The cartilaginous tissue that forms the joint is destroyed and the amount of fluid it contains decreases. As a result, the joint becomes "dry" and its mobility decreases. At later stages, the bones that form 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, these patients often have other symptoms: weakness, fever, loss of appetite. Severe rheumatoid arthritis can have extra-articular manifestations affecting 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 with severe inflammation. Pseudogout resembles gout in its symptoms, but it is caused by the deposition of a different substance - calcium pyrophosphate. Both conditions 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 they are large, they alter the range of movement of the joints.

Infectious diseases of the fingers

The most common: the criminal 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,
• abscess - collections 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's immune system is weakened.

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 often than men. Conditions in which the risk 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 job involves putting small parts together, such as tailors or surgeons, or working on a computer. Symptoms appear in the fingers supplied by the median nerve: thumb, index, middle and half of the ring finger close to them. Usually it is not only pain, but also numbness, tingling, tingling and sometimes weakness in the hand.

Dupuytren's disease or palmar fibromatosis

With this disease, it is impossible to completely straighten the fingers, they are in a forced half-bent position, which impairs the functioning of the hand. First, dense cords of connective tissue form in the palmar tendons, then they are shortened. 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 risks.

The list of possible diagnoses of pain in the joints of the hand also includes a number of rarer conditions: vibration disease, vasculitis, etc. Given this diversity, it is better not to delay in 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 assess all its characteristics:

1. The onset of pain, which can be acute or progressive.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, reaching peak symptoms within a few hours. Trauma is also associated with sharp, sharp pain.
2. Timing and factors of onset or intensification of pain during the day.In carpal tunnel syndrome, the hand may hurt at night; in osteoarthritis, the pain is greater after stress on the joints; In rheumatoid arthritis, 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:

• Characteristics of flexion and extension of the joints: with a "snap finger", the joint is locked in flexion, but can be carefully transferred to an extended position, while the "hammer finger" and contracture cannot be completelystraightened. With rheumatoid arthritis, you may notice thickening of the fingers at the joints and their deformation. In case of pathology of the ligaments, nodules can be felt in their composition.
• Stiffness and limitation of joint movement.
• 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.
• In cases of vasculitis - inflammation of the blood vessels - the fingers often turn white or blue.
• In many diseases, hand weakness can be observed: this indicates nerve damage and also occurs in cases of 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 best to consult a doctor immediately.

Diagnostic

Diagnosis begins with a consultation with a specialist, who asks detailed questions about complaints, the presence of concomitant and hereditary diseases. Next, the doctor should 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. It can be:

• X-ray of the hands in various projections- the most commonly used and accessible method for assessing the condition of bones and joints. It will be necessary in cases of 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). Used to better visualize complex fractures and assess joint condition.
• Ultrasound of soft tissues and joints of the hand. 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 injuries to ligaments and tendons.
• Electroneuromyography. This method is necessary to assess the conduction of nerve impulses. It is used if carpal tunnel syndrome is suspected.
• Blood tests.These are most often:
  1. metabolic indicators - for example, glycated hemoglobin and blood sugar in diabetes, because 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, often require consultation of specialists of several profiles. As a first step, if there has been no actual injury, you should see 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 are carried out by traumatologists and orthopedic surgeons. A consultation with an endocrinologist will be necessary in the event of metabolic disorders. If you notice weakness and numbness in the hand, you should consult a neurologist.

How to Relieve Pain in Your Finger Joints

Treatment can be surgical or conservative.

1. Surgical treatmentnecessary for purulent processes of the hand, as well as for complex wounds. 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 that, the patient wears a special orthosis on the hand until the bone is completely restored - usually 4-10 weeks, sometimes more.

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, 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.
   • Gentle hand fixationusing orthotics 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 ligament problems. Effective and safe for the treatment of deforming "finger snap" osteoarthritis, reduces the risk of relapse, improves joint mobility and functionality of the hand as a whole.
   • Kinesio recording.This involves taping special bands to the hand, which helps stabilize the joint in a comfortable position. This way it recovers faster.
   • Laser therapy.Reduces pain and helps restore cartilage, which is extremely important for osteoarthritis.
   • Magnetotherapy.Intended to reduce pain, inflammation and swelling.

Consequences

Most patients suffering from hand injuries and degenerative processes, snapping fingers and carpal tunnel syndrome are able to restore joint function and return to their normal lifestyle. The 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 hand joints are left untreated for a long time, deformities 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 select the necessary treatment 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 the risk of joint diseases is increased.For example, if your work involves overwork of your hands, try to ensure the most comfortable position, do not keep your hands constantly bent, rest them 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. Undergo regular preventive examinations from doctors.

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