Arthritis of the fingers

Inflammation of small joints most often develops not on its own, but against the background of a general disease. Arthritis of the fingers is a hallmark symptom of rheumatoid arthritis, but it can also be one of the manifestations of another disease. It is very important to see a doctor quickly, identify the cause of the disease and start 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

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 suffer from it more after 40 years. This is because, compared to men, women have a greater load on their hands and fingers. Code of arthritis of the fingers of undetermined origin according to ICD-10 M13.

Depending on the cause that caused it, the disease can only occur in the small joints of the fingers and may be associated with damage to the large joints. The onset of the disease can be acute, subacute and chronic, but in most cases the course becomes prolonged or chronic. The exception is post-traumatic arthritis of the fingers: with proper treatment, it ends in complete 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. Most 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 of the onset of the disease is usually some kind of infection. After that, after some time, genetically predisposed individuals develop arthritis of the fingers. In the future, other larger joints could be affected.

Another common cause of inflammation of the small joints of the hands is psoriatic arthritis. It is also an inherited autoimmune disease, in which the joints of the fingertip (distal) are mainly affected, with a simultaneous characteristic lesion of the nails. Usually this 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 joint and periarticular tissues, causing an inflammatory process.

Post-traumatic arthritis of the joints of the fingers is sometimes occupational in nature. It develops with a constant minor injury at the hands of jewelers, seamstresses, hairdressers, etc. The inflammatory process is constantly supported by additional trauma and becomes chronic. After acute injuries (sports, household), acute arthritis may develop, which then goes away completely.

Other types of arthritis rarely cause damage to 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 work activities.

Symptoms of arthritis of the fingers

Symptoms may 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 movement in the morning. At first, such a symptom does not last on average for more than half an hour, then passes. The pains are painful, constant, their intensity increases slowly.

Less often, the onset is acute. Pain appears in one or more small joints of the fingers, accompanied by redness and swelling of surrounding tissue. The function of the joint is impaired: it is difficult to bend and unfold, sometimes it is impossible to do so 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 subacute or chronically, there may not be general manifestations, changes in the affected joints may also not be very pronounced.

The most important thing to do when symptoms of arthritis appear is to see a doctor. The earlier this happens, the more likely it is that the inflammatory process will stop at the very beginning.

Obvious symptoms

The obvious signs of arthritis of the hand during the 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 thepathological process on the one hand or another. 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 most 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 movements appears, patients note the feeling of tight gloves on the hand, which does not allow movement. Some time after getting up in the morning and starting to exercise, this sensation decreases or even disappears. The appearance of crepitations (rubbing and clicking) in the affected 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 fingers and their shortening (with psoriatic arthritis). Arthritis of the thumb most often develops with gout, manifests as severe pain, swelling, redness, and then goes away without a trace, but with frequent relapses, deformity and loss of joint function occurs. are also developing.

Dangerous symptoms

Emergency medical attention is needed for the following symptoms of arthritis of the fingers:

• elevated body temperature (38 - 39 °) for 5 days or more;
• a sharp increase in temperature, increased inflammation and pain in the joint with an already existing inflammatory process - may indicate the appearance 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 the progression of the inflammatory process, which eventually becomes degenerative-dystrophic with deformation of the limbs and disability. The longer the arthritis lasts, the greater 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.If there are severe or minor clinical signs of inflammation on the x-ray, you may 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 may be pronounced or almost absent during the chronic course of the disease.
2. Progressive inflammation. On x-rays and ultrasounds, signs of inflammation are clearly visible. Joint cartilage is destroyed, in their place loose connective tissue is formed - pannus. The process takes a wavy (exacerbation-remission) or constantly gradual course. Pain and stiffness increase.
3. Ankylosis of connective tissue.The connective tissue of the pannus becomes rough, it grows and connects the bony surfaces forming the joints, which limits the movement of the joint. 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 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;
• necrosis of the fingertips, shortening and inflammation of soft tissues;
• subluxation and dislocation of small joints;
• various types of joint deformities;
• complete loss of function of fingers and hands.

What to do with an exacerbation

With an exacerbation of arthritis, the joints become very painful, the skin above them reddens, swells, movements of the fingers become impossible due to the pain. To reduce suffering, you must:

• give your hands a slightly raised position - this will reduce swelling;
• are taking any drug from the group of nonsteroidal anti-inflammatory drugs (NSAIDs) - Diclofenac, Nimesulide, Indomethacin, Ibuprofen; it will reduce pain and inflammation;
• apply to the skin of the diseased joint any external agent from the group of NSAIDs - gel or ointment; Diclofenac emulgel helps a lot;
• see a doctor or call 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 does arthritis of the fingers of the hands develop 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. 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 starts slowly, imperceptibly. There are aching pains in the fingers. The nature of the pain is constant, painful, exhausting. In the morning after sleep, stiffness of movement appears, which can last up to 30 minutes or more.

After some time, the patient notices that the fingers have started to swell in the joints. Most often, the overlying metacarpophalangeal and interphalangeal joints of the 2nd and 3rd fingers are affected. The defeat is symmetrical on both arms. The pain of varying intensity is permanent. 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, progresses steadily, accompanied by constant debilitating 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 already existing skin manifestations of psoriasis. But sometimes joint symptoms appear before or at the same time as skin symptoms. In most cases, the disease begins acutely or subacutely with the appearance of redness, swelling and pain in the small joints of the fingers. The lesion is usually asymmetrical, while the fingers resemble sausages.

The disease progresses with severe exacerbations and remissions. Almost always nail plates are involved in the pathological process. Over time, deformation of the fingertips occurs, they thicken, the nails also become thinner and 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 (fusion) 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 starts with 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 intense, the attack can last from several hours to several weeks, 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 home, industrial or sports injury, proceed acutely with subsequent complete healing, or (in the absence of the necessary assistance) be complicated by theaddition of purulent infection. Sometimes such an inflammatory process can become chronic, followed by deformity of the affected joints.

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

Other types of arthritis

With such types of arthritis as reactive, infectious and idiopathic lesions of the small joints of the fingers, it is practically not found.

Diagnostic

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

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

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

Treatment of arthritis of the fingers

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

• drug therapy;
• physiotherapy procedures;
• therapeutic gymnastics and massage;
• reflexology course;
• folk remedies.

Drug therapy

The first task of drug therapy is to improve the condition of a sick person. For this, drugs of 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. 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 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 group of NSAIDs. In this case, glucocorticoid hormones are used - Prednisolone, Dexamethasone, etc. in the form of injections, inside tablets or outside in the form of ointments. Intra-articular injection of hormones into small joints is rarely done.

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 cures.

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 restore tissue trophism.

As fortifying agents, vitamins and minerals are prescribed which improve metabolism and help restore the general balance of 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. This can be electrophoresis with Hydrocortisone, UHF, laser or magnetotherapy, etc.

Massage and exercise therapy

Courses of massage and corrective gymnastics are prescribed during the period when the inflammatory process subsides. They help improve blood circulation and tissue metabolism, 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 surface of the table with the surfaces of the fingers 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 the fingertips are slightly bent and touch the surface of the table; 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 carried out 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 decoctions and herbal infusions for oral administration, as well as external agents:

• a compress of kefir mixed with crushed chalk at the rate of 50 g of chalk for 75 - 100 ml of kefir; you should get a thick mixture, which should be applied once a day at night; for this it should be applied to a cotton napkin, applied to a sore spot, on top - polyethylene and insulation; so leave it overnight; perfectly relieves swelling and pain;
• celeriac infusion; 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 to 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 a pronounced synovectomy, not suitable for conservative treatment, arthritis is sometimes performed - the removal of part of the synovial membrane that produces a large volume of exudate.

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

The current strategy for the treatment of 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, treatment is prescribed, which is selected individually for each patient.

A feature of the treatment in our clinic is that the complex therapy includes:

• modern Western treatment methods to eliminate the main manifestations of arthritis of the fingers;
• traditional Eastern 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 the suppression of the progression of the disease.

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

General clinical guidelines

Patients with arthritis of the fingers are advised to:

• to lead a healthy life, to temper, to cure in time, to eliminate all foci of infection, which can become a trigger for the development of exacerbations of arthritis;
• get rid of bad habits, eat well, regulate sleep and wakefulness;
• in case of exacerbation of arthritis, do not load the fingers, do not do housework, including washing dishes;
• during remission at home, do physical exercises for the hands; classes should take place daily;
• completely abandon self-medication and follow the doctor's recommendations in everything.

Prevention of arthritis of the fingers

Prevention of arthritis is particularly important for people with a genetic predisposition to this disease (close relatives with this condition). To stay healthy, they should adhere to the following recommendations:

• you cannot take on your hands heavy or arduous physical work for a long time, including at home;
• hypothermia should be avoided, hands should be avoided;
• lead a healthy life, eat well, temper;
• do doable sport, train every day;
• avoid prolonged stress.

Diet

Special nutrition is only required for gouty arthritis of the fingers. The diet of these 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 and smoked foods. Meals should be regular.

Arthritis of the fingers often develops unnoticed. It is very important to pay attention to painful pains in the fingers in time and to consult a doctor in a timely manner. But even if you ran out of time and there are obvious signs of arthritis, don't despair - you can help anytime. Curing a chronic disease completely is problematic, but it is quite possible to stop its progression, relieve your pain, and improve your quality of life.