Arthritis of the fingers

Inflammation of the small joints usually does not develop on its own, but in 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 another disease. It is very important to seek medical help in a timely manner, identify the cause of the disease and start 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 metacarpophalangeal and interphalangeal joints of the fingers. The disease occurs quite often, at any age. According to statistics, women are more sick with them after 40 years. This is explained by the fact that women have a higher load on their hands and fingers than men. Marking of arthritis of the fingers of unspecified origin according to ICD-10 M13.

Depending on the cause that caused it, the disease can occur only on the small finger joints, 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 long-lasting or chronic. The exception is post-traumatic arthritis of the fingers: with proper treatment, it ends in complete recovery. But if treatment is not prescribed on time, a chronic course is also required.

Causes of the inflammatory process in the finger joints

The causes of the disease can be different. Small finger joints are most commonly affected by rheumatoid arthritis - autoimmune (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 kind of infection. After that, after a while, genetically predisposed people develop arthritis of the fingers. Other, larger joints may be affected in the future.

Another common cause of inflammation of the small joints of the hands is psoriatic arthritis. It is also an autoimmune inherited disease, in which the fingertip joints (distal) are mainly affected, with a characteristic nail lesion at the same time. This usually occurs against the background of existing cutaneous manifestations of psoriasis, but sometimes the symptoms of arthritis in the finger joints appear first.

Arthritis of the finger joints often 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 causes an inflammatory process.

Post-traumatic arthritis of the finger joints 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 aided by additional traumas and becomes chronic. After acute (sports, domestic) injuries, acute arthritis can develop, which then completely disappears.

Other types of arthritis rarely cause damage to small joints. Provoking factors that contribute to the development of arthritis of the small joints of the hand 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, depending 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. Pain in the hands and stiffness of movement in the morning are painful. At first such a symptom lasts on average no more than half an hour and then passes. The pains are painful, constant, their intensity is slowly increasing.

Rarely, the onset is acute. The pain appears in one or more joints of the little fingers, followed by redness and swelling of the surrounding tissue. The function of the joint is impaired: it is difficult to bend and bend, sometimes it is impossible to do that due to pain.

With the acute onset of the disease, the general condition of the patient often suffers: fever, malaise, and headache occur. If the process develops subacutely or chronically, there may be no general manifestations, the changes in the affected joints may also not be too pronounced.

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

Obvious symptoms

Obvious signs of arthritis of the hand in the chronic course include the appearance of edema and redness of the tissue 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 may be accompanied by a slight rise in body temperature, increased pain and dysfunction of the affected joints. But more often, rheumatoid exacerbations occur without general manifestations.

After some time, the inflammatory process may reduce its intensity somewhat, local inflammation and general symptoms decrease. After that, the process becomes chronic. Morning stiffness of movement appears, patients notice a feeling of tight gloves on the arm that do not allow movement. Some time after getting up in the morning and starting physical activity, this feeling diminishes or even disappears. The appearance of crepitus (friction and clicking) in the affected joints is also characteristic.

When the patient is not treated for arthritis, there is a change in exacerbations and remissions with constant pain and rapid formation of joint deformities (in rheumatoid arthritis) or melting of the fingertips and their shortening (in psoriatic arthritis). Arthritis of the thumb most often develops with gout, passes with severe pain, swelling, redness, then disappears without a trace, but with frequent recurrences, deformities and loss of joint function also develop.

Dangerous symptoms

Emergency medical care is needed for the following symptoms of finger arthritis:

• high body temperature (38 - 39 °) 5 or more days;
• a sudden rise in temperature, increased inflammation and pain in the joint with a pre-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 on the fingertips (necrosis) in psoriatic arthritis.

If such symptoms occur, consult a doctor immediately.

What is the danger of 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 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 serious or minor clinical signs of inflammation on X-ray, you can see signs of inflammation in the form of expansion of the joint space. You can see the presence of an increased volume of joint fluid on the ultrasound. Symptoms may be severe or almost absent in the chronic course of the disease.
2. Progressive inflammation.On X-ray and ultrasound, the signs of inflammation are clearly visible. The articular cartilage is destroyed, in their place a loose connective tissue is formed - the panus. The process takes on a wavy (worsening-remission) or constantly progressive course. Pain and stiffness increase.
3. Connective tissue ankylosis.The connective tissue of the panus becomes rough, grows and connects the bone surfaces that form the joints, as a result of which movement in the joint is limited. The fingers are deformed.
4. Bone ankylosis.Instead of connective tissue in the joint, bone tissue grows, 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 purulent inflammatory process with transition to the tissues surrounding the joint, 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 finger and hand function.

What to do with the deterioration

With the worsening of arthritis, the joints become sharply painful, the skin above them becomes red, swollen, and finger movements become impossible due to pain. To reduce suffering, you must:

• give your hands a slightly elevated position - this will reduce swelling;
• take any drug from the group of nonsteroidal anti-inflammatory drugs (NSAIDs) - Diclofenac, Nimesulide, Indomethacin, Ibuprofen; will reduce pain and inflammation;
• apply to the skin over the diseased joint any external agent from the group of NSAIDs - gel or ointment; Diclofenac emulgel helps a lot;
• visit a doctor or call him at home.

With 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 it on your own.

As arthritis of the fingers passes 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 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 starts slowly, imperceptibly. Pains in the fingers are painful. The nature of pain is constant, painful, exhausting. In the morning after sleeping, stiffness of movement appears, which can last for 30 minutes or more.

After a while, the patient notices that the fingers have started to swell in the joints. The metacarpophalangeal and overlapping interphalangeal joints of the 2nd and 3rd fingers are most commonly affected. Defeat is symmetrical on both hands. Pains of varying intensity are permanent. Over time, characteristic deformities 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, constantly progressing, accompanied by constant debilitating pain, deformation and loss of joint function.

Psoriatic arthritis

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

The disease passes with severe exacerbations and remissions. Nail plates are almost always involved in the pathological process. Over time, the tips of the fingers become deformed, they thicken, the nails become thinner and also deform, a symptom of the thimble appears - dotted depressions on the nail plates.

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

Gouty 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 1st finger and can then spread to the metacarpophalangeal and interphalangeal joints of the 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 weakened.

Posttraumatic arthritis

This type of arthritis of the fingers can develop in the background of an acute domestic, industrial or sports injury, continue acutely with subsequent complete cure 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 one, followed by deformation of the affected joints.

Initially, the chronic course of posttraumatic arthritis of the fingers on the hands takes on a permanent minor imperceptible injury to the fingers. This most often happens to people of certain professions who do small jobs. Arthritis develops slowly, the joints that are most traumatized during work are affected. If you do not change jobs, permanent deformities with finger dysfunction occur.

Other types of arthritis

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

Diagnosis

The diagnosis is determined 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 or absence of infection, antibodies to infectious agents, rheumatoid factor;
• radiography - detects changes in the bones 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 soft joint and periarticular tissues.

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

Treatment of arthritis of the fingers

After establishing the final diagnosis, treatment of arthritis of the fingers is prescribed by a rheumatologist (sometimes together with other specialists - a surgeon, a dermatovenerologist). It should be comprehensive, aimed at suppressing the progression of the pathological process and preventing the violation of joint 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, NSAIDs are prescribed to 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 from 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 NSAIDs can bring significant relief to the patient.

Sometimes the inflammatory process is so pronounced that it is impossible to remove it with drugs from the NSAID group. In this case, glucocorticoid hormones are used - prednisolone, dexamethasone, etc. In the form of injections, inside tablets or outside in the form of ointment. Intra-articular injection of hormones into small joints is rarely practiced.

Drugs of the basic group - methotrexate, sulfalazine, leflunomide and biological agents (rituximab) are prescribed to suppress autoimmune processes. These drugs are selected by a rheumatologist and prescribed according to a special scheme for long courses.

In order 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 to restore tissue trophism.

As tonics, 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 finger necessarily involves 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 and remedial gymnastics courses are prescribed during the period when the inflammatory process subsides. They help improve blood circulation and metabolism in the tissues, and 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 for a minute with the surfaces of the fingers, actively involving the affected finger joints in the process;
• with the fingertips 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;
• place your hands so that your fingertips are slightly bent and touch the surface of the table; bend each finger in turn and tap it on the table (like a piano key);
• repeat three times.

Performing such exercises should be done 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 appropriate technique. You can use herbal decoctions and infusions for oral use, as well as external means:

• kefir dressing mixed with crushed chalk in the amount 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 on a napkin made of cotton material, applied to the sore spot, from above - polyethylene and insulation; so leave overnight; perfectly relieves swelling and pain;
• celery root infusion; Put 20 g of crushed raw materials (dry or fresh) in a thermos overnight, pour 200 ml of boiling water; the next day drink 3-4 doses before meals; the course is 2 weeks; well relieves pain and swelling.

Surgery

This type of treatment for small arthritis is rarely used. With pronounced, which is not subject to conservative treatment, arthritis is sometimes performed synovectomy - removal of the part of the synovial membrane that creates a large amount of exudate.

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

The current strategy for treating rheumatoid arthritis in this article.

Clinical approach to arthritis of the fingers

In our clinic, the patient is carefully examined using the latest laboratory and instrumental methods, including MRI, and only after that is the treatment prescribed, which is individually selected for each patient.

The characteristic 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, which enable the establishment of balance in the body, the establishment of relations between all organs and systems; this leads to the elimination of inflammation, swelling and pain in the joints and suppressing the progression of the disease.

The combination of Western and Eastern techniques enables quick and painless relief of our patients from pain, and then efficient restoration of the function of damaged joints. The specialists of the clinic have extensive experience in the treatment of arthritis of the fingers. You can find out about the treatment methods in our clinic on our website.

General clinical guidelines

Patients with arthritis of the fingers are advised to:

• lead a healthy lifestyle, temperament; heal in time, remove all foci of infection, which can become a trigger in the development of worsening arthritis;
• get rid of bad habits, eat right, regulate sleep and wakefulness;
• in case of worsening arthritis, do not strain your fingers, do not do household chores, including washing dishes;
• during remission at home do physical exercises for the arms; classes should be held daily;
• completely abandon self-medication and adhere to medical recommendations in everything.

Prevention of arthritis of the fingers

Arthritis prevention is especially important for people who have a genetic predisposition to this disease (close relatives with this pathology). To maintain health, the following recommendations must be followed:

• you cannot burden your hands with heavy physical or long-term hard work, including at home;
• hypothermia, hands must be avoided;
• lead a healthy lifestyle, eat right, temperament;
• engage in feasible sports, train every day;
• avoid prolonged stress.

Diet

A special diet is needed only for gouty arthritis of the fingers. The diet of such patients should not contain strong soups, 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.

Finger arthritis often develops unnoticed. It is very important to pay attention to painful pain 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.