Hands are very important for a person.With their help, we do almost all the work, in addition, only the pleasant 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 and daily 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 mean the metacarpophalangeal, proximal and distal interphalangeal joints.These joints are the most sensitive to the negative effects of all hand joints due to their superficial location and high motor activity.
The metacarpophalangeal joints consist of 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 range of motion in the range of flexion and extension, adduction and abduction, as well as circular rotation.
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 features and functions, has an interphalangeal joint (since the finger is made of two, and not three phalanges, like the others).These joints are shaped like a block, which provides them with a range of motion in the range of flexion and extension only.
The main causes of pain
If the joints of the fingers hurt at rest or become painful when moving, then most likely you have a disease that affects these structures of the musculoskeletal system.Due to normal fatigue, pain in the fingers rarely develops.This is possible, for example, in schoolchildren after summer vacation, when the fingers did not experience stress for a long time and in similar situations.But such pain is characterized as a feeling of fatigue, does not require treatment and goes away quickly after minimal rest.
Constant pain in the joints of the fingers can indicate the following diseases:
- rheumatoid arthritis;
- polyosteoarthrosis;
- gouty arthritis;
- psoriatic arthritis;
- stenosing ligamentitis;
- acute infectious arthritis (bacterial, viral, fungal).
Let's consider each option separately.Knowing the characteristics of a certain disease will help you in any case to suspect the true causes of pain in the joints of the fingers and to prescribe the appropriate treatment.
Factors contributing to finger joint damage:
- the presence of autoimmune diseases and disorders;
- the presence of chronic foci of infection in the body (tooth decay, chronic tonsillitis, sinusitis);
- hormonal imbalance in the body, endocrine pathology;
- diseases associated with metabolic disorders;
- genetic predisposition;
- history of traumatic hand injuries;
- constant negative impact of environmental factors (cold, hot 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 aggravation and remission.It affects all age groups of patients and is observed more often 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 temperature of the skin over the diseased joints, inability to fully perform the range of motion, initially due to pain, and later due to hand deformities.
A characteristic symptom of rheumatoid arthritis is pain in the hands in the morning and a feeling of stiffness.Sometimes it hurts to make any movement for a long time - the stiffness goes away by lunch or even in the evening.
In the later stages of the disease, irreversible changes occur in the articular and musculo-ligamentous apparatus of the hands with the development of typical deformations, which are called hallmarks of rheumatoid arthritis:
- hand with lognet;
- as a boutonniere;
- swan's neck;
- fingers have a button 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 a favorite place is the joints of the fingers.
Polyosteoarthrosis
This is a chronic degenerative-dystrophic disease of the joints.Typically, osteoarthritis affects the large joints of the body (knees, hips, wrists), but sometimes even the small joints of the hands are involved in the pathological process.In addition, the symptoms more often appear in women during menopause, which confirms the relationship of the disease with the estrogen background of the body.
Finger pains with polyosteoarthritis appear more often in the evening, after a day of work and physical stress on the joints, and not in the morning, as with rheumatoid arthritis.Accompanied by a crackling noise in the affected joints, it rarely appears with signs of inflammation.Over time, with the progression of the pathological process, the joints are deformed and their mobility is lost, which often leads to the inability to perform small movements, and sometimes even to support oneself independently.
Characteristic signs of finger polyosteoarthrosis are specific formations - Bouchard's and Heberden's joints.Bouchard's nodes are formations that gradually develop near the affected proximal interphalangeal joints.Their preferred place of localization is the lateral surfaces of these joints, this leads to a special fusiform thickening of the fingers and limited mobility in the hands.
Heberden's nodes are formations that grow on the lateral surface of the distal interphalangeal joints.Their growth is associated, unlike Bouchard's nodes, with symptoms of inflammation and pain.With the progress of polyosteoarthrosis, the fingers become knots, which can be called pathognomonic signs of this disease.
A type of finger polyosteoarthrosis is rhizarthrosis.This is a lesion of the metacarpophalangeal joint of the first finger.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 arthritis and gout.
Psoriatic arthritis
Contrary to popular belief, psoriasis is not just a skin disease;in 10-15% of cases, the pathology appears with joint damage.The disease appears with periods of exacerbations and remissions.The preferred location is the distal interphalangeal joints.In some cases, psoriatic arthritis manifests itself as pandactylitis, when the whole finger suffers - it becomes swollen, red, hurts not only in the morning, but constantly, practically does not bend and is shaped like a sausage.Recognizing psoriatic arthritis is usually not difficult - along with damage to the fingers, typical psoriatic skin rashes can be observed.
Gouty arthritis
Gout is a metabolic disease characterized by a violation of purine metabolism with the 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, localization in 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 symptoms of inflammation - swelling, redness and increased local temperature.
You may also observe painless subcutaneous deposits of uric acid salts, characteristic of gout, called tophi, which can vary in size from barely visible to gigantic.
Stenotic ligamentitis
This pathology is 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 in them with specific clicks.X-rays help in diagnosis;Pathological changes will not be visible in the photos with the ligament.As a rule, local therapy for this disease, for example, anesthetic ointment, is more effective than for other lesions.
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 carried through the bloodstream or penetrate from neighboring tissues.Infectious arthritis occurs with severe pain, inflammation and deterioration of the patient's general condition.
Determining the true cause of pain in the joints of the fingers plays a very important role, because once you recognize the enemy by sight, it becomes much easier to fight it.Therefore, the treatment of joint pathology should be primarily etiological, and then symptomatic.