Hands are very important for a person.With its help we do almost all the work, in addition, only the graceful movements of the fingers allow us to write, draw, play musical instruments and create works of art.But it often happens that pain in the joints of the fingers prevents us from performing familiar, everyday movements.Only then does a person begin to appreciate this part of his body.Why such a symptom develops, what it can warn us about and how to treat it - we will talk below.
Briefly about anatomy
The hand is the distal part of the human upper limb, which consists of a large number of bones, joints, muscles and ligaments.The hand is made up of 3 anatomical parts: the wrist, the metacarpus and the skeleton of the phalanges of the fingers.When they mention pain in the finger joints, they are referring to the metacarpophalangeal, proximal and distal interphalangeal joints.These joints are the most susceptible to negative effects of all the joints of the hand due to their superficial location and high motor activity.
The metacarpophalangeal joints are formed by the heads of the metacarpal bones and the base of the proximal phalanges of the fingers.The shape of the joint is spherical, which provides a variety of movements in the range of flexion and extension, adduction and abduction, as well as circular rotation.
The interphalangeal joints are divided into proximal (between the proximal and middle phalanx of the fingers) and distal (between the middle and distal phalanx of the fingers).Only the skeleton of the first finger, due to its characteristics and functions, has an interphalangeal joint (since the finger is made up of two, and not three phalanges, like the others).These joints are block-shaped, giving them a range of motion in the range of flexion and extension only.
Main causes of pain.
If your finger joints hurt at rest or hurt when moving, you most likely have a disease that affects these structures of the musculoskeletal system.Due to normal fatigue, finger pain rarely develops.This is possible, for example, in schoolchildren after the summer holidays, when the fingers were not stressed for a long time and in similar situations.But this pain is characterized by a feeling of fatigue, does not require treatment and disappears quickly after minimal rest.
Persistent pain in the joints of the fingers may indicate the following diseases:
- rheumatoid arthritis;
- poliosteoarthritis;
- gouty arthritis;
- psoriatic arthritis;
- stenosing ligamentitis;
- acute infectious arthritis (bacterial, viral, fungal).
Let's consider each option separately.Knowing the characteristics of a specific disease will help you in each case to suspect the true causes of pain in the joints of the fingers and prescribe the correct treatment.
Factors that contribute to damage to the finger joints:
- presence of autoimmune diseases and disorders;
- the presence of chronic foci of infection in the body (carious teeth, chronic tonsillitis, sinusitis);
- hormonal imbalance in the body, endocrine pathology;
- diseases that are accompanied by metabolic disorders;
- genetic predisposition;
- history of traumatic hand injuries;
- constant negative impact of environmental factors (cold, hot water or air, vibration);
- occupational risks.
rheumatoid arthritis
This chronic autoimmune disease of the musculoskeletal system is the most common cause of damage to small joints, particularly those in the fingers.The disease has an undulating course with alternating periods of exacerbation and remission.It affects all age groups of patients and is seen more frequently in women than in men.
The initial stages of rheumatoid arthritis are characterized by pain in the small joints of the hand, sometimes it even hurts to bend the hand into a fist.An exacerbation is accompanied by inflammatory changes in the diseased joints: swelling, redness, increased local skin temperature over the diseased joints, inability to fully realize the range of motion, first due to pain, and then due to deformities of the hand.
A characteristic symptom of rheumatoid arthritis is pain in the hands in the morning and a feeling of stiffness.Sometimes it hurts to perform any movement for a long time: the stiffness disappears at lunchtime or even in the evening.
In the later stages of the disease, irreversible changes occur in the articular and musculoligamentous apparatus of the hands with the development of typical deformities, which are called a distinctive feature of rheumatoid arthritis:
- hand with lorgnette;
- like a boutonniere;
- gooseneck;
- the fingers have a buttoning position.
With an exacerbation of the disease, general symptoms can also be observed: fever, loss of appetite, muscle pain and poor health.Rheumatoid arthritis can affect any joint in the body, but its favorite location is the joints in the fingers.
Poliosteoarthrosis
This is a chronic degenerative-dystrophic disease of the joints.Typically, osteoarthritis affects the large joints of the body (knees, hips, ankles), but sometimes the small joints of the hands are also involved in the pathological process.In addition, symptoms occur more often in women during menopause, confirming the relationship of the disease with the estrogen background of the body.
Pain in the fingers with polyosteoarthritis appears most often at night, after a day of work and physical stress on the joints, and not in the morning, as occurs with rheumatoid arthritis.Accompanied by a cracking sound in the affected joints, it rarely presents with signs of inflammation.Over time, as the pathological process progresses, the joints become deformed and their mobility is lost, often leading to the inability to make small movements and sometimes even to stand independently.
Characteristic signs of polyosteoarthrosis of the fingers are specific formations: Bouchard's and Heberden's nodes.Bouchard's nodules are formations that gradually develop near the affected proximal interphalangeal joints.Its favorite place of location is the lateral surfaces of these joints, which leads to a kind of fusiform thickening of the fingers and limited mobility in the hands.
Heberden's nodules are formations that grow on the lateral surface of the distal interphalangeal joints.Its growth is accompanied, unlike Bouchard's nodes, by symptoms of inflammation and pain.As polyosteoarthritis progresses, the fingers become gnarled, which can be called pathognomonic signs of this disease.
One type of polyosteoarthrosis of the fingers is rhizarthrosis.This is an injury to the metacarpophalangeal joint of the first finger of the hand.It develops due to constant loads on this joint.Difficulties often arise when making a diagnosis, since the pathology of this localization is also characteristic of psoriatic and gouty arthritis.
psoriatic arthritis
Contrary to popular belief, psoriasis is not just a skin disease;In 10-15% of cases, pathology occurs with damage to the joints.The disease presents with periods of exacerbations and remissions.The favorite location is the distal interphalangeal joints.In some cases, psoriatic arthritis occurs as pandactylitis, when the entire finger suffers: it swells, turns red, hurts not only in the morning, but constantly, practically does not bend and has a sausage shape.It is usually not difficult to recognize psoriatic arthritis: in addition to lesions on the fingers, skin rashes typical of psoriasis can be observed.
gouty arthritis
Gout is a metabolic disease characterized by an alteration of purine metabolism with excessive formation of uric acid, which is stored in the form of salts in peripheral tissues and in the joint capsule.Although gout mainly affects the big toe, its location on the fingers is also common.The metacarpophalangeal joints, especially the thumb, are involved in the pathological process.
Gouty arthritis has a paroxysmal course.During an exacerbation, the pain is so intense that the patient cannot even touch the affected area.The pain is accompanied by symptoms of inflammation: swelling, redness and increased local temperature.
Painless subcutaneous deposits of uric acid salts, characteristic of gout, called tophi, can also be observed, the size of which can vary from barely noticeable to gigantic.
Stenosing ligamentitis
This pathology is very often confused with osteoarthritis and arthritis.It is based on inflammation of the annular ligaments of the fingers.This causes pain during active and passive movements with specific clicks.X-rays help in diagnosis;Pathological changes will not be visible on images with ligamentitis.As a rule, local therapy for this disease, for example, anesthetic ointment, is more effective than for other injuries.
Acute infectious arthritis
In most cases, infectious lesions occur as monoarthritis - damage to one joint;rarely, two or more joints are involved in the pathological process.This pathology can be caused by any pathological microorganism that can penetrate the joint directly from the external environment, be transported through the bloodstream, or penetrate from neighboring tissues.Infectious arthritis occurs with severe pain, inflammation and alteration of the patient's general condition.
Establishing the true cause of pain in the finger joints plays a very important role, because once you recognize the enemy by sight, it becomes much easier to fight him.Therefore, the treatment of joint pathology should be primarily etiological and then symptomatic.