Arthritis of the fingers

Inflammation of the small joints most often does not develop on its own, but against the background of some general diseases. Arthritis of the fingers is a characteristic symptom of rheumatoid arthritis, but it can also be one of the manifestations of any other disease. It is very important to seek medical help in a timely manner, identify the cause of the disease and start treatment in order 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

Arthritis of the finger is an inflammation of the metacarpophalangeal and interphalangeal joints of the fingers. The disease occurs quite often, at any age. According to statistics, women are sicker to them after 40 years. This is explained by the fact that, compared to men, women have a greater load on the hands and fingers. Finger arthritis code of unspecified origin according to ICD-10 M13.

Depending on the cause that caused it, the disease can only occur in the small joints of the fingers and can be combined 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 prolonged or chronic. The exception is post-traumatic arthritis of the fingers: with proper treatment, it ends in complete recovery. But if treatment was not prescribed in time, he also takes a chronic course.

Causes of the inflammatory process in the joints of the fingers

The causes of the disease can be different. Most often, small finger joints are affected in rheumatoid arthritis - an autoimmune disease (with allergies to the patient's own tissues), which is based on an inherited predisposition. The starting point for the onset of the disease is usually a type of infection. After him, after a while, genetically predisposed individuals develop finger arthritis. In the future, other, larger joints may be affected.

Another common cause of inflammation of the small joints of the hands is psoriatic arthritis. Alsoshte is also an inherited autoimmune disease, in which mainly the fingertips (distal) joints are affected, with a characteristic simultaneous damage of the nails. This usually occurs 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 articular and periarticular tissues, causing an inflammatory process.

Post-traumatic arthritis of the finger joints is sometimes of an occupational nature. It develops with a slight continuous damage to the hands of jewelers, tailors, hairdressers, etc. The inflammatory process is constantly supported by an additional trauma and becomes chronic. After acute injuries (sports, home), acute arthritis can develop, which then disappears completely.

Other types of arthritis rarely cause damage to small joints. 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 finger arthritis

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

The first signs

The onset of the disease is slow in most cases. There is excruciating pain in the hands and stiffness of movements in the morning. At first, such a symptom lasts on average no more than half an hour, and then passes. The pains are painful, constant, their intensity increases slowly.

Less often, the onset is acute. The pain appears in one or more small joints of the fingers, accompanied by redness and swelling of the surrounding tissues. Joint function is impaired: it is difficult to bend and unravel, sometimes it is impossible to do so due to pain.

With an acute onset of the disease, the general condition of the patient often suffers: fever, malaise, and headache appear. If the process takes place subacutely or chronically, there may be no general manifestations, the changes in the affected nodes may also not be very pronounced.

The most important thing to do when the symptoms of arthritis appear is to seek medical attention. The sooner this happens, the more likely it is that the inflammatory process will stop right from the start.

Visible symptoms

Obvious signs of arthritis of the hands 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 may be accompanied by a slight increase in body temperature, increased pain, and dysfunction of the affected joints. But more often rheumatoid arthritis occurs without general manifestations.

After a while, the inflammatory process may somewhat reduce its intensity, local inflammation and general symptoms decrease. After that, the process becomes chronic. Stiffness of movements appears in the morning, patients notice the sensation of tight gloves on the hand, which do not allow movement. Some time after getting up in the morning and starting physical activity, this sensation diminishes or even disappears. Also characteristic is the appearance of crepitus (friction and clicks) on the affected joint joints.

When the patient does not receive treatment for arthritis, there is an alternation of exacerbations and remissions with persistent pain and rapid formation of joint deformities (with rheumatoid arthritis) or fusion of the fingertips and their shortening (with psoriatic arthritis). Arthritis of the thumb most often develops with gout, continues with severe pain, swelling, redness, then disappears without a trace, but with frequent relapses also develops deformity and loss of joint function.

Dangerous symptoms

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

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

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

What is the risk of the disease

The main risk of any type of chronic arthritis is 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 joint damage detected during the instrumental examination:

1. Initial phase.In the presence of severe or small clinical signs of inflammation on x-ray, you may see signs of inflammation in the form of an enlargement of the joint space. On ultrasound, you can see the presence of an increased volume of joint fluid. Symptoms may be expressed or almost absent in the chronic course of the disease.
2. Progressive inflammation.On x-rays and ultrasound, the signs of inflammation are clearly visible. The articular cartilage is destroyed, in their place a loose connective tissue is formed - pannus. The process takes a wavy course (deterioration-forgiveness) or continuously progressive. Pain and stiffness increase.
3. Connective tissue ankylosis.The connective tissue of the panus becomes rough, it grows and connects the bone surfaces that form joints, as a result of which movement in the joints is limited. The fingers are deformed.
4. Bone ankylosis.Instead of connective tissue, bone tissue grows in the joint, which leads to complete immobility of the joint and loss of its function.

Possible complications

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

• development of a purulent inflammatory process with passage to the tissues surrounding the node, development of abscesses, phlegmon and sepsis;
• fingertip necrosis, shortening and inflammation of soft tissues;
• subluxation and displacement of small nodes;
• different types of joint deformities;
• complete loss of function of fingers and hands.

What to do with a deterioration

With an exacerbation of arthritis, the joints become very painful, the skin above them reddens, swells, movements in the fingers become impossible due to the pain. To reduce suffering, you should:

• give your hands a slightly elevated position - this will reduce swelling;
• take any medicine from the group of non-steroidal anti-inflammatory drugs (NSAIDs) - Diclofenac, Nimesulide, Indomethacin, Ibuprofen; will reduce pain and inflammation;
• apply on the skin of the diseased joint any external agent from the NSAID group - a gel or oil; Emulgel Diclofenac helps a lot;
• visit a doctor or call home.

With a worsening, it is impossible to delay a visit to the doctor, it is urgent to suppress the progression of the disease. It is impossible to do this yourself.

How arthritis of the fingers develops in different clinical forms of the disease

The symptoms of arthritis of the hand 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 arthritis, psoriatic and gout. But it can also occur in other clinical forms of arthritis.

Rheumatoid arthritis

In most cases, arthritis starts slowly, invisibly. There is aching pain in the fingers. The nature of the pain is constant, aching, exhausting. In the morning after sleep, stiffness of movements appears, which can last up to 30 minutes or more.

After a while, the patient notices that the fingers began to swell at the joints. Most often, the metacarpophalangeal and overlapping interphalangeal joints of the 2nd and 3rd fingers are affected. The loss is symmetrical on both sides. Pain of varying intensity is permanent. Over time, characteristic deformations of the fusiform fingers appear.

Small, painless subcutaneous rheumatoid nodules appear on the skin of the fingers and elbows. The course of the disease is slow, progressing steadily, accompanied by persistent debilitating pain, deformity, and loss of joint function.

Psoriatic arthritis

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

The disease continues with severe exacerbations and remission. Almost always, nail plates are involved in the pathological process. Over time, the fingertips become deformed, they thicken, the nails become thinner and also deformed, a toe symptom appears - dotted indentations on the nail plates.

With a prolonged course of the disease, displacements and subluxations of the small distal joints develop, as well as lysis (melting) of the fingertip bones (X-ray mark) and shortening of the fingers.

Gout arthritis

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

The pain is very strong, the attack can last from a few hours to a few weeks, and then everything disappears. But with frequent attacks with damage to the same joints, their function is impaired.

Post-traumatic arthritis

This type of toe arthritis can develop against the background of an acute home, industrial or sports injury, proceed acutely with subsequent complete recovery, or (in the absence of necessary help) be complicated by the addition of a purulent infection. Sometimes such an inflammatory process can turn into a chronic process, followed by deformation of the affected joints.

Initially, the chronic course of post-traumatic arthritis of the fingers gets a persistent small invisible damage to the fingers. Most often this happens to people with certain professions who perform small jobs. Arthritis develops slowly, affecting the most traumatized joints during labor. If you do not change jobs, continuous deformation develops with the malfunction of the fingers.

Other types of arthritis

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

Diagnosing

The diagnosis is determined based on the characteristic symptoms of the disease and is confirmed by the examination data:

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

Without additional examination methods, it is impossible to establish the correct diagnosis (and, therefore, prescribe adequate treatment). Therefore, if pain occurs in the small joints of the fingers, you should consult a doctor as soon as possible.

Treatment of Finger Arthritis

After establishing the final diagnosis, the treatment of finger arthritis is prescribed, which is performed by a rheumatologist (sometimes in collaboration with other specialists - a surgeon, dermatovenerologist). It should be comprehensive, aiming to suppress the progression of the pathological process and prevent violations of articular function. Complex treatment includes:

• drug therapy;
• physiotherapy procedures;
• therapeutic gymnastics and massage;
• reflexology courses;
• folk remedies.

Drug therapy

The first task of drug therapy is to alleviate the condition of a sick person. 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, medicines in this group are prescribed externally in the form of gels, oils and creams.

The most effective NSAID is Diclofenac, but it irritates the walls of the gastrointestinal tract, so it can not be taken for a long time. Instead of Diclofenac, the most modern drugs of the NSAID group are prescribed - Nimesulide, Celecoxib, etc. Such agents are used externally, Diclofenac ointment. The use of NSAIDs can bring significant relief to the patient.

Sometimes the inflammatory process is so pronounced that it is impossible to remove it with NSAID group drugs. In this case, glucocorticoid hormones are used - Prednisolone, Dexamethasone, etc. In the form of injections, inside tablets or externally in the form of oils. Intra-articular injection of hormones into small nodes is rarely practiced.

To suppress autoimmune processes, basic group drugs are prescribed - Methotrexate, Sulfasalazine, Leflunomide and biological agents (Rituximab). These drugs are selected by a rheumatologist and prescribed according to a special scheme for long courses.

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

Tools that improve blood circulation and tissue metabolism - Pentoxifylline and others help restore tissue trophism.

As tonic agents, vitamins and minerals are prescribed that improve metabolism and help restore overall balance in the body.

Physiotherapy procedures

Complex treatment of arthritis of the finger necessarily involves physiotherapy procedures. They, like drugs, are selected individually, depending on the clinical form and activity of the pathological process. This can be electrophoresis with Hydrocortisone, UHF, laser or magnetotherapy, etc.

Massage and exercise therapy

Massage and improvement gymnastics courses are prescribed during the period when the inflammatory process subsides. They help to improve blood circulation and metabolism in tissues, to restore the function of small nodes. At home, you can do the following exercises to improve movement:

• roll a small elastic ball on the table surface with the finger surfaces for one minute, actively including the affected finger joints in the process;
• with the fingertips of one hand, touch the pillow 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 surface of the table; bend each finger in turn and hit the table with it (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 arthritis of the fingers with folk remedies should be shown by the doctor. He also chooses the most appropriate technique. You can use herbal decoctions and infusions for oral administration, and external agents:

• a compress of kefir mixed with crushed chalk at the rate of 50 g of chalk per 75 - 100 ml of kefir; you should take a thick mixture, which should be applied once a day at night; for this, it should be applied to a napkin made of cotton material, applied to a sore spot, on top - polyethylene and insulation; so leave it overnight; perfectly relieves swelling and pain;
• infusion of celery roots; 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 doses before meals; the course of treatment is 2 weeks; relieves pain and swelling well.

Surgery

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

In some cases, the node is replaced with an artificial one, but this is a fairly 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 using the latest laboratory and instrumental methods, including MRI, and only after that a treatment is prescribed, which is selected individually for each patient.

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

• modern western methods of treatment to eliminate the main manifestations of finger arthritis;
• traditional oriental methods of treating diseases, allowing the restoration of balance in the body, the establishment of relations 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 quickly and painlessly relieve our patients from pain, and then effectively restore the function of damaged joints. Clinic specialists have extensive experience in treating finger arthritis. You can learn more about treatment methods at our clinic on our website.

General clinical guidelines

Patients with finger arthritis are advised to:

• leads a healthy lifestyle, patience; heals in time, eliminates all foci of infection, which can trigger the development of arthritis exacerbations;
• get rid of bad habits; eat well, regulate sleep and wakefulness;
• in case of worsening arthritis, do not load your fingers, do not do housework, including washing dishes;
• while praying at home, do physical exercises for the hands; classes should be held daily;
• completely abandon self-medication and adhere to the doctor's recommendations in everything.

Prevention of finger arthritis

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

• you can not load your hands with heavy physical or meticulous long-term work, including at home;
• hypothermia should be avoided, hands should be avoided;
• lead a healthy lifestyle, eat well, temper;
• do feasible sports, train every day;
• avoid prolonged stress.

diets

Special diet is required only for gouty arthritis of the fingers. The diet of such patients should not contain strong soup, offal, meat of 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 (fatty sea fish is useful), whole grains, cereals, vegetables, fruits. Avoid high-calorie foods, sweets, muffins, hot spices, fried and smoked foods. Food should be regular.

Arthritis of the finger often develops unnoticed. It is very important to pay attention to the pain in your fingers in time and to consult a doctor in time. But even if you have lost time and there are clear signs of arthritis, do not despair: you can help at any stage. It is problematic to completely cure a chronic disease, but it is quite possible to stop its progression, relieve you of pain, and improve your quality of life.