Arthritis of the fingers

Inflammation of the small joints often does not develop on its own, but in the context of some general disease. 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 disease, and begin 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.

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 are sicker with them 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 what caused it, the disease can occur only 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, you end up with a full recovery. But if the treatment was not prescribed in time, it also follows a chronic course.

Causes of the inflammatory process in the joints of the fingers.

The causes of the disease can be different. Very often, 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 a hereditary 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 of the hands is psoriatic arthritis. It is also a hereditary autoimmune disease, in which the joints of the fingertips (distal) are mainly affected, with a characteristic simultaneous injury to the nails. This usually occurs against the background of the existing skin manifestations of psoriasis, but sometimes the symptoms of arthritis in the finger joints appear first.

Most 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, which provokes an inflammatory process.

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

Other types of arthritis rarely cause damage to the small joints. The provoking 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 of the fingers

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.

First signs

The onset of the disease is slow in most cases. There are aching pains 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 it passes. The pains are painful, constant, their intensity increases slowly.

Less often, the onset is acute. The pain appears in one or more joints of the little fingers, accompanied by redness and swelling of the surrounding tissue. The function of the joint is affected: it is difficult to bend and unfold, 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 develops subacute or chronic, then there may be no general manifestations, changes in the affected joints may also not be very pronounced.

The most important thing to do when arthritis symptoms appear is to seek medical attention. The sooner it happens, the more likely the inflammatory process will stop early on.

Obvious symptoms

Obvious signs of chronic ongoing 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 of 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 rheumatoid exacerbations occur without general manifestations.

After a while, the inflammatory process may reduce its intensity somewhat, local inflammation and general symptoms diminish. After that, the process becomes chronic. Morning stiffness of movements appears, patients note the feeling of tight gloves on the hand, which do not allow movement. Some time after getting up in the morning and starting physical activity, this feeling diminishes or even disappears. Crepitations (friction and clicking) in the affected joint joints are also characteristic.

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

Dangerous symptoms

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

• high body temperature (38 - 39 °) for 5 or more days;
• a sharp increase in temperature, increased inflammation and pain in the joint with an already existing inflammatory process, may indicate the onset of suppuration;
• participation in the pathological process of new small or large joints;
• the appearance of blackened tissue on 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 in the progression of the inflammatory process, which eventually becomes degenerative-dystrophic with deformity and disability of the limbs. 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:

1. Initial stage.In the presence of severe or mild clinical signs of inflammation on x-ray, you may see signs of inflammation in the form of expansion of the joint space. On ultrasound, you can see the presence of a larger volume of joint fluid. Symptoms can be pronounced or almost absent in the chronic course of the disease.
2. Progressive inflammation.On x-rays and ultrasound, signs of inflammation are clearly visible. Articular cartilage is destroyed, in its place a loose connective tissue is formed - pannus. The process acquires a wavy course (exacerbation-remission) or constantly progressive. Pain and stiffness increase.
3. Connective tissue ankylosis.The connective tissue of pannus becomes rough, grows and connects the bony surfaces that make up the joint, as a result of which the movement in the joint is limited. The fingers are deformed.
4. Bone ankylosis.Instead of connective tissue, bone tissue grows in the joint, resulting in complete immobility of the joint and loss of function.

Possible complications

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 the tissues surrounding the joint, the development of abscesses, phlegmon and sepsis;
• fingertip necrosis, soft tissue shortening and inflammation;
• subluxation and dislocation of small joints;
• various types of joint deformities;
• complete loss of function of the fingers and hands.

What to do with an exacerbation

With an exacerbation of arthritis, the joints become very painful, the skin over them becomes red, swollen, and movements of the fingers become impossible due to pain. To reduce suffering, you need:

• give your hands a slightly elevated position, this will reduce swelling;
• take any drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs): diclofenac, nimesulide, indomethacin, ibuprofen; it will reduce pain and inflammation;
• apply to the skin over the diseased joint any external agent from the NSAID group: 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 is impossible to do this on your own.

How finger arthritis progresses in different clinical forms of the disease.

Symptoms of arthritis of the hand and the nature of its course depend on the disease that provoked its development. The 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.

Rheumatoid arthritis

In most cases, arthritis begins slowly and unnoticeably. There are aching pains in the fingers. The nature of pain is constant, painful, exhausting. In the morning after sleeping, stiffness of movements appears, which can last up to 30 minutes or more.

After some time, the patient notices that the fingers begin to swell at the joints. Most often, the overlying metacarpophalangeal and interphalangeal joints of the second and third toes are affected. The defeat is symmetrical in both arms. Pain of varying intensity is permanent. Over time, characteristic spindle-shaped finger deformities appear.

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

Psoriasic arthritis

In this disease, arthritis develops in the distal (terminal) interphalangeal joints of the fingers against the background of existing skin manifestations of psoriasis. But sometimes joint symptoms appear before or simultaneously with skin symptoms. The disease in most cases begins acutely or subacute with the appearance of redness, swelling and pain in the joints of the little finger. The lesion is usually asymmetrical, while the fingers look like sausages.

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

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

Gout Arthritis

An attack of gout begins acutely, with the appearance of severe pain, swelling and redness in the area of the affected joints. Small joints are often affected. 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 several hours to several weeks, and then everything goes away. But 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 in the context of an acute domestic, industrial or sports injury, proceed acutely with a subsequent complete cure, or (in the absence of the necessary assistance) be complicated by the addition of a purulent infection. Sometimes such an inflammatory process can become chronic, followed by deformation of the affected joints.

Initially, the chronic course of post-traumatic arthritis of the fingers of the hands acquires a constant minor imperceptible injury to the fingers. In most cases, this occurs in people in certain professions who do small jobs. Arthritis develops slowly, the joints most traumatized during work are affected. If you do not change jobs, persistent deformity develops 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.

Diagnostics

The diagnosis is established on the basis of the characteristic symptoms of the disease and is confirmed by the 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 - reveals bone changes in the joints;
• Ultrasound - the presence of a larger volume of exudate in the joint cavity is a sign of an active inflammatory process;
• Magnetic resonance: changes in the articular and periarticular soft tissues.

Without additional methods of examination, 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 arthritis of the fingers

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

• drug therapy;
• physiotherapy procedures;
• therapeutic gymnastics and massages;
• reflexology courses;
• home remedies.

Drug therapy

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 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. Also, the 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 taken for a long time. Instead of diclofenac, more modern drugs from the group of NSAIDs are prescribed - nimesulide, celecoxib, etc. Such 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 eliminate it with drugs from 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 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 according to a special scheme 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 improve blood circulation and metabolism in tissues - pentoxifylline and others help to restore trophism of tissues.

As fortifying agents, vitamins and minerals are prescribed that improve metabolism and help to restore the general balance in the body.

Physiotherapy procedures

Complex treatment of arthritis of the fingers necessarily includes physiotherapy 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 exercise therapy

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

• roll a small elastic ball on the table surface with the surfaces of the fingers for one minute, actively engaging the joints of the affected fingers in the process;
• with the fingertips of one hand, touch the fingertip of the 1st finger of the opposite hand; start with the 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 hit the table with it (like the keys on a piano);
• repeat three times.

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

Home remedies

The doctor should tell you how to treat finger arthritis with home remedies. Also select the most appropriate technique. You can use both decoctions and herbal 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 need to get a thick mixture, which should be applied once a day in the evening; 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 materials (dry or fresh) in a thermos overnight, pour 200 ml of boiling water; the next day, drink 3 to 4 servings before meals; the course of treatment is 2 weeks; relieves pain and swelling well.

Surgery

This type of treatment for arthritis of the small joints is used infrequently. With pronounced treatment, not amenable to conservative treatment, arthritis is sometimes performed synovectomy - removal of a part of the synovium that produces a large volume of exudate.

In some cases, the joint 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 magnetic resonance imaging, and only after a treatment is prescribed, which is selected individually for each patient.

A characteristic of treatment in 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 treatment of diseases, which allow 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 the suppression of the progression of the disease.

The combination of Western and Eastern techniques makes it possible to quickly and painlessly relieve pain for our patients, and then effectively restore function to damaged joints. The specialists at the clinic have extensive experience in treating arthritis of the fingers. You can learn more about the treatment methods in our clinic on our website.

General clinical guidelines

Patients with arthritis in the fingers are advised to:

• lead a healthy lifestyle, temperament, heal in time, eliminate all foci of infection, which can become a trigger in the development of exacerbations of arthritis;
• get rid of bad habits, eat right, regulate sleep and wakefulness;
• in case of exacerbation of arthritis, do not load your fingers, do not do household chores, including washing dishes;
• during remission at home, do physical exercises for your hands; classes must be held every day;
• Give up self-medication entirely and adhere to the doctor's recommendations on everything.

Prevention of arthritis of the fingers

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

• you cannot load your hands with long-term heavy or laborious physical work, even at home;
• hypothermia should be avoided, hands should be avoided;
• lead a healthy lifestyle, eat well, have a temper;
• do feasible sports, train every day;
• Avoid prolonged stress.

Diet

Special nutrition is required only for gouty arthritis of the fingers. The diet of these patients should not contain strong broths, offal, meat from young animals, alcohol, sorrel, salad, 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), cereals, cereals, vegetables, fruits. Avoid high-calorie foods, sweets, muffins, hot spices, fried and smoked foods. Meals must be regular.

Arthritis of the fingers often goes unnoticed. It is very important to pay attention to finger pains in time and consult a doctor in a timely manner. But even if time is wasted and there are clear signs of arthritis, don't despair - it can help at any stage. It is problematic to completely cure a chronic disease, but it is very possible to stop its progression, relieve pain and improve your quality of life.