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 varied. To treat hand pathology, it is important that the patient seeks 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 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 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 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 among 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 more often affected.
Risk factors include:
- Overfatigue of the wrist flexor muscles. This can happen when working at a computer for long periods of time, driving long distances, carrying heavy bags, playing the guitar, repeated blunt trauma to the hand, or working with tools that need to be held tightly in the hand, such 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 hammer toe is common. This finger is bent and hurts a lot when you try to straighten it. It is distinguished from the "snapping finger" by the following characteristics:
- Reason for appearance. "Hammer finger" is a consequence of injury, for example, from a strong blow to the tip of an extended finger, for example, being hit by a ball while playing basketball.
- Localization 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 "snap 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 finger 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 of age, especially 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. 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 clench his hand into 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 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 formed inside the body and also come from food. Gout crystals can appear not only inside joints, but also under the skin and in 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 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 may appear in bone tissue and joints. They cause pain, and when 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 tissues. Other infections include:
- cellulite - inflammation of the subcutaneous tissue,
- lymphangitis - inflammation of the lymphatic vessel,
- abscesses - 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 has a weakened immune system.
Carpal tunnel syndrome
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 likelihood of developing the disease increases: thyroid disease, pregnancy, obesity, diabetes. Constant work with prolonged holding of the wrist in an 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 a computer. Symptoms appear in the fingers that are supplied by the median nerve: thumb, index, middle and half of the ring finger close to them. Usually this is not only 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 are formed in the palmar tendons, then they are shortened. More often, the disease appears in men over 50 years of age 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: 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:
- The onset of pain, which may be acute or gradual.Diseases caused by degenerative changes and overfatigue of the ligamentous apparatus are characterized by a gradual onset, since the development of these processes takes time. Autoimmune diseases can manifest either 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.
- Time and factors for the appearance or intensification of pain during the day.With carpal tunnel syndrome, the hand may hurt at night; with osteoarthritis, the pain is stronger after putting stress on the joints; 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 associated symptoms, including:
- Features of flexion and extension of 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 fully straightened. With rheumatoid arthritis, you can see thickening of the fingers in the joints and their deformation. If there is pathology of the ligaments, nodules can be felt in their composition.
- Stiffness and limitation of movements 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, goosebumps, tingling, and decreased sensitivity to heat, cold, and touch may occur.
- With vasculitis - inflammation of blood vessels - the fingers often turn white or blue.
- With many diseases, weakness in the hand may be observed: this indicates damage to the nerves, 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.
Diagnostics
Diagnosis begins with a consultation with a specialist, who asks in detail about complaints, the presence of concomitant and hereditary diseases. Afterwards, the doctor must 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 hands in various projections- the most commonly used and accessible method for assessing the condition of bones and joints. It will be required if there is a suspected fracture, foreign body, developmental anomaly, 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 the condition of the joints.
- 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 evaluate the conduction of nerve impulses. It is used if carpal tunnel syndrome is suspected.
- Blood tests.Most often this is:
- metabolic indicators - for example, glycated hemoglobin and blood sugar in diabetes, since metabolic diseases affect the condition of nerves, small vessels and ligaments.
- 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 hand structures, due to their enormous diversity, often require consultation with specialists of several profiles. Initially, if there was no actual injury, 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 are carried out by orthopedic traumatologists and surgeons. Consultation with an endocrinologist will be necessary for metabolic disorders. If weakness and numbness in the hand are noted, you should consult a neurologist.
How to relieve pain in your finger joints
Treatment can be surgical or conservative.
- 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: for 7-10 days for non-displaced fractures and for 3 weeks for displaced fractures. After this, the patient wears a special orthosis on the hand until the bone is completely restored - usually 4-10 weeks, sometimes longer.
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 methods of influence give a good effect:
- Injectionscorticosteroids into the joints of the hand, into the tendons. They effectively relieve inflammation, but have side effects, so they must be used according to strict indications.
- Soft fixation of the handusing 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 been gaining popularity in the treatment of ligament problems. Effective and safe for the treatment of "snapping finger", deforming osteoarthritis, reduces the likelihood of relapse, improves joint mobility and the functionality of the hand as a whole.
- Kinesio taping.This involves gluing special tapes onto the hand, which helps stabilize the joint in a comfortable position. This way he recovers faster.
- Laser therapy.Reduces pain and helps in cartilage restoration, which is extremely important for osteoarthritis.
- Magnetotherapy. Aimed at reducing pain, inflammation and swelling.
Consequences
Most patients with hand injuries and degenerative processes, snapping finger, 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, correct wearing of a bandage, orthosis, if indicated, and compliance with prescribed recommendations. If the joints of the hand are left untreated 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 select the necessary therapy for you.
Prevention
- 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 patients with gout, and some are prescribed anti-gout medications. It will be useful to periodically check the status 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 overworking your hands, try to ensure the most comfortable position, do not keep your hands constantly bent, give them a rest and do a little warm-up. Play sports in special gloves, monitor the condition of your skin and nails so that infection does not penetrate into the tissues of your hand. Regularly undergo preventive examinations with doctors.
Follow the recommendations listed and this will help reduce the risk of problems with your hands.