Arthritis of the fingers

Inflammation of the small joints most often does not develop spontaneously, but develops against the background of some common diseases. Arthritis of the fingers is a characteristic symptom of rheumatoid arthritis, but can also be a manifestation of some other diseases. To prevent serious complications and disability, it is very important to get timely medical care, determine the cause of the disease and start treatment. In this article you will find all the information you need to know about this disease.

General information about the disease

Arthritis of the fingers is an inflammation of the metacarpophalangeal and interphalangeal joints of the fingers. The disease occurs quite often at any age. According to statistics, women get sick more often after 40 years. This is due to the fact that women have more load on their hands and fingers than men. Arthritis code of fingers of unspecified origin in accordance with ICD-10 M13.

Depending on the cause, 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 in most cases the course is prolonged or chronic. The exception is post-traumatic arthritis of the fingers: it ends with complete recovery with appropriate treatment. However, if the treatment is not prescribed in time, it also takes a chronic course.

Causes of the inflammatory process in the joints of the fingers

The causes of the disease may be different. Often the small joints of the fingers are affected in rheumatoid arthritis - an autoimmune disease based on a hereditary predisposition (the patient is allergic to their own tissues). The starting point of the disease is usually a kind of infection. After that, after a while, people with genetic predisposition develop arthritis of the fingers. Other, larger joints may be affected in the future.

Another cause of inflammation of the small joints of the hands is psoriatic arthritis. It is also an autoimmune inherited disease in which the joints of the fingertips (distal) are affected by a characteristic lesion of the nails. This usually occurs against the background of existing skin manifestations of psoriasis, but sometimes the symptoms of arthritis in the joints of the fingers appear first.

Arthritis of the joints of the fingers often develops with gout. The disease has a metabolic (metabolic) origin - the metabolism of uric acid salts is disrupted, it is deposited in the articular and periarticular tissues and causes an inflammatory process.

Post-traumatic arthritis of the finger joints is sometimes professional. Jewelers, tailors, hairdressers, etc. It develops with a persistent minor injury to the hands. The inflammatory process is constantly supported by additional trauma and becomes chronic. Acute (sports, internal) injuries can lead to the development of acute arthritis, which then disappears completely.

Other types of arthritis rarely cause damage to small joints. The triggers for 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 occupational activities.

Symptoms of finger arthritis

The symptoms may be different, depending on the nature of the inflammatory process (acute, subacute, chronic), as well as the clinical form of the underlying disease.

The first signs

In most cases, the onset of the disease is slow. In the morning there is a sharp pain in the hands and stiffness of movements. At first, such a symptom lasts on average more than half an hour, and then passes. The pains are painful, persistent, and gradually increase in intensity.

Less often the onset is acute. Pain appears 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 and flex, sometimes it is impossible to do so due to pain.

With an acute onset of the disease, the patient's general condition often suffers: fever, weakness and headache appear. If the process develops subacutely or chronically, there may be no general manifestations, and changes in the affected joints may not be very obvious.

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 that the inflammatory process will initially stop.

Obvious symptoms

Obvious signs of chronic hand arthritis 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 at the same time or on 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. However, more rheumatoid exacerbations occur without common manifestations.

After a while, the intensity of the inflammatory process may decrease, local inflammation and general symptoms decrease. After that, the process becomes chronic. The stiffness of the morning movements is visible, and patients notice a tight glove feeling that does not allow movement in the hands. After waking up in the morning and starting physical activity, this feeling decreases or disappears. The appearance of crepitus (friction and clicks) in the affected joints is also characteristic.

When a patient is not treated for arthritis, there is an alternation of exacerbations and remissions with persistent pain and rapid onset of joint deformities (with rheumatoid arthritis) or melting and shortening of the fingertips (with psoriatic arthritis). Arthritis of the thumb most often develops with gout, continues with severe pain, swelling, redness, then disappears without a trace, but often develops with recurrence, deformity and loss of joint function.

Dangerous symptoms

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

• High body temperature for 5 or more days (38 - 39 °);
• a sharp rise in temperature, increased inflammation and pain in the joint with an increased inflammatory process - may indicate the onset of lactation;
• participation in the pathological process of new small or large joints;
• appearance of dark tissue (necrosis) on the fingertips in psoriatic arthritis.

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

What is the danger of the disease

The main danger of any chronic arthritis is the progression of the inflammatory process, resulting in degenerative-dystrophic limb deformity and disability. The longer the arthritis lasts, the higher the risk of complications.

Stages of the disease

Arthritis of the joints of the fingers has 4 stages of development, depending on the degree of joint damage detected during instrumental examination:

1. The initial stage.If there are signs of severe or minor inflammation on the x-ray, you may see signs of inflammation in the form of enlargement of the joint space. On ultrasound, you can see an increase in the volume of joint fluid. In the chronic course of the disease, symptoms are detected or almost absent.
2. Progressive inflammation. Signs of inflammation are clearly visible on X-rays and ultrasound. Joint cartilage is destroyed, and in its place is formed loose connective tissue - pannus. The process takes a wavy (exacerbation-remission) or constantly progressive course. Pain and stiffness increase.
3. Connective tissue ankylosis.The connective tissue of the pannus becomes rough, enlarged, and connects the bone surfaces that make up the joint, resulting in limited movement in the joint. Fingers are deformed.
4. Bone ankylosis.Instead of connective tissue, bone tissue grows in the joint, leading to complete immobilization and loss of function of the joint.

Possible complications

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

• development of a purulent inflammatory process with the development of abscesses, phlegmon and sepsis, transition to the tissues surrounding the joint;
• necrosis, shortening and soft tissue inflammation of the fingertip;
• subluxation and protrusion 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 sharply painful, the upper skin becomes red and swollen, and movements in your fingers become impossible due to the pain. To reduce the pain:

• give your hands a slightly elevated position - this reduces swelling;
• Take any medication from the group of non-steroidal anti-inflammatory drugs (NSAIDs) - Diclofenac, Nimesulide, Indomethacin, Ibuprofen; reduces pain and inflammation;
• Any external agent from the NSAID group - apply to the skin on a diseased joint - a gel or ointment; Diclofenac emulgel helps a lot;
• see a doctor or seek it at home.

It is not possible to postpone a visit to the doctor with an exacerbation, it is urgent to suppress the development of the disease. It is impossible to do it alone.

How arthritis of the fingers persists in various clinical forms of the disease

The symptoms and course of hand arthritis depend on the disease that causes it. Defeat of the small joints of the hands is most common in rheumatoid, psoriatic and gouty arthritis. However, it can also occur in other forms of clinical arthritis.

Rheumatoid arthritis

In most cases, arthritis starts slowly without being felt. There is a sharp pain in the fingers. The nature of the pain is persistent, painful, tiring. In the morning, after sleep, stiffness of movements that can last 30 minutes or more is seen.

After a while, the patient sees that the fingers begin to swell in the joints. Often, the metacarpophalangeal and superficial phalangeal joints of the 2nd and 3rd fingers are affected. Defeat is symmetrical in both arms. Pain of varying intensity is permanent. Over time, characteristic deformations of fusiform fingers appear.

Small, painless subcutaneous rheumatoid nodules appear on the skin of the fingers and elbows. The course of the disease progresses slowly, steadily, and is accompanied by constant 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 the already existing skin manifestations of psoriasis. However, sometimes articular symptoms appear before or at the same time as skin symptoms. The disease often begins with the appearance of redness, swelling and pain in the little finger joints, acutely or subacutely. The lesion is generally asymmetrical, the fingers resemble sausages.

The disease continues with acute exacerbations and remissions. Nail plates are almost always involved in the pathological process. Over time, the fingertips become deformed, thickened, the nails become thinner and more deformed, and a symptom of highness appears - dotted indentations in the nail plates.

With a long course of the disease develops dislocation and subluxation of small distal joints, as well as lysis (melting) of the bones of the fingertips and shortening of the fingers.

Gouty arthritis

The attack of gout begins sharply, with severe pain, swelling and redness in the affected joint area. Small joints are often involved. Inflammation usually begins with the metacarpophalangeal joint of the first 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 a few hours to a few weeks, and then everything disappears. However, with frequent attacks of damage to the same joints, their functions are impaired.

Traumatic post-arthritis

This type of arthritis of the fingers can develop against the background of an acute home, industrial or sports injury, can continue acutely with subsequent full treatment, or (without proper help) can 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 results in a persistent small imperceptible injury to the fingers. This often happens to certain professionals who do small jobs. Arthritis develops slowly, affecting the joints that are most traumatized during work. If you do not change jobs, persistent deformation develops with the dysfunction of your fingers.

Other types of arthritis

Types of arthritis, such as reactive, infectious, idiopathic lesions of the small joints of the fingers, are practically uncommon.

Diagnostics

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

• laboratory tests - detect the presence of an inflammatory process, the presence 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 articular cavity is a sign of an active inflammatory process;
• MRI - changes in the soft articular and periarticular tissues.

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

Treatment of finger arthritis

After the final diagnosis, arthritis of the fingers is prescribed by a rheumatologist (sometimes with other specialists - a surgeon, dermatovenerologist). It should be comprehensive, aimed at suppressing the progression of the pathological process and preventing joint dysfunction. Complex treatment includes:

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

Drug treatment

The first task of drug treatment is to reduce the condition of a sick person. For this purpose, NSAIDs are prescribed to relieve pain, inflammation and tissue swelling. Depending on the degree of activity of the inflammatory process, these drugs are prescribed for oral administration in the form of injections (injections) or tablets. 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 gastrointestinal tract, so it can not be taken for a long time. Diclofenac is replaced by more modern drugs of the NSAID group - Nimesulide, Celecoxib, etc. Such substances are used externally, Diclofenac ointment. The use of NSAIDs can bring significant relief to the patient.

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

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

Chondroprotectors are prescribed to restore the function of the joints - drugs that restore the cartilage tissue of the joints. They are also assigned for long courses.

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

Vitamins and minerals are prescribed as boosters, which improve metabolism and help restore the body's overall balance.

Physiotherapy procedures

Complex treatment of finger arthritis necessarily includes physiotherapy procedures. Like drugs, they are selected individually depending on the clinical form and activity of the pathological process. These include hydrocortisone, UHF, laser or magnetotherapy, and more. can be electrophoresis with.

Massage and exercise therapy

Courses of massage and therapeutic gymnastics are prescribed during the period when the inflammatory process is reduced. They help to improve blood circulation and metabolism in the tissues, restore the function of small joints. You can do the following physical exercises to improve mobility at home:

• Roll a small elastic ball on the table surface for one minute with the finger surfaces, actively involving the affected finger joints;
• touch the pad of the 1st finger of the opposite hand with the fingertips of one hand; start with your little finger and end with the index; 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 it on the table (like piano keys);
• Repeat three times.

Such exercises should be performed daily, gradually increasing the number of approaches.

Folk remedies

The doctor should tell you how to treat arthritis of the fingers with folk remedies. He also chooses the most suitable technique. You can use both herbal solutions, infusions and foreign substances for oral administration:

• A kefir compress mixed with crushed chalk in the ratio of 50 g of chalk per 75 - 100 ml of kefir; you should take a thick mixture that should be applied once a day at night; for this purpose it should be applied to a painful napkin made of cotton material, the surface - polyethylene and insulation; therefore leave overnight; perfectly eliminates swelling and pain;
• infusion of celery roots; Put 20 g of crushed raw materials (dry or fresh) in a thermos overnight, pour 200 ml of boiling water; drink 3-4 doses the next day before meals; the course of treatment is 2 weeks; Eliminates pain and swelling well.

Surgery

This treatment is rarely used in arthritis of the small joints. With arthritis, which is not treated conservatively, sinovectomy is sometimes performed - a part of the synovial membrane that produces large amounts of exudate is removed.

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

This article is an existing strategy for the treatment of rheumatoid arthritis.

Clinical approach to finger arthritis

In our clinic, the patient is carefully examined using the latest laboratory and instrumental methods, including MRI, and then a separate treatment is prescribed for each patient.

One of the features of treatment in our clinic is that the complex therapy consists of the following.

• modern Western treatments to eliminate the main manifestations of finger arthritis;
• traditional methods of treatment of diseases that allow to restore balance in the body, to establish connections of all organs and systems; This leads to the elimination of inflammation, swelling and pain in the joints, and stifling the development of the disease.

The combination of Western and Eastern techniques allows our patients to quickly and painlessly relieve pain and then effectively restore the function of damaged joints. The specialists of the clinic have extensive experience in the treatment of arthritis of the fingers. You can find more information about treatment methods in our clinic on our website.

General clinical guidelines

Recommended for patients with arthritis of the fingers:

• to lead a healthy lifestyle, temperament; timely healing, elimination of all sources of infection that may be a cause of the development of arthritis;
• get rid of bad habits; regulate proper eating, sleep and wakefulness;
• in case of exacerbation of arthritis, do not load your fingers, do household chores, including washing dishes;
• do physical exercises for the hands during remission at home; classes should be held daily;
• Abstain from self-medication completely and follow your doctor's advice 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). The following recommendations should be followed to protect your health:

• you can't burden your hands with heavy physical or long-term strenuous work, including at home;
• hypothermia should be avoided, hands should be avoided;
• lead a healthy lifestyle, eat right, be discreet;
• to engage in possible sports, to train every day;
• Avoid long-term stress.

Diet

Special nutrition is required only in gouty arthritis of the fingers. The diet of such patients should not contain strong broths, offal, meat of young animals, alcohol, sorrel, salads, strong tea, coffee, chocolate.

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

Finger arthritis often develops unnoticed. It is very important to pay attention to the painful pains in your fingers in time and consult a doctor in time. But even if you miss the time and have obvious signs of arthritis, do not despair: you can help at any stage. It is difficult to completely cure a chronic disease, but it is quite possible to stop its development, relieve pain and improve your quality of life.