Finger arthritis

Arthritis of the small joints usually does not develop on its own, but against the background of a number of general diseases. Arthritis of the fingers is a characteristic symptom of rheumatoid arthritis, but it can also be one of the manifestations of a number of other diseases. It is important to seek medical attention promptly, determine the cause, and initiate treatment to avoid serious complications and disability. 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 joints of the fingers and the joints between the fingers. The disease occurs quite often, at any age. According to statistics, women get sick with them more after 40 years old. This is explained by the fact that, compared to men, women bear a greater load on their hands and fingers. Code for arthritis of the finger of unspecified origin according to ICD-10 M13.

Depending on the cause, the disease may occur only in the small joints of the fingers, and may be associated with damage to the large joints. The onset of the disease can be acute, subacute, and chronic, but then the course in most cases becomes protracted or chronic. The exception is posttraumatic finger arthritis: with proper treatment, the disease makes a full recovery. But if the treatment is not prescribed on time, it will also become a chronic stage.

Causes of the inflammatory process in the knuckles

The causes of the disease can be different. Most often, the small joints of the fingers are affected in rheumatoid arthritis - an autoimmune disease (allergy to the patient's own tissues), which is based on a genetic predisposition. The starting point for the onset of the disease is usually some kind of infection. Then, after a while, people with a genetic predisposition develop arthritis of the fingers. In the future, other, larger joints may be affected.

Another common cause of inflammation of the small joints of the hands is psoriatic arthritis. It is also an autoimmune genetic disease, in which the joints of the (distal) fingers are mainly affected, with a characteristic concomitant lesion of the nails. This often occurs against the background of existing skin manifestations of psoriasis, but sometimes arthritis symptoms in the knuckles appear first.

Often, arthritis of the joints of the fingers develops along with gout. Diseases of metabolic (metabolic) origin - the metabolism of uric acid salts is disturbed, they are deposited in joint and periarticular tissues, causing inflammatory processes.

Post-traumatic finger arthritis is sometimes of an occupational nature. It develops with a constant minor trauma to the hands of jewelers, seamstresses, hairdressers, etc. v. The ongoing inflammatory process is supported by additional trauma and becomes chronic. After an acute injury (sports, domestic), acute arthritis may develop, then disappear completely.

Other types of arthritis rarely cause damage to the small joints. The 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 heterotopic diseases. reactions, bad habits and professional activities.

Symptoms of Finger Arthritis

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

First sign hiệu

The onset of the disease is slow in most cases. Appears pain in the hand and stiffness when moving in the morning. At first, such a symptom lasts an average of no more than half an hour, and then disappears. The pain, constant, slowly increasing intensity.

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

When the disease has an acute onset, the patient's general condition is often encountered: fever, malaise, headache appear. If the development is subacute or chronic, there may be no general presentation, and changes in the affected joints may also be indistinct.

The most important thing to do when symptoms of arthritis appear is to see a doctor. The sooner this happens, the more likely it is to stop the inflammatory process in the first place.

Clear symptoms

The obvious signs of hand arthritis in the chronic stage include the appearance of edema and redness of the tissues around the affected area of the hand, as well as the involvement of other joints in the process. similar or otherwise. 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. But exacerbations of rheumatic disease more often occur without general symptoms.

After a while, the inflammatory process can somewhat decrease in intensity, local inflammation and general symptoms decrease. Then the process becomes chronic. In the morning, motion stiffness appeared, the patient noted the feeling that the hand was tight, not allowing movement. Some time after waking up in the morning and starting physical activity, this feeling decreases or even disappears. The presence of crepitus (friction and clicking) in the affected joints is also characteristic.

When the patient is left untreated for arthritis, there will be an alternation of exacerbations and remissions with constant pain and rapid development of joint deformities (with rheumatoid arthritis) or discharge of the fingertips. and shortened (with psoriatic arthritis). Thumb arthritis usually develops with gout, progresses with severe pain, swelling, and redness, then disappears without leaving a trace, but with frequent recurrence, deformity and loss of joint functionalso develop.

Danger symptoms

Urgent medical attention is needed for the following symptoms of finger arthritis:

• high body temperature (38 - 39°) for 5 days or more;
• a sharp increase in temperature, increased inflammation and joint pain with an already existing inflammatory process - may indicate the beginning of the process of deterioration;
• participation in the pathological process of new small or large joints;
• the appearance of black tissue at the fingertips (necrosis) in psoriatic arthritis.

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

What is the danger of the disease?

The main danger of any type of chronic arthritis is the progression of the inflammatory process, which eventually turns into degenerative-dystrophy with limb deformity and disability. The longer arthritis is present, the higher the risk of complications.

Stages of the disease

Finger arthritis has 4 stages of development, depending on the extent of joint damage, detected on physical examination:

1. Initial stage.When there are clinical signs of severe or mild inflammation on radiographs, you may see signs of inflammation as joint space enlargement. On ultrasound, you can see the presence of an increased volume of joint fluid. Symptoms may be pronounced or almost absent during the chronic course of the disease.
2. Progressive inflammation. On x-ray film and ultrasound, signs of infection can be clearly seen. Joint cartilage is destroyed, in their place a loose connective tissue is formed - pannus. This process is either rippling (acute-remission) or continuously progressive. Pain and stiffness increase.
3. Connective tissue dystrophy.The connective tissue of the pannus becomes rough, it grows and connects the bony surfaces that form the joint, so the movement of the joint is limited. The fingers are deformed.
4. Osteoarthritis.Instead of connective tissue, bone tissue grows in the joint, resulting in complete immobility and loss of joint function.

Possible complications

If left untreated, hand and finger arthritis will progress. The following complications may also occur:

• the development of a purulent inflammatory process with a transition to the tissues around the joint, the development of abscesses, bulges and sepsis;
• necrosis of the fingertips, shortening and inflammation of soft tissues;
• dislocations and minor dislocations;
• types of joint deformities;
• complete loss of function of fingers and hands.

What to do with the exacerbation?

During an acute attack of arthritis, the joints become extremely painful, the upper skin becomes red, swollen, and movement in the fingers is not possible due to the pain. To reduce suffering, you need:

• keep your hands in a slightly elevated position - this will reduce swelling;
• taking any medicine from the nonsteroidal anti-inflammatory drug (NSAID) class of drugs - Diclofenac, Nimesulide, Indomethacin, Ibuprofen; it will reduce pain and inflammation;
• apply to the skin of the affected joint any external agent from the NSAID group - 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 a doctor, which is urgent to prevent the progression of the disease. Can't do this alone.

How does arthritis of the fingers of the hand progress in different clinical forms of the disease?

The symptoms of hand arthritis and the nature of the disease depend on the disease that led to its development. The defeat of the small joints of the hand is often found in rheumatoid arthritis, psoriasis and gout. But it can also occur in other clinical forms of arthritis.

Rheumatoid arthritis

In most cases, arthritis begins slowly, imperceptibly. There is pain in the fingers. The nature of the pain is constant, aching, fatigue. In the morning after sleeping, stiff movements occur, which can last up to 30 minutes or more.

After a while, the patient noticed that the fingers began to swell in the joints. Usually, the little finger joints and the superior interphalangeal joints of the 2nd and 3rd fingers are affected. Success and failure symmetrically on two arms. Bruises of varying intensities are permanent. Over time, the characteristic deformities of the fusiform finger appear.

Small, painless subcutaneous rheumatic nodules appear on the skin of the fingers and elbows. The course of the disease is slow, steadily progressing, accompanied by constant pain that causes weakness, deformity and loss of joint function.

Psoriatic arthritis

In this disease, arthritis develops in the distal (terminal) middle finger joints against the background of pre-existing skin manifestations of psoriasis. But sometimes joint symptoms appear before or concurrently with skin symptoms. The disease in most cases begins acutely or acutely with redness, swelling, and pain in the small finger joints. Lesions are often 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, deformation of the fingertips occurs, they thicken, the nails become thinner and also deformed, the symptom of tremor appears - dotted indentations on the nail plates.

With a prolonged course of disease, dislocations and dislocations of the distal small joints develop, as well as lysis (melting) of the bones of the fingertips (X-ray signs) and shortening of the fingers.

Gout arthritis

A gout attack begins acutely, with the appearance of severe pain, swelling, and redness in the affected joint. Small joints are often involved. Usually, the inflammation starts at the first finger joint, and can then spread to the little finger joint and the interphalangeal joints of other fingers.

The pain is very intense, it can last from a few hours to a few weeks and then it goes away. But with frequent attacks accompanied by damage to joints of the same type, their function is impaired.

Post-traumatic arthritis

This type of finger arthritis can develop against the background of an acute injury in the family, industry or sport, followed by definitive treatment or (in the absence of necessary support)complicated by purulent infection. Sometimes such an inflammatory process can turn chronic, which entails deformity of the affected joints.

Initially, the chronic process of post-traumatic finger arthritis causes a small, continuous imperceptible injury to the fingers. This usually happens in people of certain professions who perform small jobs. Arthritis develops slowly, the most injured joints during work are affected. If you do not change jobs, a persistent deformity develops with dysfunction of the fingers.

Other types of arthritis

With such types of arthritis as reactive, infectious, idiopathic lesions in the small joints of the fingers are practically not found.

Diagnose

Diagnosis is established on the basis of characteristic symptoms of the disease and confirmed by examination data:

• laboratory tests - reveal the presence of an inflammatory process, the presence or absence of infection, antibodies to infectious agents, rheumatoid factor;
• X-ray - 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 and periarticular tissues.

Without additional testing methods, it is not possible to establish an accurate diagnosis (and thus prescribe appropriate treatment). Therefore, if the pain appears in the small joints of the fingers, you should consult a doctor as soon as possible.

Finger arthritis treatment

After the final diagnosis is established, treatment of finger arthritis is prescribed, which is carried out by a rheumatologist (sometimes in conjunction with other specialists - surgeons, dermatologists). It must be comprehensive, aimed at stopping the progression of the pathological process and preventing violations of joint function. Complex treatments include:

• drug treatment;
• physical therapy procedures;
• physiotherapy and massage;
• reflexology courses;
• folk remedies.

Drug treatment

The first task of drug therapy is to alleviate the patient's condition. For this, drugs of the NSAID group are prescribed, which relieve pain, inflammation and swelling of tissues. 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, drugs 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 digestive tract so it can't be taken for a long time. Instead of Diclofenac, more modern drugs of the NSAID group are prescribed - Nimesulide, Celecoxib, etc. Such agents are used externally, Diclofenac ointment. The use of drugs of the NSAID class can bring about significant remission to the patient.

Sometimes the inflammatory process is so pronounced that it is impossible to eliminate it 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 externally in the form of ointments. Intra-articular hormone injections into small joints are rarely performed.

To suppress the autoimmune process, drugs of the basic group are prescribed - Methotrexate, Sulfasalazine, Leflunomide and biologic agents (Rituximab). These drugs are selected and prescribed by a rheumatologist according to a special program for long courses.

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

Means that help improve blood circulation and metabolism in tissues - Pentoxifylline and others help to restore the nutritional properties of tissues.

As for supplements, vitamins and minerals are prescribed to improve metabolism and help restore general balance in the body.

Physiotherapy procedures

Complex treatment of finger arthritis necessarily includes physiotherapeutic procedures. They, like drugs, are selected individually, depending on the clinical form and activity of the pathological process. This could be electrophoresis with Hydrocortisone, UHF, laser or magnetic therapy, etc. v.

Massage therapy and exercise

Courses of massage and healing gymnastics are prescribed during the period of remission of the inflammatory process. They help improve blood circulation and metabolism in tissues, restore the function of small joints. At home, you can do the following exercises to improve mobility:

• roll a small elastic ball on the tabletop with the finger surfaces for one minute, actively involving the affected knuckles in the process;
• with the fingertips of one hand, touch the pad of the first finger of the opposite hand; begins with the little finger and ends with the index finger; repeat the exercise 10 times;
• place your hands so that the tips of your fingers are slightly bent and touch the surface of the table; bend each finger in turn and hit the table (like the keys of a piano);
• repeat three times.

Performing such exercises should be done daily, gradually increasing the number of approaches.

Folk remedies

How to treat finger arthritis with folk remedies should be prescribed by a doctor. He also chooses the most suitable technique. You can use both decoction and infusion of herbs for oral and external use:

• a compress of kefir mixed with crushed chalk at the rate of 50 g of chalk per 75 - 100 ml of kefir; you will get a thick paste, which must be applied once a day in the evening; for this, it must be applied to napkins made of cotton material, applied to a sore spot, on top - polyethylene and insulation; so leave it overnight; perfectly reduces swelling and pain;
• celery root infusion; Put 20 g of crushed ingredients (dry or fresh) in a thermos overnight, pour 200 ml of boiling water; the next day take 3-4 doses before meals; the course of treatment is 2 weeks; Good pain and swelling relief.

Surgery

This type of arthritis treatment of small joints is rarely used. With markedly, unresponsive conservative treatment, arthritis is sometimes performed with a bursectomy - removal of the part of the synovial membrane that produces a large amount of exudate.

In some cases, the joint is replaced with an artificial joint, but this is a fairly rare surgery.

Current strategies for the treatment of rheumatoid arthritis are covered in this article.

Clinical approach to finger arthritis

At our clinic, patients are carefully examined using the latest laboratory and instrumentation methods, including MRI, and only then a treatment is prescribed, selected specifically for the patient. each patient.

One feature of our clinic treatments is complex therapy that includes:

• modern Western methods of treatment aimed at eliminating the main manifestations of arthritis of the fingers;
• traditional methods of treating diseases of the East, allowing to restore balance in the body, establish the relationship of all organs and systems; This leads to the elimination of inflammation, swelling and pain in the joints and stops the progression of the disease.

The combination of Western and Eastern techniques helps patients relieve pain quickly and painlessly, thereby effectively restoring the function of damaged joints. The clinic's specialists have extensive experience in the treatment of finger arthritis. You can learn more about our clinic's treatments on our website.

General clinical guidelines

Patients with finger arthritis should:

• have a healthy, peaceful lifestyle; timely treatment, eliminating any foci of infection, which can become a trigger for the development of exacerbations of arthritis;
• give up bad habits, eat in moderation, sleep in moderation;
• in case of acute exacerbation of arthritis, do not pick up fingers, do not do housework, including washing dishes;
• during remission at home, exercise for hands; classes should be held daily;
• completely give up self-medication and follow the doctor's recommendations in everything.

Prevention of finger arthritis

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

• you cannot load your hands with heavy or strenuous work for long periods of time, including at home;
• must lower body temperature, avoid using hands;
• practice a healthy lifestyle, eat properly and in moderation;
• to perform possible sports, to train every day;
• Avoid prolonged stress.

Diet

Special nutrition is only required for gouty finger arthritis. The diet of these patients should be free from rich broths, offal, young animal meat, alcohol, sorrel, salads, strong tea, coffee, chocolate.

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

Finger arthritis often develops unnoticed. Timely attention to pain in the fingers and to see a doctor promptly is extremely important. But even if you've missed your period and have obvious signs of arthritis, don't despair: you can help at any stage. A complete cure for a chronic illness is daunting, but it's possible to stop its progression, relieve pain, and improve your quality of life.