Arthritis of the fingers

Inflammation of the small joints most often does not develop on its own, but against the background of some common 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, to determine the cause of the disease and to start treatment to avoid serious complications and injuries. 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 worse off 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. Arthritis code of fingers of unspecified origin according to 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 then the course in most cases becomes prolonged or chronic. An exception is post-traumatic arthritis of the fingers: with proper treatment, it ends in complete recovery. But 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 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 type of infection. After that, after some time, genetically predisposed individuals 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 joints of the fingertips (distal) are mainly affected, with a simultaneous characteristic lesion of the nails. This usually occurs against the background of existing cutaneous 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 metabolism of uric acid salts is disturbed, they are deposited in the joint and periarticular tissues, causing an inflammatory process.

Post-traumatic arthritis of the finger joints is sometimes occupational in nature. It develops with constant minor injuries to the hands of jewelers, seamstresses, hairdressers and others. The inflammatory process is constantly supported by additional trauma and becomes chronic. After acute (sports, home) 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 hands are hormonal changes (adolescence, pregnancy, menopause), stress, frequent colds and allergic diseases, bad habits and professional activities.

Symptoms of arthritis of the fingers

The 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 is pain in the hands and stiffness in the morning. Initially, such a symptom lasts an average of no more than half an hour and then passes. The pain is painful, constant, their intensity increases slowly.

Less often, the onset is acute. Pain occurs 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 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. If the process develops subacutely or chronically, there may be no general manifestations, the changes in the affected joints are also not very pronounced.

The most important thing to do when arthritis symptoms 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 chronic arthritis of the hands include the appearance of swelling 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 may be accompanied by a slight increase in body temperature, increased pain and dysfunction of the affected joints. But more often exacerbations of rheumatoid occur without common manifestations.

After some time, the inflammatory process may to some extent reduce its intensity, local inflammation and general symptoms decrease. Then the process becomes chronic. Morning stiffness of the movements appears, the patients notice 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 decreases or even disappears. The appearance of crepitus (rubbing and clicking) in the affected joint 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 (with psoriatic arthritis). Arthritis of the thumb most often develops with gout, occurs with severe pain, swelling, redness, then disappears without a trace, but with frequent recurrences develop deformity and loss of joint function.

Dangerous symptoms

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

• high body temperature (38 - 39 °) for 5 or more days;
• a sharp rise in temperature, increased inflammation and pain in the joint with a pre-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 occur, you should consult a doctor immediately.

What is the danger of the disease

The main danger of any type of chronic arthritis is the progression of the inflammatory process, which eventually becomes degenerative-dystrophic with deformity of the limbs and damage. 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 found during the instrumental examination:

1. Initial phase.In the presence of severe or insignificant clinical signs of 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 the presence of increased volume of joint fluid. Symptoms may be severe or almost absent in the chronic course of the disease.
2. Progressive inflammation.Signs of inflammation are clearly visible on X-rays and ultrasound. The composite cartilage is destroyed, in their place is formed loose connective tissue - panus. The process takes a wavy (exacerbation-remission) or constantly progressive course. Pain and stiffness increase.
3. Connective tissue ankylosis.The connective tissue of the pancreas becomes rough, it grows and connects the articular bone surfaces, as a result of which the movement in the joint is limited. The fingers are deformed.
4. Bone ankylosis.Instead of connective tissue in the joint grows bone tissue, 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:

• the development of a purulent inflammatory process with a transition to the tissues surrounding the joint, the development of abscesses, phlegmons and sepsis;
• finger necrosis, shortening and inflammation of soft tissues;
• subluxation and dislocation of small joints;
• different types of joint deformities;
• complete loss of function of the fingers and hands.

What to do with exacerbation

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

• give your hands a slightly raised 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 above the diseased joint some external agent from the group of NSAIDs - gel or ointment; Diclofenac emulgel helps a lot;
• visit a doctor or call him at home.

In case of exacerbation it is impossible to postpone a visit to the doctor, it is urgent to suppress the progression of the disease. It is impossible to do this alone.

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

The symptoms of arthritis of the hands and the nature of its course depend on the disease that led to its development. Lesions of the small joints of the hands are most commonly 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 is pain in the fingers. The nature of the pain is constant, painful, exhausting. In the morning after sleep, stiffness of movements appears, which can last up to 30 minutes or more.

After some time, the patient notices that the fingers have begun to swell in the joints. The metacarpophalangeal and overlapping interphalangeal joints of the 2nd and 3rd fingers are most commonly affected. The defeat is symmetrical on both hands. The pain of varying intensity is constant. Over time, characteristic deformations of the spindle-shaped 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 excruciating pain, deformity and loss of joint function.

Psoriatic arthritis

In this disease, arthritis develops in the distal (terminal) interphalangeal joints of the fingers against the background of pre-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 finger. The lesion is usually asymmetrical, while the fingers resemble sausages.

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

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

Gouty arthritis

The onset of gout begins acutely, with the appearance of severe pain, swelling and redness in the affected joints. Small joints are often involved. Inflammation usually begins in 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 strong, the attack can last from several hours to several weeks and then everything disappears. But in 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 acute domestic, industrial or sports trauma, continue 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 become chronic, followed by deformation of the affected joints.

Initially, the chronic course of post-traumatic arthritis of the fingers assumes a permanent slight imperceptible injury to the fingers. This most often happens to people from certain professions who do small jobs. Arthritis develops slowly, the most injured joints are affected during work. If you do not change jobs, a permanent deformity with finger dysfunction develops.

Other types of arthritis

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

Diagnosis

The diagnosis is established on the basis of the characteristic symptoms of the disease and is confirmed by the data from the study:

• 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 joint cavity is a sign of an active inflammatory process;
• MRI - changes in the soft joint and periarticular tissues.

Without additional testing methods, it is impossible to establish the correct diagnosis (and therefore prescribe adequate treatment). Therefore, if you experience pain in the small joints of the 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, which is performed by a rheumatologist (sometimes together with other specialists - surgeon, dermatovenereologist). It should be comprehensive, aimed at suppressing the progression of the pathological process and preventing disorders of joint 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 purpose, drugs from the group of NSAIDs are prescribed, which relieve pain, inflammation and swelling of the 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, 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 and others. Such funds 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 with drugs from the group of NSAIDs. In this case, glucocorticoid hormones are used - Prednisolone, Dexamethasone and others. In the form of injections, inside tablets or externally in the form of ointments. Intra-articular injection of hormones into small joints is rarely practiced.

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

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

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

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

Physiotherapeutic procedures

The complex treatment of arthritis of the fingers necessarily includes physiotherapeutic 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 magnetic therapy and more.

Massage and exercise therapy

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

• roll a small elastic ball on the surface of the table with finger surfaces for a minute, 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 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 piano keys);
• repeat three times.

The implementation of 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 tell the doctor. He also chooses the most appropriate technique. You can use both herbal decoctions and infusions for oral administration and external agents:

• kefir compress mixed with crushed chalk in the amount of 50 g of chalk per 75 - 100 ml of kefir; you should get a thick mixture that should be applied once a day at night; for this it should be applied on a napkin made of cotton material, applied to the sore spot, on top - polyethylene and insulation; so leave 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 3-4 doses before meals; the course of treatment is 2 weeks; relieves pain and swelling well.

Surgery

This type of treatment for small arthritis is rarely used. In severe, non-conservative treatment of arthritis, a synovectomy is sometimes performed - 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 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 then treatment is prescribed, which is selected individually for each patient.

A 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 Eastern methods of treating diseases, allowing to restore the balance in the body, to establish the connection of all organs and systems; this eliminates inflammation, swelling and pain in the joints and suppresses the progression of the disease.

The combination of western and eastern techniques allows us to quickly and painlessly relieve our patients of 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 learn more about the methods of treatment in our clinic on our website.

General clinical guidelines

Patients with arthritis of the fingers are recommended:

• lead a healthy lifestyle, temperament; heal in time, remove all foci of infection, which can become a trigger in the development of exacerbations of arthritis;
• get rid of bad habits; to eat properly, to regulate sleep and wakefulness;
• in case of exacerbation of arthritis, do not strain your fingers, do not do housework, including washing dishes;
• during remission at home, do arm exercises; classes should be held daily;
• completely give up self-medication and follow the doctor's recommendations in everything.

Prevention of arthritis of the fingers

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

• you cannot strain your hands with heavy physical or long-term hard work, including at home;
• hypothermia should be avoided, hands should be avoided;
• lead a healthy lifestyle, eat right, temper;
• to play sports, to train every day;
• 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 from young animals, alcohol, sorrel, salad, strong tea, coffee, chocolate.

In other cases, it is enough to adhere to the principles of healthy eating: eat lean meat and dairy products, fish (oily sea fish is useful), cereals, cereals, vegetables, fruits. Avoid high-calorie foods, pastries, muffins, hot spices, fried, smoked foods. Eating should be regular.

Arthritis of the fingers often develops unnoticed. It is very important to pay attention to the pain in the fingers in time and to consult a doctor in a timely manner. But even if you miss the time and there are obvious 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 your pain and improve your quality of life.