Hands are very important to man.With their help, we do almost all the work, besides, only the graceful movements of our 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 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 deal with it - we will talk below.
Briefly about the 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 refer to finger joint pain, 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 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 one interphalangeal joint (since the finger is made of two, not three phalanges, like the others).These joints are shaped like a block, which gives them a range of motion in the range of flexion and extension only.
Major causes of pain
If your finger joints hurt at rest or become painful with movement, you most likely have a disease that affects these structures of the musculoskeletal system.Finger pain rarely develops due to normal fatigue.This is possible, for example, in students after the summer holidays, when the fingers have not experienced stress for a long time and in similar situations.But such pain is characterized as a feeling of fatigue, does not require treatment and quickly disappears 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 look at each option separately.Knowing the characteristics of a disease will help you in any case to suspect the true causes of pain in the joints of the fingers and to prescribe the correct treatment.
Factors that contribute to damage to the joints of the fingers:
- 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 accompanied by metabolic disorders;
- genetic predisposition;
- history of traumatic hand injuries;
- constant negative impact of environmental factors (cold, hot water or air, vibrations);
- 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 seen 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 your hand into a fist.Exacerbation is accompanied by inflammatory changes in the diseased joints - swelling, redness, increase in local temperature of the skin over the diseased joints, inability to fully perform movements, first 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 movements for a long time - the stiffness disappears by noon 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 deformations, which are called the hallmark of rheumatoid arthritis:
- hand with binoculars;
- as a boutonniere;
- swan neck;
- the fingers have a buckle position.
When 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 the preferred location is the joints of the fingers.
Polyosteoarthrosis
It is a chronic degenerative-dystrophic disease of the joints.Osteoarthritis usually affects large joints of the body (knees, hip joints, ankles), but sometimes the small joints of the hands are also involved in the pathological process.In addition, the symptoms most often appear in women during menopause, which confirms the connection of the disease with the estrogenic background of the body.
Finger pain with polyosteoarthritis occurs more often in the evening, after a working day and physical load on the joints, and not in the morning, as in rheumatoid arthritis.Accompanied by crunching in the affected joints, it rarely occurs 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 self-support.
Characteristic signs of polyosteoarthrosis of the fingers are specific formations - nodes of Bouchard and Heberden.Bouchard nodes are formations that develop gradually near the affected proximal interphalangeal joints.Their favorite place of localization 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 nodes are formations that grow on the lateral surface of the distal interphalangeal joints.Their growth is accompanied, unlike Bouchard's nodes, by symptoms of inflammation and pain.As polyosteoarthrosis progresses, the fingers become knotty, which can be called pathognomonic signs of this disease.
A type of polyosteoarthrosis of the fingers is rhizarthrosis.This is a lesion of the metacarpophalangeal joint of the first finger.It develops due to constant loads on this joint.Difficulties in diagnosis often arise, 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, the pathology proceeds with damage to the joints.The disease progresses with periods of exacerbations and remissions.The preferred site is the distal interphalangeal joints.In some cases, psoriatic arthritis proceeds like pandactylitis, when the whole finger suffers - it swells, turns red, hurts not only in the morning, but constantly, practically does not bend and has the shape of 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 that is characterized by a disorder of purine metabolism with excessive formation of uric acid, which is stored in the form of salts in peripheral tissues and the joint capsule.Although gout primarily affects the big toe, localization to the toes is also common.Metacarpophalangeal joints, especially the thumb, are involved in the pathological process.
Gouty arthritis has a paroxysmal course.During an exacerbation, the pain is so severe that the patient cannot even touch the affected area.The illness 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 range in size from barely noticeable to gigantic.
Stenotic ligamentitis
This pathology is often confused with arthrosis and arthritis.It is based on 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;pathologic changes will not be seen on pictures with ligamentitis.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 proceed 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 microorganisms that can penetrate the joint directly from the external environment, be transferred through the blood stream or penetrate from neighboring tissues.Infectious arthritis proceeds with severe pain, inflammation and a disturbance in the patient's general condition.
Establishing 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 becomes much easier to fight with him.Therefore, the treatment of joint pathology should be primarily etiological, and then symptomatic.