Arthritis of the fingers

Inflammation of small joints usually does not develop on its own, but against the background of a general disease. Arthritis of the fingers is a characteristic symptom of rheumatoid arthritis, but it can also be one of the manifestations of another disease. It is very important to seek medical attention in a timely manner, identify the cause of the disease and start treatment in order to avoid serious complications and disability. This article will give you all the information you need to know about this disease.

General information about the disease

Finger arthritis is inflammation of the metacarpophalangeal and interphalangeal joints of the fingers. The disease is fairly common at any age. According to statistics, women are more likely to develop them after 40 years of age. This can be explained by the fact that women have more stress on their hands and fingers than men. Arthritis code of fingers of unspecified origin according to ICD-10 M13.

Depending on the cause, the disease can only occur in the little finger joints and be associated with damage to the large joints. The onset of the disease can be acute, subacute and chronic, but then in most cases the course becomes protracted or chronic. The exception is post-traumatic arthritis of the fingers: with proper treatment, it ends in full recovery. But if treatment was not prescribed in a timely manner, then it also takes a chronic course.

Causes of the inflammatory process in the finger joints

The causes of the disease can be different. The little finger joints are most commonly affected in rheumatoid arthritis - an autoimmune disease (with an allergy to the patient's own tissues) based on a hereditary predisposition. The starting point for the onset of the disease is usually an infection. According to this, genetically predisposed people develop finger arthritis after a while. In the future, other, larger joints may also be affected.

Another common cause of inflammation of the small joints of the hands is psoriatic arthritis. It is also an autoimmune hereditary disease that mainly affects the joints of the fingertips (distal) with a characteristic lesion of the nails. This usually happens against the background of existing skin manifestations of psoriasis, but sometimes the symptoms of arthritis in the finger joints appear first.

Very often arthritis of the finger joints develops with gout. The disease has a metabolic (metabolic) origin - the exchange of uric acid salts is disturbed, they are deposited in the joint and periarticular tissues and cause an inflammatory process.

Post-traumatic arthritis of the finger joints is sometimes professional in nature. It develops with a constant slight injury to the hands of jewelers, seamstresses, hairdressers, etc. The inflammatory process is constantly supported by additional trauma and becomes chronic. After acute (sports, domestic) injuries, acute arthritis can develop, which then disappears completely.

Other types of arthritis rarely cause damage to the small joints. The triggering factors that contribute to the development of arthritis of the small wrists are hormonal changes (adolescence, pregnancy, menopause), stress, frequent colds and allergic diseases, bad habits and professional activities.

Symptoms of finger osteoarthritis

Symptoms can be different, they depend on the type of inflammatory process (acute, subacute, chronic), as well as the clinical form of the underlying disease.

First signs

The onset of the disease is slow in most cases. There is sore hands and stiff movements in the morning. At first, on average, such a symptom lasts no more than half an hour, and then it passes. The pain is constant, its intensity slowly increasing.

The onset is more rarely acute. Pain occurs in one or more small finger joints, accompanied by redness and swelling of the surrounding tissue. The function of the joint is impaired: it is difficult to bend and bend, sometimes it is impossible because of the pain.

With an acute onset of the disease, the general condition of the patient often suffers: fever, malaise and headache occur. If the process develops subacutely or chronically, then there can be no general manifestations, changes in the affected joints can also not be very pronounced.

The most important thing to do when experiencing symptoms of arthritis is to see a doctor. The sooner this happens, the more likely it is to stop the inflammatory process at the very beginning.

Obvious symptoms

Obvious signs of hand osteoarthritis in the chronic course include the appearance of edema and redness of the tissues around the affected areas of the hands, as well as the involvement of other joints in the pathological process on the same or the other side. The appearance of new foci of inflammation can be accompanied by a slight increase in body temperature, increased pain and dysfunction of the affected joints. But more often, exacerbations of rheumatism occur without general manifestations.

After a while, the inflammatory process may decrease in intensity somewhat, local inflammation and general symptoms decrease. After that, the process becomes chronic. Morning stiffness of movement occurs, patients notice the feeling of tight gloves on the hand that do not allow movement. Some time after getting up in the morning and starting physical activity, this feeling subsides or even disappears. The occurrence of crepitation (friction and clicks) in the affected joint joints is also characteristic.

If the patient does not receive arthritis treatment, there is an alternation of exacerbations and remissions with constant pain and rapid formation of joint deformities (in rheumatoid arthritis) or melting of the fingertips and shortening (in psoriatic arthritis). Thumb arthritis most often develops with gout, continues with severe pain, swelling, redness, and then disappears without a trace, but with frequent relapses, deformations and loss of joint function also develop.

Dangerous symptoms

Emergency medical care is required for the following symptoms of finger osteoarthritis:

• high body temperature (38 - 39 °) for 5 or more days;
• a sharp rise in temperature, increased inflammation and pain in the joint with an already existing inflammatory process - can indicate the onset of suppuration;
• Involvement in the pathological process of new small or large joints;
• the appearance of blackened tissue on the fingertips (necrosis) in psoriatic arthritis.

If you experience such symptoms, you should immediately consult a doctor.

What is the danger of the disease

The main danger of any type of chronic arthritis lies in the progression of the inflammatory process, which eventually turns into degenerative-dystrophic with deformity and disability of the limbs. The longer the arthritis lasts, the higher the risk of complications.

Stages of the disease

Arthritis of the finger joints has 4 stages of development, depending on the degree of damage to the joint, which is determined during the instrumental examination:

1. Initial phase.In the case of severe or mild clinical signs of inflammation on the X-ray, you can recognize signs of inflammation in the form of an enlarged joint space. On the ultrasound, you can see the presence of an increased amount of synovial fluid. The symptoms can be pronounced in the chronic course of the disease or almost absent.
2. Progressive inflammation.Signs of inflammation are clearly visible on X-rays and ultrasound. The articular cartilage is destroyed, in its place a loose connective tissue is formed - pannus. The process takes on a wavy (exacerbation remission) or steadily progressive course. Pain and stiffness increase.
3. Connective tissue sankylosis.The connective tissue of the pannus becomes rough, it grows and connects the joint-forming bone surfaces, which restricts movement in the joint. The fingers are deformed.
4. Bone ankylosis.Instead of connective tissue, bone tissue grows in the joint, which leads to the complete immobility of the joint and the loss of its function.

Possible complications

If left untreated, arthritis of the hands and fingers progresses. The following complications are also possible:

• the development of a purulent inflammatory process with transition to the tissues surrounding the joint, the development of abscesses, phlegmon and sepsis;
• Fingertip necrosis, shortening and soft tissue inflammation;
• Subluxation and dislocation of small joints;
• different types of joint deformities;
• complete loss of function of the fingers and hands.

What to do in the event of an exacerbation

With an exacerbation of arthritis, the joints hurt a lot, the skin over them reddens, swells, movements in the fingers become impossible due to pain. To reduce suffering you need to:

• give your hands a slightly elevated position - this will reduce swelling;
• take any drug from the group of nonsteroidal anti-inflammatory drugs (NSAIDs) - diclofenac, nimesulide, indomethacin, ibuprofen; it will reduce pain and inflammation;
• apply to the skin over the diseased joint an external agent from the NSAID group - a gel or ointment; Diclofenac emulgel helps a lot;
• Go to the doctor or call him at home.

With an exacerbation, it is impossible to postpone a visit to the doctor, there is an urgent need to suppress the progression of the disease. It is impossible to do this alone.

How arthritis of the fingers of the hands proceeds in different clinical forms of the disease

Symptoms of hand osteoarthritis and the nature of its course depend on the disease that led to its development. The defeat of the small joints of the hands is most common in rheumatoid, psoriatic and gouty arthritis. However, it can also occur in other clinical forms of arthritis.

Rheumatoid arthritis

In most cases, arthritis begins slowly and imperceptibly. There is aching pains in the fingers. The nature of pain is constant, painful, exhausting. In the morning after sleeping, movements become stiff and may last up to 30 minutes or more.

After a while, the patient notices that the fingers in the joints become swollen. The metacarpophalangeal and overlying interphalangeal joints of the 2nd and 3rd fingers are most commonly affected. The defeat is symmetrical on both arms. Pain of varying intensity is permanent. Over time, characteristic deformities of the spindle-shaped fingers appear.

Small, painless subcutaneous rheumatoid nodules appear on the skin of the fingers and elbows. The disease progresses slowly and steadily, accompanied by constant debilitating pain, deformities and loss of joint function.

Psoriatic arthritis

With this disease, arthritis develops in the distal (terminal) interphalangeal finger joints against the background of pre-existing skin manifestations of psoriasis. But sometimes joint symptoms appear before or at the same time as skin symptoms. In most cases, the disease begins acutely or subacutely with the appearance of redness, swelling and pain in the little finger joints. The lesion is usually asymmetrical while the fingers resemble sausages.

The disease progresses with severe exacerbations and remissions. Almost always the nail plates are involved in the pathological process. Over time, deformations of the fingertips appear, they thicken, the nails become thinner and also deformed, a thimble symptom appears - dotted depressions on the nail plates.

In the longer course of the disease, dislocations and subluxations of the small distal joints as well as lysis (melting) of the bones of the fingertips (X-ray signs) and shortening of the fingers occur.

Gouty arthritis

An attack of gout begins acutely with severe pain, swelling, and redness in the area of the affected joints. Small joints are often affected. Usually, the inflammation begins with the metacarpophalangeal joint of the 1st finger and can then spread to the metacarpophalangeal and interphalangeal joints of the other fingers.

The pain is very severe, the attack can last from several hours to several weeks, and then everything goes away. However, with frequent attacks with damage to the same joints, their function is impaired.

Post traumatic arthritis

This type of arthritis of the fingers can develop against the background of an acute household, work or sports injury, be acute with the subsequent complete healing, or (without the necessary help) be complicated by the addition of a purulent infection. Sometimes such an inflammatory process can turn into a chronic one, followed by deformation of the affected joints.

The chronic course of post-traumatic arthritis of the fingers of the hands initially assumes a constant minor, imperceptible injury to the fingers. Most often this occurs with people of certain occupations who do small jobs. Arthritis develops slowly, affecting the joints most traumatized at work. If you do not change jobs, persistent deformation with dysfunction of the fingers develops.

Other types of arthritis

In arthritis types such as reactive, infectious, idiopathic lesions of the little finger joints, practically none are found.

diagnosis

The diagnosis is made on the basis of the characteristic symptoms of the disease and confirmed by the examination data:

• laboratory tests - show the presence of an inflammatory process, the presence or absence of infection, antibodies to infectious agents, rheumatoid factor;
• radiography - shows bone changes in the joints;
• Ultrasound - the presence of an increased volume of exudate in the joint cavity is a sign of an active inflammatory process;
• MRI - changes in the soft joint and periarticular tissues.

Without additional methods of investigation, it is impossible to make the correct diagnosis (and therefore to prescribe appropriate treatment). Therefore, if there is pain in the little finger joints, you should consult a doctor as soon as possible.

Treatment of finger arthritis

After the final diagnosis is made, treatment for arthritis of the fingers is prescribed, which is carried out by a rheumatologist (sometimes in collaboration with other specialists - a surgeon, dermatovenerologist). It should be comprehensive and aimed at suppressing the progression of the pathological process and preventing violations of joint function. The complex treatment includes:

• Drug therapy;
• physiotherapeutic procedures;
• therapeutic gymnastics and massage;
• Reflex zone courses;
• Home remedies.

Drug therapy

The first task of drug therapy is to alleviate a sick person's condition. To do this, drugs from the NSAID group are prescribed, which relieve pain, inflammation and tissue swelling. Depending on the level of activity of the inflammatory process, these drugs are prescribed in the form of injections (injections) or tablets for oral administration. In addition, drugs of this group are prescribed externally in the form of gels, ointments and creams.

The most effective NSAID is diclofenac, but it irritates the walls of the gastrointestinal tract so it cannot be used for long periods of time. Instead of diclofenac, more modern drugs of the NSAID group are prescribed - nimesulide, celecoxib, etc. Such funds are used externally, diclofenac ointment. Taking drugs of the NSAID group can bring significant relief to the patient.

Sometimes the inflammatory process is so pronounced that it cannot be eliminated with drugs of the NSAID group. In this case, glucocorticoid hormones are used - prednisolone, dexamethasone, etc. in the form of injections, inside in tablets or outside in the form of ointments. Intra-articular injection of hormones into small joints is rarely practiced.

To suppress autoimmune processes, drugs of the basic group are prescribed - methotrexate, sulfasalazine, leflunomide and biological agents (rituximab). These drugs are selected by a rheumatologist and prescribed for long courses according to a special scheme.

To restore the functioning of the joints, chondroprotectors are prescribed - drugs that restore the cartilage tissue of the joints. They are also required for long courses.

Means that improve blood circulation and metabolism in tissues - pentoxifylline and others help restore tissue trophism.

Vitamins and minerals are prescribed as tonic, which improve metabolism and restore general balance in the body.

Physiotherapeutic procedures

Complex treatment of finger osteoarthritis necessarily includes physiotherapeutic procedures. Like drugs, they are selected individually depending on the clinical form and activity of the pathological process. This can be electrophoresis with hydrocortisone, UHF, laser or magnetic therapy, etc.

Massage and exercise therapy

During the period when the inflammatory process subsides, massage and therapeutic gymnastics courses are prescribed. They help improve blood circulation and metabolism in tissues and restore the function of small joints. At home, you can do the following physical exercises to improve mobility:

• roll a small elastic ball with the palm of your fingers on the table surface for one minute and actively involve the affected finger joints.
• With the fingertips of one hand, touch the fingertip of the 1st finger of the other hand; Start with your pinky finger and end with your index finger; repeat the exercise 10 times;
• adjust your hands so that the fingertips are slightly bent and touch the surface of the table; bend each finger in turn and strike the table with them (like the keys of a piano);
• repeat three times.

The implementation of such exercises should be carried out daily, gradually increasing the number of approaches.

Home remedies

How to treat arthritis of the fingers with folk remedies should be explained by the doctor. He also chooses the most appropriate technique. You can use both herbal decoctions and infusions for oral administration, and external agents:

• a compress of kefir mixed with crushed chalk in the amount of 50 g of chalk per 75-100 ml of kefir; You should get a thick mixture to be applied once a day at night; to do this, it must be applied to a napkin made of cotton material, which is applied to a sore spot - polyethylene and insulation; so leave it overnight; perfectly relieves swelling and pain;
• Celery root infusion; Put 20 g of crushed raw materials (dry or fresh) in a thermos overnight, pour 200 ml of boiling water; drink 3 - 4 doses before meals the next day; the course of treatment is 2 weeks; relieves pain and swelling well.

surgery

This type of treatment for arthritis of the small joints is rarely used. With pronounced arthritis inaccessible to conservative treatment, synovectomy is sometimes performed - removal of part of the synovial membrane that produces a large volume of exudate.

In some cases, the joint is replaced with an artificial one, but this is a rather rare operation.

The current strategy for treating rheumatoid arthritis in this article.

Clinical approach to finger osteoarthritis

In our clinic, the patient is carefully examined using the most modern laboratory and instrumental methods, including MRI, and only then is a treatment prescribed, which is selected individually for each patient.

A feature of treatment in our clinic is that the complex therapy includes:

• modern western methods of treatment aimed at eliminating the main manifestations of finger arthritis;
• traditional oriental methods of treating diseases that make it possible to restore balance in the body, establish the relationship of all organs and systems; This will remove inflammation, swelling, and pain in the joints and suppress the progression of the disease.

The combination of western and eastern techniques enables our patients to be relieved of pain quickly and painlessly and to effectively restore the function of damaged joints. The clinic's specialists have many years of experience in the treatment of finger osteoarthritis. You can find out more about the treatment methods in our clinic on our website.

General clinical guidelines

Patients with finger osteoarthritis are recommended:

• lead a healthy lifestyle, temper, cure in a timely manner, eliminate all foci of infection that can be a trigger for the development of exacerbations of arthritis;
• getting rid of bad habits, eating right, regulating sleep and wakefulness;
• in case of exacerbation of arthritis, do not strain your fingers, do not do housework, including washing dishes;
• doing physical exercises for the hands at home during remission; classes should be held daily;
• completely refrain from self-medication, and in everything stick to the recommendations of the doctor.

Prevention of finger osteoarthritis

Prevention of arthritis is especially important for people with a genetic predisposition to the disease (close relatives with this pathology). To maintain health, they must adhere to the following recommendations:

• You cannot put heavy physical or long-term laborious work on your hands, even at home;
• Hypothermia must be avoided, hands should be avoided;
• lead a healthy lifestyle, eat right, temperate;
• doing feasible sport, exercising every day;
• avoid prolonged stress.

diet

A special diet is required only with gouty arthritis of the fingers. The diet of such patients should not include strong broths, offal, meat from young animals, alcohol, sorrel, lettuce, strong tea, coffee, chocolate.

In other cases, it is enough to adhere to the principles of a healthy diet: eat lean meat and dairy products, fish (oily sea fish is useful), cereals, cereals, vegetables, fruits. Avoid high-calorie foods, sweets, muffins, hot spices, fried, smoked foods. Meals should be regular.

Finger arthritis often develops unnoticed. It is very important to watch out for aching finger pain in a timely manner and to consult a doctor in good time. But even if you missed the time and there are clear signs of arthritis, do not despair: you can help at any stage. Complete cure of a chronic disease is problematic, but it is entirely possible to stop its progression, relieve pain, and improve quality of life.