Hands are very important for humans.With their help, we do almost all work, and moreover, only the graceful movements of the fingers make it possible to write, draw, play an instrument, and create works of art.But it often happens that the pain in the joints of the fingers prevents us from carrying out usual and everyday movements.Only then does one begin to appreciate this part of the 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 pain in the joints of the fingers is mentioned, they mean the metacarpophalangeal, proximal and distal interphalangeal joints.These joints are the most sensitive to the negative effects of the joints of the hand due to their surface location and high motor activity.
The metacarpophalangeal joints consist of the heads of the metacarpals and the bases of the proximal phalanges of the fingers.The shape of the joint is spherical, which provides a range of motion in the range of flexion and extension, adduction and abduction, and circular rotation.
Interphalangeal joints are divided into proximal (between the proximal and middle phalanxes of the fingers) and distal (between the middle and distal phalanxes of the fingers).Due to its characteristics and functions, only the skeleton of the first finger has an interphalangeal joint (since the finger is made up of two and not three phalanges like the others).These joints are block-shaped, which gives them range of motion only in the range of flexion and extension.
The main causes of pain
If your finger joints hurt at rest or become painful during movement, you probably have a disease that affects these structures of the musculoskeletal system.Pain in the fingers rarely develops due to normal fatigue.This is possible, for example, in schoolchildren after the summer holidays, when the fingers have not experienced stress for a long time, and in similar situations.But such 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;
- polyosteoarthrosis;
- gouty arthritis;
- psoriatic arthritis;
- stricture ligamentitis;
- acute infectious arthritis (bacterial, viral, fungal).
Let's look at each option separately.In any case, knowing the characteristics of a particular disease will help you suspect the real causes of pain in the joints of the fingers and prescribe the appropriate treatment.
Factors that contribute to damage to the joints of the fingers:
- the presence of autoimmune diseases and disorders;
- the presence of chronic foci of infection in the body (cavity teeth, chronic tonsillitis, sinusitis);
- hormonal imbalance in the body, endocrine pathology;
- diseases associated with metabolic disorders;
- genetic predisposition;
- history of traumatic injuries to the hands;
- constant negative impact of environmental factors (cold, warm water or air, vibration);
- occupational hazards.
Rheumatoid arthritis
This chronic autoimmune disease of the musculoskeletal system is the most common cause of damage to small joints, especially the joints of the fingers.The disease has an undulating course, with alternating periods of exacerbation and remission.It affects all age groups of patients and is observed more often in women than in men.
The initial stage of rheumatoid arthritis is characterized by pain in the small joints of the hand, sometimes it even hurts when you bend your hand into a fist.Exacerbation is accompanied by inflammatory changes in the diseased joints - swelling, redness, local skin temperature increase over the diseased joints, inability to fully perform movements, first pain, later due to deformation of the hand.
A characteristic symptom of rheumatoid arthritis is hand pain and stiffness in the morning.Sometimes it hurts when you do any movement for a long time - the stiffness goes away by lunch time or even in the evening.
In the later stages of the disease, irreversible changes occur in the joint and muscle-ligament apparatus of the hands with the development of typical deformities, which are called the characteristic of rheumatoid arthritis:
- hand with lorgnette;
- like a boutonniere;
- gooseneck;
- the fingers are buttoned.
As the disease worsens, 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 place is the joints of the fingers.
Polyosteoarthrosis
This is a chronic degenerative-dystrophic disease of the joints.Osteoarthritis typically 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, the symptoms most often appear during menopause in women, which confirms the connection of the disease with the estrogenic background of the body.
In the case of polyosteoarthritis, pain in the fingers occurs more often in the evening, after a working day and physical stress on the joints, and not in the morning, as in the case of rheumatoid arthritis.Accompanied by a creaking sound in the affected joints, it rarely occurs with signs of inflammation.Over time, as the pathological process progresses, the joints are deformed and their mobility is lost, which often leads to the inability to perform small movements and sometimes even to maintain oneself independently.
Characteristic signs of polyosteoarthrosis of the fingers are specific formations - nodes of Bouchard and Heberden.Bouchard nodes are formations that gradually develop near the affected proximal interphalangeal joints.Their favorite location is the lateral surface of these joints, which leads to a specific fusiform thickening of the fingers and limited movement of the hand.
Heberden nodes are formations that grow on the lateral surface of the distal interphalangeal joints.Unlike Bouchard nodes, their growth is accompanied by symptoms of inflammation and pain.As polyosteoarthrosis progresses, the fingers become lumpy, which can be called the pathognomonic signs of this disease.
One type of polyosteoarthrosis of the fingers is rhizarthrosis.This is a lesion of the metacarpophalangeal joint of the first finger of the hand.It develops due to the constant loading of this joint.Difficulties often arise when establishing the diagnosis, since the pathology of this localization is also characteristic of psoriasis and gouty arthritis.
Psoriatic arthritis
Contrary to popular belief, psoriasis is not just a skin disease;in 10-15% of cases, the pathology is associated with damage to the joints.The disease occurs with periods of exacerbation and remission.Its favorite site is the distal interphalangeal joints.In some cases, psoriatic arthritis occurs as pandactylitis, when the whole finger suffers - it swells, it becomes red, it hurts not only in the morning, but constantly, it practically does not bend, and it has the shape of a sausage.Recognizing psoriatic arthritis is usually not difficult - typical psoriatic skin rashes can be observed along with damage to the fingers.
Gouty arthritis
Gout is a metabolic disease characterized by a violation 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 primarily affects the big toe, localization 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 strong that the patient cannot even touch the affected area.The pain is accompanied by inflammatory symptoms - swelling, redness and increased local temperature.
Painless subcutaneous deposits of uric acid salts characteristic of gout, so-called tophi, can also be observed, the size of which can vary from barely noticeable to gigantic.
Stenotizing ligamentitis
This pathology is very often confused with arthrosis and arthritis.It is based on the inflammation of the annular ligaments of the fingers.This leads to pain during active and passive movements with specific clicks.X-rays help with diagnosis;pathological changes will not be visible on the images with ligamentitis.In general, local therapy for the disease, such as anesthetic ointment, is more effective than for other lesions.
Acute infectious arthritis
In most cases, infectious lesions appear 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 directly penetrates the joint from the external environment, passes through the bloodstream, or penetrates from adjacent tissues.Infectious arthritis manifests itself with severe pain, inflammation and disruption of the patient's general condition.
Determining the real cause of pain in the joints of the fingers plays a very important role, because once you recognize the enemy by sight, it will be much easier to fight with him.Therefore, the treatment of joint pathology should be primarily etiological and then symptomatic.