Inflammation of small joints most often does not develop on its own, but in the context of some general illness. Arthritis of the fingers is a characteristic symptom of rheumatoid arthritis, but it can also be one of the manifestations of some other disease. It is very important to seek medical help in a timely manner, identify the cause of the illness and initiate treatment to avoid serious complications and disabilities. In this article you will find all the information you need to know about this disease.
General information about the disease
Finger arthritis is an inflammation of the metacarpophalangeal and interphalangeal joints of the fingers. The disease occurs quite frequently, at any age. According to statistics, women get sick more after 40 years. This is explained by the fact that, compared to men, women have a greater load on their hands and fingers. Finger arthritis code of unspecified origin according to ICD-10 M13.
Depending on the cause, the disease may only occur in the small joints of the fingers and may be associated with damage to the large joints. Disease onset can be acute, subacute and chronic, but then the course in most cases becomes prolonged or chronic. The exception is post-traumatic arthritis of the fingers: with proper treatment, it ends up in full recovery. But if treatment has not been prescribed at the right time, it also takes a chronic course.
Causes of the inflammatory process in finger joints
The causes of the disease may be different. Most of the time, the small joints of the fingers are affected in rheumatoid arthritis - an autoimmune disease (with an allergy to the patient's own tissues), which is based on an inherited predisposition. The starting point for the onset of the disease is usually some type of infection. After that, after a while, genetically predisposed individuals develop arthritis of the fingers. In the future, other larger joints may be affected.
Another common cause of inflammation of the small joints in the hands is psoriatic arthritis. It is also an inherited autoimmune disease, in which the joints of the fingertips (distal) are mainly affected, with a characteristic simultaneous lesion of the nails. This usually occurs in the context of existing skin manifestations of psoriasis, but sometimes symptoms of arthritis in the finger joints appear first.
Arthritis of the finger joints often develops with gout. The disease has a metabolic (metabolic) origin - the exchange of uric acid salts is disturbed, they are deposited in the articular and periarticular tissues, causing an inflammatory process.
Post-traumatic arthritis of the finger joints is sometimes professional in nature. It develops with a constant injury to the hands of jewelers, seamstresses, hairdressers, etc. The inflammatory process is constantly sustained by additional trauma and becomes chronic. After acute injuries (sports, domestic), acute arthritis can occur, which then disappears completely.
Other types of arthritis rarely damage small joints. The provocative factors that contribute to the development of arthritis of the small joints of the hands are hormonal changes (adolescence, pregnancy, menopause), stress, frequent colds and allergic diseases, bad habits and professional activities.
Symptoms of Arthritis in Fingers
Symptoms may differ depending on the nature of the course of the inflammatory process (acute, subacute, chronic), as well as the clinical form of the underlying disease.
Disease onset is slow in most cases. There are pain in the hands and stiffness in movement in the morning. At first, this symptom lasts on average for no more than half an hour and then passes. The pains are strong, constant, their intensity increases slowly.
Less often, the onset is acute. Pain appears in one or more small finger joints, accompanied by redness and swelling of the surrounding tissue. Joint function is impaired: it is difficult to bend and unfold, sometimes it is impossible because of the pain.
With the acute onset of the disease, the patient's general condition often suffers: fever, malaise and headache appear. If the process develops subacutely or chronically, there may not be general manifestations, the changes in the affected joints may also not be very pronounced.
The most important thing to do when arthritis symptoms appear is to see a doctor. The sooner this happens, the more likely it is to stop the inflammatory process early on.
The obvious signs of chronic ongoing hand arthritis include the appearance of swelling and redness of the tissues around the affected areas of the hands, as well as involvement of other joints in the pathological process in the same or the other hand. The appearance of new foci of inflammation may be accompanied by a slight increase in body temperature, increased pain and dysfunction of the affected joints. More often, however, rheumatoid exacerbations occur without general manifestations.
After a while, the inflammatory process may reduce its intensity somewhat, local inflammation and general symptoms decrease. After that, the process becomes chronic. Appears morning stiffness of movements, patients notice the feeling of tight gloves on the hand, which does not allow movement. Some time after waking up in the morning and starting physical activity, this sensation diminishes or even disappears. The appearance of crackling (friction and clicking) in the affected joint joints is also characteristic.
When the patient is not treated for arthritis, exacerbations and remissions alternate with constant pain and rapid formation of joint deformities (in rheumatoid arthritis) or fingertip melting and shortening (in psoriatic arthritis). Arthritis of the thumb usually develops with gout, proceeds with severe pain, swelling, redness and disappears without a trace, but with frequent relapses, deformation and loss of joint function also develop.
Emergency medical attention is required for the following symptoms of arthritis of the fingers:
- elevated body temperature (38 - 39 °) for 5 or more days;
- a sharp rise in temperature, increased inflammation, and joint pain with an existing inflammatory process - may 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 these symptoms appear, you should see a doctor right away.
what is the danger of the disease
The main danger of any type of chronic arthritis is the progression of the inflammatory process, which ends up becoming degenerative-dystrophic with limb deformity and disability. The longer the arthritis lasts, the greater the risk of complications.
Stages of the disease
Arthritis of the finger joints has 4 stages of development, depending on the degree of joint damage detected during the instrumental examination:
If left untreated, arthritis of the hands and fingers will progress. The following complications are also possible:
- the development of a purulent inflammatory process with the transition to tissues surrounding the joint, the development of abscesses, phlegmon and sepsis;
- fingertip necrosis, shortening and soft tissue inflammation;
- subluxation and dislocation of small joints;
- various types of joint deformities;
- complete loss of function of fingers and hands.
What to do with an exacerbation
With the exacerbation of arthritis, the joints become acutely painful, the skin above them becomes red, swollen, finger movements become impossible due to the pain. To reduce suffering, you need to:
- place your hands slightly elevated - this will reduce swelling;
- taking any medication from the group of non-steroidal anti-inflammatory drugs (NSAIDs) - Diclofenac, Nimesulide, Indomethacin, Ibuprofen; will reduce pain and inflammation;
- apply any external NSAID agent to the skin over the diseased joint - a gel or ointment; Diclofenac emulgel helps a lot;
- see a doctor or call him at home.
With an exacerbation, it is impossible to delay a visit to the doctor, it is urgent to suppress the progression of the disease. It's impossible to do this alone.
How Arthritis of the Fingers Occurs in the Different Clinical Forms of the Disease
The symptoms of arthritis of the hands and the nature of its course depend on the disease that led to its development. Defeat of the small joints of the hands is most often found in rheumatoid, psoriatic, and gouty arthritis. But it can also occur in other clinical forms of arthritis.
In most cases, arthritis starts slowly, imperceptibly. There are pain in the fingers. The nature of pain is constant, painful, exhausting. In the morning, after sleep, rigidity of movements appears, which can last up to 30 minutes or more.
After a while, the patient notices that the fingers have started to swell in the joints. Most of the time, the overlapping metacarpophalangeal and interphalangeal joints of the second and third fingers are affected. Defeat is symmetrical in both arms. Pains of varying intensity are permanent. Over time, characteristic deformities of fusiform fingers appear.
Small, painless subcutaneous rheumatoid nodules appear on the skin of the fingers and elbows. The course of the disease is slow, steadily progressing, accompanied by constant debilitating pain, deformity, and loss of joint function.
In this disease, arthritis develops in the distal (terminal) interphalangeal finger joints in the context of existing cutaneous manifestations of psoriasis. But sometimes joint symptoms appear before or simultaneously with skin symptoms. The disease, in most cases, 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. The nail plates are almost always involved in the pathological process. Over time, deformation of the fingertips occurs, they thicken, the nails become thinner and also deformed, a symptom of a thimble appears - dotted cuts in the nail plates.
With the prolonged course of the disease, dislocations and subluxations of the small distal joints occur, as well as lysis (melting) of the bones of the fingertips (X-ray sign) and shortening of the fingers.
An attack of gout begins acutely, with the appearance of severe pain, swelling and redness in the area of the affected joints. Often small joints are involved. The inflammation usually starts with the metacarpophalangeal joint of the first finger and can 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. But with frequent attacks with damage to the same joints, its function is impaired.
This type of arthritis of the fingers may develop in the context of an acute domestic, industrial, or sporting injury, proceed acutely with a subsequent complete cure, or (in the absence of necessary assistance) be complicated by the addition of a purulent infection. Sometimes this inflammatory process can become chronic, followed by deformation of the affected joints.
Initially, the chronic course of post-traumatic arthritis of the fingers assumes constant and imperceptible damage to the fingers. Most of the time, this occurs in people from certain professions who carry out small jobs. Arthritis develops slowly, joints more traumatized during labor are affected. If you don't change jobs, you develop persistent deformity with dysfunction of the fingers.
Other types of arthritis
With types of arthritis, such as reactive, infectious and idiopathic lesions of the small joints of the fingers, they are practically not found.
Diagnosis is established based on the characteristic symptoms of the disease and is confirmed by examination data:
- laboratory tests - reveal the presence of an inflammatory process, presence or absence of infection, antibodies to infectious agents, rheumatoid factor;
- radiography - reveals bone changes in the joints;
- Ultrasound - the presence of increased exudate volume in the joint cavity is a sign of an active inflammatory process;
- MRI - changes in soft and periarticular articular tissues.
Without additional methods of examination, it is impossible to establish the correct diagnosis (and therefore prescribe the appropriate treatment). Therefore, if pain in the small joints of the fingers occurs, you should see a doctor as soon as possible.
Finger Arthritis Treatment
Once the final diagnosis is established, treatment for arthritis of the fingers is prescribed, which is performed by a rheumatologist (sometimes in conjunction with other specialists - a surgeon, dermatovenerologist). It must be comprehensive, aiming to suppress the progression of the pathological process and prevent violations of joint function. Complex treatment includes:
- drug therapy;
- physiotherapy procedures;
- therapeutic gymnastics and massage;
- reflexology courses;
- folk remedies.
The first task of drug therapy is to alleviate the condition of a sick person. For this, drugs from the NSAID group are prescribed, which relieve pain, inflammation and tissue swelling. Depending on the degree of activity of the inflammatory process, these drugs are prescribed in the form of injections (injections) or tablets for oral administration. In addition, medications in 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 taken for long. Instead of Diclofenac, more modern drugs from the group of NSAIDs are prescribed - Nimesulide, Celecoxib, etc. These agents are used externally, Diclofenac ointment. The use of drugs from the NSAID group can bring significant relief to the patient.
Sometimes the inflammatory process is so pronounced that it is impossible to remove it with NSAID drugs. In this case, glucocorticoid hormones are used - Prednisolone, Dexamethasone, etc. in the form of injections, internally in pills or externally in the form of ointments. Intra-articular injection of hormones into small joints is rarely practiced.
To suppress autoimmune processes, drugs from the basic group are prescribed - Methotrexate, Sulfasalazine, Leflunomide and biological agents (Rituximab). These drugs are selected by a rheumatologist and prescribed according to a special long-course schedule.
To restore joint function, chondroprotectors - drugs that restore the cartilage tissue in the joints are prescribed. They are also prescribed for long courses.
Means that improve blood circulation and metabolism in tissues - pentoxifylline and others help to restore tissue trophism.
As fortifying agents, vitamins and minerals are prescribed to improve metabolism and help restore the body's overall balance.
The complex treatment of arthritis of the fingers necessarily includes physical therapy procedures. They, like drugs, are selected individually, depending on the clinical form and activity of the pathological process. It can be electrophoresis with hydrocortisone, UHF, laser or magnetotherapy, etc.
Massage and therapeutic exercises
Massage and corrective gymnastics courses are prescribed during the period when the inflammatory process stops. They help improve blood circulation and tissue metabolism, restoring small joint function. At home, you can do the following physical exercises to improve mobility:
- roll a small elastic ball on the table surface with your finger surfaces for one minute, actively engaging the affected finger joints in the process;
- with the fingertips of one hand, touch the pulp of the 1st finger of the opposite hand; start with the little finger and end with the index finger; repeat the exercise 10 times;
- place your hands so that your fingertips are slightly bent and touch the table surface; bend each finger in turn and tap the table with it (like the keys on a piano);
- repeat three times.
These exercises should be performed daily, gradually increasing the number of approaches.
How to treat arthritis of the fingers with folk remedies must be informed by the doctor. He also selects the most suitable technique. You can use herbal decoctions and infusions for oral administration and external agents:
- a kefir compress mixed with crushed chalk in the proportion of 50 g of chalk per 75 - 100 ml of kefir; you should get a thick mixture, which should be applied once a day at night; for this, it must be applied on a cotton cloth napkin, applied over the wound, on the upper part - polyethylene and insulating; then leave it overnight; perfectly relieves swelling and pain;
- celery root infusion; Put 20 g of crushed raw material (dry or fresh) in a thermos overnight, pour 200 ml of boiling water; the next day, drink 3-4 servings before meals; the course of treatment is 2 weeks; it relieves pain and swelling well.
This type of treatment for small joint arthritis is rarely used. Pronounced, not amenable to conservative treatment, arthritis is sometimes performed by synovectomy—removal of a part of the synovial membrane that produces a large volume of exudate.
In some cases, the joint is replaced by an artificial one, but this is a very rare operation.
The current strategy for treating rheumatoid arthritis in this article.
Clinical Approach to Finger Arthritis
In our clinic, the patient is carefully examined with the most modern laboratory and instrumental methods, including MRI, and then a treatment is prescribed, which is individually selected for each patient.
A feature of the treatment at our clinic is that complex therapy includes:
- modern western methods of treatment to eliminate the main manifestations of arthritis of the fingers;
- traditional oriental methods of treating illnesses, allowing to restore the balance of the body, establishing the relationship of all organs and systems; this leads to the elimination of inflammation, swelling and pain in the joints and suppression of disease progression.
The combination of Western and Eastern techniques makes it possible to relieve our patients' pain quickly and painlessly and then effectively restore the function of the damaged joints. The clinic's specialists have extensive experience in the treatment of digital arthritis. You can find out more about treatment methods at our clinic on our website.
General Clinical Guidelines
Patients with arthritis of the finger are advised to:
- lead a healthy lifestyle, temperament; cure at the right time, eliminate all infection foci, which can become a trigger in the development of arthritis exacerbations;
- get rid of bad habits, eat well, regulate sleep and wakefulness;
- in case of aggravation of arthritis, do not carry your fingers, do not do household chores, including washing dishes;
- during remission at home, do physical exercises for the hands; classes must be held daily;
- completely abandon self-medication and follow the doctor's recommendations at all.
Prevention of Arthritis in Fingers
Prevention of arthritis is especially important for people with a genetic predisposition to this disease (close relatives with this condition). To maintain health, they need to adhere to the following recommendations:
- you cannot carry your hands with long-term heavy or meticulous physical labor, including at home;
- hypothermia must be avoided, hands must be avoided;
- lead a healthy lifestyle, eat well, season;
- do viable sports, train every day;
- avoid prolonged stress.
Special nutrition is only needed for gouty arthritis of the fingers. The diet of such patients should not contain strong broths, viscera, meat from young animals, alcohol, sorrel, salad, strong tea, coffee, chocolate.
In other cases, just follow the principles of healthy eating: eat lean meat and dairy products, fish (fatty sea fish are useful), cereals, cereals, vegetables, fruits. Avoid high-calorie foods, sweets, muffins, hot spices, fried and smoked foods. Meals should be regular.
Arthritis of the fingers usually goes unnoticed. It is very important to pay attention to finger pain early and consult a doctor in a timely manner. But even if you've overslept and there are clear signs of arthritis, don't despair: you can help at any stage. It is problematic to completely cure a chronic disease, but it is perfectly possible to stop its progression, relieve pain, and improve your quality of life.