Arthritis of the fingers

Inflammation of small joints most often does not develop on its own, but against the background 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 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

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

Depending on the cause that caused it, the disease can occur only in the small joints of the fingers, and it 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 protracted or chronic. The exception is post-traumatic arthritis of the fingers: with proper treatment, it ends in full recovery. But if the treatment was not prescribed on time, it 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, the small joints of the fingers are affected in rheumatoid arthritis - an autoimmune (with an allergy to the patient's own tissues) disease, which is based on a hereditary predisposition. The starting point for the onset of the disease is usually some kind of infection. After it, 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 an autoimmune hereditary disorder in which the joints of the fingertips (distal) are mainly affected, with a simultaneous 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.

Quite often, arthritis of the joints of the fingers 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 joints of the fingers is sometimes of a professional nature. It develops with a constant minor injury to the hands of jewelers, seamstresses, hairdressers, etc. The inflammatory process is constantly supported by additional trauma and becomes chronic. After acute (sports, domestic) injuries, 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 finger arthritis

Symptoms can be different, they depend on the nature of the course of the inflammatory process (acute, subacute, chronic), as well as on 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 passes. The pains are aching, 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. The function of the joint is impaired: it is difficult to bend and unbend, sometimes it is impossible to do this because of the 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 subacutely or chronically, there may be no general manifestations, changes in the affected joints may also be not very pronounced.

The most important thing to do when symptoms of arthritis appear is to seek medical attention. The sooner this happens, the more likely it is to stop the inflammatory process at the very beginning.

Obvious symptoms

The obvious signs of hand arthritis in 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 on the other hand. The appearance of new foci of inflammation can be accompanied by a slight rise in body temperature, increased pain and dysfunction of the affected joints. But more often exacerbations of rheumatoid occur without general manifestations.

After a while, the inflammatory process can somewhat reduce its intensity, local inflammation and general symptoms decrease. 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 the beginning of physical activity, this sensation decreases or even disappears. The appearance of crepitus (friction and clicks) in the affected articular joints is also characteristic.

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

Dangerous symptoms

Emergency 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 pain in the joint with an already 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 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 in the progression of the inflammatory process, which eventually turns into degenerative-dystrophic with limb deformity and disability. The longer 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. Initial stage.In the presence of severe or minor clinical signs of inflammation on the x-ray, you can see signs of inflammation in the form of an expansion of the joint space. On ultrasound, you can see the presence of an increased 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 their place a loose connective tissue is formed - pannus. The process takes on a wavy (exacerbation-remission) or constantly progressive course. Pain and stiffness increase.
3. Connective tissue ankylosis.The connective tissue of pannus becomes rough, it grows and connects the joint-forming bone surfaces, as a result of which movement in the joint 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 the loss of its function.

Possible complications

If left untreated, arthritis in 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, shortening and soft tissue 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 sharply painful, the skin above them reddens, swells, movements in 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 medicine 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 is excellent;
• 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 arthritis of the fingers of the hands proceeds in different clinical forms of the disease

The symptoms of hand arthritis and the nature of its course depend on the disease that led to 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, imperceptibly. There are aching pains 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 in the joints. Most often, the metacarpophalangeal and overlying interphalangeal joints of the 2nd and 3rd fingers are affected. The defeat is symmetrical on 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 articular function.

Psoriatic arthritis

In this disease, arthritis develops in the distal (terminal) interphalangeal finger joints against the background of already existing skin manifestations of psoriasis. But sometimes articular 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 small finger joints. The lesion is usually asymmetric, while the fingers resemble sausages.

The disease proceeds 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, 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.

Gouty arthritis

A gout attack begins acutely, with the appearance of severe pain, swelling and redness in the area of the affected joints. Small joints are often involved. Usually, the inflammation begins in the metacarpophalangeal joint of the 1st finger, and then 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, their function is impaired.

Post-traumatic arthritis

This type of arthritis of the fingers can develop against the background of an acute household, industrial or sports injury, proceed acutely with 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 turn into a chronic one, followed by deformation of the affected joints.

Initially, the chronic course of post-traumatic arthritis of the fingers of the hands takes on a constant minor imperceptible injury to the fingers. Most often this occurs in persons of certain professions who perform small jobs. Arthritis develops slowly, the joints most traumatized during work are affected. If you do not change jobs, persistent deformation develops with dysfunction 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.

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;
• radiography - reveals 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 soft articular and periarticular tissues.

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

Finger Arthritis Treatment

After establishing the final diagnosis, treatment of arthritis of the fingers is prescribed, which is carried out by a rheumatologist (sometimes in conjunction with other specialists - a surgeon, dermatovenerologist). It should be comprehensive, aimed at suppressing the progression of the pathological process and preventing violations of articular function. The 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 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, 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 cannot 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 group can bring significant relief to the patient.

Sometimes the inflammatory process is so pronounced that it is impossible to remove 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 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 cartilaginous tissue of the joints. They are also prescribed for long courses.

Means that improve blood circulation and metabolism in tissues - Pentoxifylline and others help restore tissue trophism.

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

Physiotherapy procedures

The complex treatment of arthritis of the fingers necessarily includes physiotherapy. 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

Courses of massage and remedial gymnastics are prescribed during the period when the inflammatory process subsides. They help to 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 finger surfaces for a minute, actively involving the affected finger joints in the process;
• with the tips of the fingers of one hand, touch the pad of the 1st finger of the opposite hand; start with the little finger and end with the index; repeat the exercise 10 times;
• set your hands so that the fingertips are slightly bent and touch the table surface; 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 told by the doctor. He also selects the most suitable technique. You can use both 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 get a thick mixture, which must be applied once a day at night; for this, it must 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; Place 20 g of crushed raw materials (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 arthritis of the small joints is rarely used. With pronounced, not amenable to 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 joint is replaced with an artificial one, but this is a rather rare operation.

The current strategy for the treatment of 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 individually selected 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 arthritis of the fingers;
• traditional oriental methods of treating diseases, allowing to restore balance in the body, to establish the relationship of all organs and systems; this leads to the elimination of inflammation, swelling and pain in the joints and suppression of the progression of the disease.

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

General clinical guidelines

Patients with finger arthritis are advised to:

• lead a healthy lifestyle, temper; heal on 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 fingers, do not do housework, including washing dishes;
• during remission 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). In order to maintain health, they need to adhere to the following recommendations:

• you cannot load your hands with heavy physical or long-term painstaking work, including at home;
• hypothermia must be avoided, hands should be avoided;
• lead a healthy lifestyle, eat right, temper;
• to do feasible sports, to train daily;
• avoid prolonged stress.

Diet

Special nutrition is required only for gouty arthritis of the fingers. The diet of such patients should not contain strong broths, offal, meat of 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, smoked foods. Meals should be regular.

Arthritis of the fingers often develops imperceptibly. It is very important to pay attention to aching pains in the fingers in time and consult a doctor in a timely manner. But even if you missed the 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.