Arthritic changes affect the metacarpophalangeal and interphalangeal joints, and, most often, result from already existing diseases. In order not to lose the opportunity to work, do your favorite things and serve yourself in everyday life, you should begin the treatment of arthritis of the fingers at the onset of the first symptoms.
Signs of Arthritis of the Hands
Despite the fact that the inflammatory process in the joints of the fingers can be triggered by various reasons, there are always common signs that can be suspected of the presence of pathological changes:
- Pain in the joints. At first, the pain can be barely noticeable, it makes itself felt after a long inactivity (in the morning after sleep), during the performance of small painstaking or heavy physical actions. Gradually, with the increase of inflammation, the pain appears more and more often, it becomes stronger.
- Meteoric dependence of the joints - the reaction in the form of pain, aches before the change of weather, atmospheric pressure.
- The skin near the joints affected by arthritic changes becomes sensitive, hyperemic, hot to the touch, tightly stretched.
- The joints become thick and swollen.
- During movement the joints make characteristic sounds.
- There is a weakness, fatigue, body temperature can rise.
Causes and risk factors
The primary inflammatory process usually develops on the background of an infection, rheumatic or metabolic pathology, less often on the basis of a trauma or surgical intervention. In the case of rheumatoid arthritis, hereditary predisposition plays a significant role.
Secondary arthritis of small joints, as a rule, is a complication of allergic, atopic and autoimmune conditions, common infectious or underlying somatic diseases, such as gout, diabetes or psoriasis. In the pathogenesis of reactive arthritis, the history of tuberculosis, dysentery, hepatitis, granulomatosis, influenza, measles, mumps, scarlet fever, tonsillitis and chronic tonsillitis, borreliosis, Reiter's syndrome and sexually transmitted diseases plays a leading role. In children, vaccination may play the role of a provoking factor.
The likelihood of inflammation in the joints of the fingers increases with frequent microtraumatic articular structures during manual labor. The disease is often found in tailors, seamstresses, shoemakers, watchmakers and jewelers.
Exacerbations of chronic arthritis of the fingers can be triggered by hypothermia, dampness or weather changes, vibration, stressful situations and changes in the hormonal status of the body. Since fluctuations in hormonal levels are more characteristic of women, the incidence of arthritis of the fingers among them is 3–5 times higher than among men. Arterial hypertension, advanced age, poor nutrition, bad habits and diseases of the excretory system also increase the likelihood of arthritis.
Finger arthritis is characterized by a variety of manifestations that influence the choice of therapeutic strategies and medications. Depending on the nature of the course of the disease, acute and chronic forms of arthritis are distinguished, and in identifying the main etiological factors, primary finger arthritis is differentiated as an independent nosological form and secondary finger arthritis as a symptom complex in the clinic of concomitant infectious, rheumatic and metabolic diseases. It should be noted that secondary arthritis of the fingers occurs much more often than an independent disease.
Based on the number of affected joints, polyarthritis and oligoarthritis of fingers are distinguished: in the first case four and smaller joints are involved in the inflammatory process, in the second - from two to four. Monoarthritis is extremely rare, of which the most common is risotritis - inflammation of the first metacarpal-carpal joint.
Finger arthritis is one of the most common forms of peripheral arthritis, in which the inflammatory process involves the metacarpophalangeal and interphalangeal joints.
Arthritis of the fingers is one of the rapidly progressing diseases. Depending on the degree of joint damage, there are four stages of the pathological process.
- In the absence of clinical symptoms, early signs of inflammation are detected on hand X-rays. Periodically there is a slight constraint of movement.
- As the inflammatory process develops, an exudate accumulates in the articular sac, which destroys the articular structures. In the area of the affected joints, swelling, swelling and redness appear, local temperature may be elevated, finger movements are difficult and are accompanied by severe pain and severe crepitus. Due to the blood supply disturbance, the skin of the hand becomes dry, cold and thin.
- Progressive destruction of the joints leads to pronounced deformities of the fingers and constant severe pain in the hands, because of the limited mobility of the hand, muscle atrophy and tendon contractures are observed.
- Ankylosis of the articular heads of the bones manifests itself in irreversible deformation of the joints and complete immobilization of the fingers, as a result of which the patient loses the ability to perform basic household activities.
Causes of Arthritis and Inflammatory Factors
Among the causes of inflammation in the joints of the fingers, note:
- Pathological conditions of connective tissue - rheumatoid arthritis in frequency occupies a leading place,
- A complication of severe autoimmune disease, psoriasis, becomes psoriatic arthritis of the fingers,
- Exchange disorders lead to the development of gouty arthritis,
- Influenza, scarlet fever, tuberculosis, gonorrhea and other infections cause as a complication infectious arthritis,
- Posttraumatic arthritis, as the name makes clear, is the result of injuries to the fingers and hands,
- Deforming arthrosis appears as an age-related change
- Changes in the phalanges are more susceptible to people engaged in delicate manual labor associated with the constant tension of the hands and fingers - seamstresses, jewelers, watchmakers, professional athletes,
- A significant role in the inflammatory processes of the joints is played by the hereditary factor,
- In some cases, arthritis of the joints of the fingers is allergic.
Arthritis of the thumb can even cause a single strong load, sudden movement.
Symptoms of arthritis of the fingers
The clinical picture of arthritis of the fingers is characterized by great variability and depends on the etiological form and stage of the disease. Early stage of rheumatoid arthritis is characterized by stiffness of the joints in the morning and after prolonged rest. In this case, there is a characteristic feeling of tight gloves, limiting the mobility of the brush. In some cases, the patient may not have complaints at all, and the only manifestations of the disease are early radiographic signs of finger arthritis:
- thickening and compaction of soft tissues,
- slight narrowing of individual interarticular crevices,
- periarticular osteoporosis,
- single cystic enlightenment in bone tissue,
- roughness and erosion on the articular heads of the bones.
Characteristic signs of inflammation of the joints of the fingers are usually observed at stage II of the disease, starting with the appearance of painful swelling, erythema and crepitus in the affected joints, and multiple narrowing of the inter-articular crevices, cystic bleeding of the bone tissue and marginal deformities of bone epiphyses are added to radiological signs. Dislocations, subluxations and ankylosis of the joints are detected mainly in the terminal stages of the disease.
Localization of the inflammatory process and the nature of deformities of the joints is also of great diagnostic value. In rheumatoid arthritis, the first signs of inflammation affect the second and third metacarpal-phalangeal joints and the third proximal interphalangeal joint. Later, the pathological process extends to the distal interphalangeal joints, and then to the bone and joint structures of the wrist, as well as the styloid process of the ulna. The lesion of the joints is usually symmetrical. In the later stages of the disease, characteristic hand deformities are observed: finger-like curvatures of the “boutonniere” or “swan-neck” type, spindle-shaped hand and ulnar deformities caused by partial dislocations of the metacarpophalangeal joints.
Osteomyelitis, osteolysis and necrosis of bone tissues, often followed by generalized sepsis, are among the most dangerous complications of arthritis in the fingers.
In the case of reactive and psoriatic arthritis, the joints are asymmetrically affected. The psoriatic form is characterized by a thickening of the joints and sausage-shaped fingers. Morning stiffness of movements, as a rule, is not observed, the flexion function is limited mainly.
In the reactive form of arthritis, inflammation of the joints of the fingers occurs on the background of fever, chills, headache, conjunctivitis, and symptoms of infectious inflammation of the urinary tract.
In gouty arthritis, mainly the metacarpophalangeal joint of the thumb is affected, in the area of which elastic subcutaneous nodules-tophi are formed, filled with urate crystals.
Features of the flow of arthritis of the fingers in children
In childhood, infectious and reactive arthritis, most often developing on the background of streptococcal infection, is often diagnosed. The clinical picture of arthritis of the fingers of the hands in children is more pronounced than in adults: severe pain and marked deformities of the joints are accompanied by severe fever and general intoxication of the body.
Rheumatoid arthritis in children is characterized by persistent course and a weak response to therapy. Inflammation of the joints of the fingers usually develops on the background of the lesion of large joints and internal organs. If it is not possible to detect the etiological factor of inflammation of the joints of the fingers of a child, juvenile idiopathic arthritis is diagnosed.
A vivid clinical picture of the inflammatory process in the joints of the fingers makes it possible to diagnose arthritis with a high degree of confidence, but to clarify the etiological form and stage of the disease, a number of additional diagnostic procedures will be required.
During the medical history, the doctor draws attention to the connection of manifestations of arthritis with previously transferred infectious diseases, metabolic and somatic pathologies, as well as the impact of damaging factors. During physical examination, the size, shape and temperature of joints, skin color, nature of painful sensations, functional tests, the presence of extra-articular manifestations, etc. become a valuable source of diagnostic information. Sometimes, consultations of other specialists such as an orthopedic traumatologist, dermatologist and allergist-immunologist are needed. Identification of characteristic changes in the joints of the fingers requires the use of instrumental techniques - X-ray, MRI and CT of the hands, ultrasound of small joints.
Laboratory diagnosis plays a crucial role in determining the cause of the inflammatory response. Complete blood count reliably reveals signs of inflammation. During the biochemical analysis of blood, the level of uric and sialic acid is determined, which allows to confirm or exclude the diagnosis of gouty arthritis. High rates of rheumatoid factor and C-reactive protein, fibrinogen, seromucoid, cryoglobulins, etc., indicate rheumatoid pathology. In some cases, shown laboratory research punctate synovial fluid.
Arthritis of the fingers is common in tailors, seamstresses, shoemakers, watchmakers and jewelers.
Finger arthritis treatment
The medical strategy for arthritis of the fingers is based on a combination of pathogenetic and symptomatic approaches. During the acute phase of the disease, the main goal is the elimination of inflammation and pain. In the early stages, a course of analgesics, muscle relaxants, nonsteroidal anti-inflammatory drugs is usually enough, and in some cases it is possible to get away with the external use of ointments containing cyclooxygenase-1 (COX-1) blockers, painkillers and vasodilators. In infectious and reactive arthritis, antibiotics are included in the treatment regimen, in the presence of an allergic component - antihistamines, and in rheumatoid arthritis - immunosuppressants and immunomodulators.
For more severe forms of arthritis, it may be necessary to evacuate the exudate from the articular cavity, followed by the administration of corticosteroids with 1% lidocaine or novocaine solution. Rapid relief from hemocorrection, carried out in an extracorporeal way - cryopheresis, leukocytapheresis or cascade filtration of blood plasma.
After achieving remission, the therapeutic strategy focuses on the normalization of trophism and local metabolism in the area of the affected joints, stimulation of regeneration processes in the articular structures and restoration of hand functions. Individually selected combinations of physiotherapy and exercise therapy accelerate the rehabilitation of the patient, helping to return to an active lifestyle as soon as possible.
In the treatment of arthritis of the fingers, the following physiotherapy provides a good effect:
With persistent deformities of the joints conservative treatment is ineffective. In order to prevent the patient’s disability, arthroplasty or endoprosthesis replacement is recommended.
Dieting for arthritis of the fingers contributes to the prolongation of remission. During exacerbations, it is necessary to refrain from protein foods - meat products and legumes, as well as salty, fried, fatty and spicy dishes, chocolate, muffins, strong tea, coffee, cocoa and spirits. After stopping the inflammatory process, food restrictions become less - it is enough to avoid alcohol and limit the consumption of meat, smoked meats and heavy dishes rich in saturated fats and instant carbohydrates.
In gouty arthritis, red meat, by-products and smoked meat are also strongly contraindicated. Milk-vegetarian diet is preferred, with the exception of vegetables and fruits containing solanine. Eggplants, tomatoes, pumpkin, green onions, sorrel, rhubarb and hot peppers should be used as little as possible.
Finger arthritis is characterized by a variety of manifestations that influence the choice of therapeutic strategies and medications.
In the diet of the patient must be present products with a high content of polyunsaturated fatty acids, easily digestible protein and vitamin C:
- fat sea fish (tuna, sardines, salmon),
- buckwheat, oatmeal, rice and millet porridge,
- lean poultry
- dairy products,
- fresh apples, apricots and peaches,
- citrus fruits, kiwi and papaya,
- nuts and seeds,
- ginger root.
Possible complications and consequences
In acute infectious arthritis of the fingers in the absence of adequate treatment increases the risk of purulent-septic complications that threaten the patient's life. The protracted course of the disease threatens to turn into irreversible deformation of the joints of the fingers, which lead to disability of the patient.Osteomyelitis, osteolysis and necrosis of bone tissues, often followed by generalized sepsis, are among the most dangerous complications of arthritis in the fingers.
Severe side effects of prolonged use of nonsteroidal anti-inflammatory drugs have also been reported. In some patients who received inhibitors of COX-1 in injection and oral form for a long time, there have been cases of gastroduodenitis, enterocolitis and peptic ulcer due to regular irritation of the mucous membranes of the gastrointestinal tract, nephropathy was somewhat less common.
The outcome of arthritis of the fingers depends on the nature of the primary manifestations and the etiological form, the response to therapy, the patient's age at the time of the debut of the disease, as well as the presence and severity of associated pathologies. Early diagnosis and timely treatment increases the chances of recovery.
In order to prevent arthritis of the fingers, it is necessary to monitor the state of health in general and to consult a doctor in a timely manner when there are signs of infection, metabolic disturbances and other pathologies. It is especially important to prevent the formation of chronic foci of infection, to give up alcohol and to control food. Moderation in food with a sufficient amount of vitamins and minerals in the diet reduces the likelihood of arthritis and gout, in particular, you should not abuse heavy meat and fatty foods. Active lifestyle, exercise and hardening contribute to the improvement of the condition of the joints, but it should avoid injuries and hypothermia hands. With frequent manual exercises, it is recommended to pause after every 2-3 hours and perform exercises for the fingers.
Symptoms of arthritis of the fingers and hands
Symptoms of the disease can vary depending on what caused it.
But while there are common signs that are characteristic of arthritis of the hands of any etiology:
The pain that a person experiences when committing any action with his hands. At the initial stage of the disease, it may be mild, but as the pathogenesis progresses, the discomfort becomes stronger. First, the pain manifests itself only in the morning hours, after the person has remained motionless for a long time, and disappears after 30 minutes. Often, patients call the pain that occurs in the joints of the fingers, aches, which clearly indicates her character. Sometimes it can be accompanied by burning sensation and tingling,
Joint response to weather changes, as well as changes in atmospheric pressure,
The stiffness of the hands, the inability to move the fingers, this symptom is especially pronounced in the morning hours, immediately after waking up. It feels like it was wearing a narrow glove. Often, in order to perform basic self-care activities, a person must first develop his hands and fingers,
The skin on the knuckles and around the affected joints becomes red, hot to the touch, tight,
Swelling and swelling are formed around the joints. It makes hands look like pillows, fingers thicken,
Body temperature rises locally - in the place where the affected joint is located. But sometimes, for example, in infectious or rheumatoid arthritis, the general body temperature may rise, fever is often observed,
Arthritic joints of the hands are affected symmetrically,
During movement with the fingers, a characteristic articular creak - crepitus can be heard. It should not be confused with ordinary clicks, which are the norm,
Subcutaneous nodules may appear,
Sometimes there is a loss of body weight associated with the inflammatory process occurring in the body, as well as fatigue and weakness. More often, similar symptoms are observed in rheumatoid arthritis. Hands get a spindle shape.
Causes of Arthritis of the Hands
As the main factors leading to arthritis of the joints of the hands, the following reasons can be identified:
Age. The older the person, the more his joints wear, the nature of the damage is mechanical. In addition, with age, the metabolism slows down somewhat, nutrients are not supplied to the cartilage in the proper volume (due to circulatory disorders). In women, arthritis of the hands occurs due to the fact that hormonal changes occur in their bodies during the menopause, which negatively affects the state of the articular and bone tissues,
One of the common causes of the development of hand arthritis is a previous injury. It may be bruises, fractures, cracks. Of course, they heal with time, but the joints remain damaged, which over the years remind of themselves with arthritis,
Working conditions affect the incidence of hand arthritis. So, this pathology is considered to be an occupational disease of seamstresses, jewelers, tennis players, and all other people whose work is connected with the fact that fingers and hands are in tension all the time,
Hereditary predisposition Scientists have found that if blood relatives suffered from arthritis, then their descendants, most likely, will also be exposed to this disease,
Impaired immunity can cause inflammation of small joints,
Previous infectious disease. Often, damage to the joints of the hand occurs after a person has had a sore throat, the cause of which is streptococcus or staphylococcus. Especially often these complications occur against the background of improper treatment of the disease. But the cause of the development of inflammation can be normal SARS, as well as hypothermia,
Diseases such as psoriasis, rheumatism, sexually transmitted infections, lupus erythematosus, diabetes, gout, tuberculosis can all cause arthritis of the hands and fingers,
Do not ignore stress, as a factor influencing the occurrence of the disease.
Stages of hand arthritis
There are several stages of development of arthritis of the fingers and hands, each of which has its own symptoms:
The first stage is characterized by the fact that there are no obvious signs of the disease. However, knowing what you should pay attention to, you can already suspect arthritis yourself at this stage and consult a doctor. When the disease begins to affect the hands, a person is not able to perform simple actions in the morning — turn on water or gas. In this case, stiffness passes very quickly, so patients often do not seek medical help.
The second stage is characterized by the formation of bone erosion, the signs of the disease become brighter. The joints of the fingers begin to ache, crunch and swell; a person experiences difficulties not only in the morning, but also in the daytime. Due to the fact that performing professional actions becomes more difficult, people at this stage often go to a doctor,
The third stage is determined by the deformation of the joints. Hands are always affected symmetrically, the pain in the fingers becomes very strong. Most of all she torments a person in the morning, the skin turns red, the local temperature rises, the movements are constrained. These signs may not go away until the patient takes an anesthetic,
Fourth stage. The articular cartilage grows together, it becomes impossible to move with your fingers, even the simplest self-care skills are lost. A person becomes helpless, and he is assigned one of the degrees of disability.
Types of arthritis of the fingers and hands
If you refer to the classification, you can count up to 10 varieties of this disease.
Most often, the hands are subject to the following types of arthritis:
Infectious arthritis is the result of an infection in the joint that can be transmitted by blood or by direct means.
Exchange arthritis, which can also be called "gouty." The reason is the accumulation of uric acid salts around the joints. It occurs most often systemically,
Rheumatoid arthritis. In most cases, it begins with small joints, which include the joints of the fingers. Subsequently, the disease affects larger joints
Post-traumatic arthritis is the result of damage to bone tissue and articular cartilage. The inflammatory process is often delayed by the time
Depending on the location of inflammation, arthritis of the hands may be proximal, middle or distal,
You can find the name "risarthritis" - this is the definition of arthritis that hit only the thumb,
Secondary arthritis, which occurs as a reaction of the body to immune disorders, allergic reactions or to somatic diseases.
Prognosis of the disease
The sooner the disease is detected, and the more strictly the patient adheres to all medical recommendations, the more favorable the prognosis for recovery. Even in the case when it is not possible to recover completely, a person has a stable remission, during which he can fully live and work. Mobility of the joints will be maintained for a long time. A person may not get a disability until the end of his life and will serve himself on his own, as well as work at any job until retirement. Thus, the prognosis directly depends on the patient himself, or rather, on how he will follow the medical recommendations.
Hand arthritis treatment
Before embarking on a treatment, it is necessary to remember the following rules, which will make any therapeutic regimen more effective, will make it possible to forget about the disease for a long time:
Self-healing should be forgotten. Everything, even seemingly the most proven methods of treating aching joints of the hands, should be preliminarily agreed with the doctor,
The load on the sore joints of the fingers should be minimal. If this cannot be done because of professional activity, then it is necessary to go to the hospital, at least for the time of exacerbation of the disease. Responsibilities for housekeeping should be as much as possible reassign to close people
Perform daily exercises, which the doctor will recommend. They should be done competently, effortlessly and only in the period of remission,
All appointments of the attending physician must be unquestionably fulfilled,
It is forbidden to lift heavy objects, as well as make sharp movements with your hands,
Rest at night should be full and be at least 8 hours,
If necessary, you need to purchase special devices that make life easier for people with arthritis,
It is necessary to strictly adhere to the chosen diet, not to take breaks during the holidays,
Every day you need to drink the amount of water that advises the doctor.
Drug treatment of arthritis of the hands
Since most often the arthritis of the hands proceeds systematically, and many joints are involved in the pathological process, starting with the small ones and ending with the large ones, there is no way to do without the medication effect. If therapy is carried out as prescribed by a doctor, then side effects can be minimized. Moreover, modern means for the treatment of arthritis are developed taking into account the latest advances in medicine.
Drug treatment of arthritis of the hands is carried out using the following drugs:
When the disease is in the acute phase, NSAIDs should be taken. The preparations of this group include diclofenac, ibuprofen, ketonal, ibuklin. They will help to reduce inflammation and swelling, as well as reduce pain, which will immediately have a beneficial effect on the patient's well-being,
Drugs that are based on chondroitin sulfate and glucosamine. But it is necessary to tune in to the fact that they will need to be taken over a long period of time. The minimum duration of therapy is 3 months. In the future, the feasibility of admission is determined by the patient's condition. Such a long period of treatment is due to the fact that the hyaline cartilage of the joints of the fingers and hand is restored slowly,
The means promoting expansion of vessels. Their reception is necessary in order that joints receive food from blood in due volume. To provide this process with narrowed vessels is impossible. As such tools prescribed trental, teonikol, aktovegin. They are available in the form of injections, which are administered intramuscularly or intravenously, at the discretion of the physician. A single course consists of 10 injections,
If arthritis is bacterial in nature, then its therapy is impossible without the use of systemic antibiotics. These can be penicillins, as well as macrolides,
To optimize the nutrition of the joint, vitamin complexes are prescribed, sometimes they are supplemented with calcium preparations,
If the disease does not respond to the above therapy, then corticosteroids or antimalarial drugs may be prescribed. But doctors try to avoid these drugs, since their action is short-lived, and there may be many side effects,
For external use appoint a variety of ointments containing NSAIDs. It can be fast-gel, voltaren and others. The advantage of local treatment is that it does not (unlike tablets) irritate the gastrointestinal tract.
The need to undergo physiotherapy procedures is dictated by the fact that the treatment of arthritis of the hands must be carried out in combination. Physiotherapy provides a lot of opportunities, helps to improve the metabolic process and stop the destructive effect of the disease on the joints.
Ultrasound therapy, electrophoresis, massage, quartz treatment and acupuncture are successfully applied. Since the joints of the hands are in close proximity to the surface of the skin, exposure to them using any of these procedures will be most effective.
Electrophoresis is carried out using a special apparatus. The joint is affected by a current having a different frequency. It improves blood circulation, relieves pain and contributes to the regeneration of cartilage tissue. Using electrophoresis, various drugs are delivered to the joint, for example, dimexide, analgin, novocaine, etc.
Electrophoresis can not be performed if:
There is a built-in implant that falls under the area of impact,
There are skin diseases.
Ultrasound is equally popular in the treatment of hand joints. It helps relieve spasms, restore mobility of the fingers, reduce pain. However, this method of treatment can be used only when the acute stage of the disease has passed, since exposure to ultrasound affects the degree of vascular permeability. Although this method is highly effective, it also has a number of contraindications, for example, menopause, coronary heart disease, vascular dystonia, hypertension and other diseases.
Thus, ultrasound therapy and electrophoresis are considered to be the most effective for arthritis of the fingers and hands. These are the two most commonly used methods of adjuvant treatment of arthritis of the hands in modern domestic medicine. Although in other countries adhere to other methods. So, in China for the treatment of arthritis of the hands use acupuncture. However, only complex therapy is able to relieve a person from pain and inflammation in the joints.
Treatment depending on the stage of the disease
During the acute period, anti-inflammatory drugs are prescribed, as well as painkillers. The form can be any: injections, ointments, tablets. It is selected individually for each patient.
When the period of remission begins, the edema subsides, the pain subsides, and the joint itself is not inflamed, then it is necessary to actively restore the joint and at the same time eliminate the cause of what caused the arthritis.If the inflammation began on the background of gout, then purine metabolism in the body should be normalized, which will reduce the level of uric acid. To do this, be sure to follow a diet. In rheumatoid arthritis, it is necessary to normalize the work of the immune system as a whole. It is at the stage of remission that the course of physiotherapy is prescribed.
If the patient asked for help too late, when the phalanges of the fingers had come together, then endoprosthesis replacement will be necessary.
Endoprosthetics of the joints of the fingers
This procedure is effective in treating most diseases of the joints. But she is appointed when other methods of therapy do not give the desired effect. Before replacing the prosthesis, even the small finger joint, the patient is fully examined. Each artificial joint is developed individually, taking into account the physiological characteristics of the person.
The task of arthroplasty is to restore the functionality of the hands. After the operation, the person will be able to perform self-care activities. However, this procedure has significant drawbacks - high cost and a long rehabilitation period.
How is the endoprosthetics of the fingers:
An incision is made on the back side of the hand, then the joint capsule is opened,
The heads of the bones are removed, as well as the phalanges of the fingers, but usually not completely, but partially. The decision is made by the doctor,
Dentures are installed in extended channels.
After a successful operation and rehabilitation course, a person will be able to restore the motor activity of the hands and significantly improve the quality of life. Also, he will cease to torment the perennial pain that arthritis of the hands in the last stage.
However, there are a number of contraindications to the operation of endoprosthetics:
Acute or chronic osteomyelitis,
Any skin infections until they are completely cured,
Pathologies of the cardiovascular system (meaning severe forms in which a person cannot undergo anesthesia),
Foci of infection until cure - sinusitis, caries, tonsillitis, otitis.
If earlier the problem of replacing the native joint with an artificial one could not be solved due to the fact that the prosthesis was often rejected by the body, now orthopedic surgeons in most cases perform the operation successfully. The joints themselves are made of special materials that have increased strength and at the same time, they perfectly take root in the human body.
Diet for Arthritis
There are certain foods that are able to alleviate the symptoms of arthritis. These include:
Sea fish with high fat content. These could be members of the salmon family, tuna, sardines,
Fresh fruits and vegetables rich in vitamin C. These are papaya, kiwi, peaches and oranges.,
We should not forget about apples, which contain elements that contribute to the removal of inflammation in the joints and the restoration of cartilage tissue,
Nuts and seeds. Preference should be given to almonds. But it is important that the nuts are not salty, since salt in large quantities is prohibited for people with arthritis,
Products such as ginger and turmeric will reduce not only inflammation, but also help reduce pain,
Garlic perfectly helps to cope with inflammation. But do not be too carried away with it, so it irritates the stomach. It is better to consume a few cloves of garlic, along with the main meal,
Cereals such as millet, buckwheat, oatmeal and rice.
Sometimes doctors insist on the transition of a patient with arthritis to a fully vegetarian diet. In this case, heat treatment of fruits and vegetables should be reduced to a minimum. It is not necessary to forever exclude animal products from your diet, you only need to do this for a week until the acute phase of the disease passes. During this time, substances that have a destructive effect on cartilage and bone tissue will be removed from the body to some extent.
However, there are products from the consumption of which it is important to refrain always: both during an exacerbation and during remission.
Hot peppers, tomatoes, eggplants and pumpkin. These vegetables can trigger an attack of pain. Especially if the arthritis of the hands was caused by gout,
All products containing saturated fats. These include fatty meats and delicacies, offal, pastry on margarine,
Chocolate, cocoa, gingerbread, biscuits, condensed milk,
Sorrel, rhubarb, spinach and scallions.
For those people who suffer from arthritis of the fingers, certain nutritional rules have been developed.
If you stick to them, the diet will be effective and will certainly have a positive effect:
The daily ration should be divided into 3 main meals and 3 snacks. Thus, it will be possible to regulate the level of sugar in the blood, and, importantly, the level of purine acids, due to which deposits are formed on the joints of the hands,
You can not consume at one time a large amount of food, as well as starve,
Body weight should be controlled. If there are excess kilos, they must be discarded. But this process should take place under medical supervision,
You need to drink enough water, which the doctor can calculate, based on how much a person weighs,
You can drink not only ordinary, but alkaline mineral water, if this is not contraindicated.
Gymnastics for Arthritis
There are special exercises aimed at developing sick fingers and hands. But they must be performed during remission and in such a way as not to cause harm to health.
Several effective exercises to restore the function of the joints of the hands:
Exercise 1. "Fist". Warm-up, which is to strongly squeeze hands into a fist. In this case, the thumb should be on top of the other four. It is necessary to press them on the fingers and stay in that position for at least half a minute. After that, the fist opens and the fingers are spread out as wide as possible. Doing the exercise is necessary with two hands synchronously. Need to repeat up to 4 times. An important limitation to the exercise - the occurrence of pain. If discomfort appears, exercise should either stop completely or reduce the intensity of compression,
Exercise 2. "Rosary". Alternately, you need to touch the pads of each of the remaining fingers with your thumb. You should start with the index, stopping on the little finger and returning back. Run at least 5 times
Exercise 3. "Fan". Hands should be pressed tightly to any flat surface, but without relying on them. Try to strain the brush and spread your fingers as wide as possible. Repeat 5 times, try to perform as if the fingers are wearing a tight elastic band, the resistance of which must be overcome,
Exercise 4. "Piano". Hands remain in the same position as in the previous exercise. At the same time it is necessary to alternately try to raise a finger up, while leaving the adjacent fingers on the table. In the joints they do not bend. Repeat 3 times for each brush,
Exercise 5. "Pendulum". To do this, the hands should also be left on the table, the fingers should be raised alternately upwards, but at the same time they should be moved in different directions - two times, and then the same number of times in a circle
Exercise 6. "Claws". To do this, you need to leave your hands in the same position, bend and unbend your fingers, pulling them to the palm. But you need to do not alternately, but all five fingers at once,
Exercise 7. "Pencil". It is necessary to take a pencil, put it on a flat surface and roll it from the fingertips to the base of the palm. The same exercise should be performed while holding the pencil in weight, in an upright position. It is better if it has ribbed edges, rather than a smooth surface,
Exercise 8. "Ball". The ball must be placed on a flat surface and rolled forward and back with your fingers. Diversify exercise can be rolling the ball in a circle. It is better if it is a special massage ball that has small ribbed spikes. Thus, it will be possible to achieve the effect of massage and to improve the blood supply to the hands.
Causes of the disease
The causes of the disease may be as follows:
- common metabolic disorders cause non-infectious arthritis. This form of the disease often affects older people who have occupational diseases, endocrine glands, microtrauma,
- infectious diseases: brucellosis and gonorrhea, influenza and scarlet fever, syphilis and tuberculosis, dysentery and chlamydia. There are also small focal lesions, such as chronic tonsillitis. Pathogens are staphylococci and streptococci.
- Transferred injuries of joints, bruises and operations on them,
- It is impossible to discount hereditary predisposition, although it is also wrong to argue that arthritis is inherited.
Arthritis of the joints of the hands is very important to diagnose at an early stage and find an individual treatment. Only in this case, the patient can be cured. Proper diagnosis will determine the cause of the disease and the type of arthritis (and there are up to 150).
If infectious arthritis is detected, a course of antibiotics, vaccines, and corticosteroids will be prescribed. Treatment is directed to the process that caused the arthritis. Nonsteroidal anti-inflammatory drugs, analgesics with antispasmodic action are used to relieve inflammation and pain in the acute form of the disease. Chondroprotectors will help stop the development of the degenerative process and restore cartilage tissue. If these agents did not produce the expected result, basic antirheumatic products and biological response modifiers are prescribed.
The progression of the disease is closely associated with impaired blood supply in the joints, therefore, correction of diseases associated with changes in blood vessels (vascular spasms, normalization of blood pressure) is carried out. With short-term, occurring after significant loads and "starting" pains, it is advisable to assign nitrates.
Severe illness is accompanied by irritability, tearfulness, sleep disturbance. To improve the patient’s psyche, they use sedatives and hypnotics, as well as drugs that relieve feelings of anguish, anxiety and "improve the quality of life."
Also, the treatment of arthritis of the fingers involves the use of diverting agents - these are painkillers and anti-inflammatory ointments, creams, tinctures and rubbing.
It should be remembered that arthritis affects the nerves, because the body must be supported with vitamins. The most effective of them is thiamine or vitamin B, which is a catalyst for metabolism. Most often it is prescribed in the form of injections, but can be used in pills or apply brewer's yeast, rich in this vitamin.
In the case of hand arthritis, the treatment should be combined with physiotherapeutic methods. It may be electrophoresis by means of which antibiotics, procaine and various complex medicinal compounds are injected through the skin, diadynamic therapy - the impact of low-frequency impulse currents, UHF, magnetic therapy, ultrasound. Hydrotherapy and mud applications are also used in the remission stage. All of these methods are assigned individually.
Mud applications on the hands - an element of complex therapy
When the exacerbation is removed, the doctor prescribes remedial gymnastics, as a rule, in the prone position or in the pool, because water achieves the greatest muscle relaxation. But at the same time, no exercise should cause you discomfort, much less pain. Metabolic disorders are 90% due to malnutrition. Because you have to enrich your body with vitamins E and D, antioxidants and omega-3 fatty acids. All this can be obtained from fresh vegetables and fruits, salmon and herring, liver, walnuts, pumpkin seeds and sunflower seeds, bran.
Along with drug therapy can be carried out and treatment of folk remedies. These are compresses and ointments with mustard, blue clay, mummy and, of course, infusions and decoctions of medicinal herbs, turpentine baths. However, before using any of them, be sure to consult your doctor.
In particularly advanced cases, when conservative treatment can no longer give positive results, they resort to surgical intervention and prosthetic joints.
Here we are with you and figured out how to treat this disease. But to this we must add the rules of behavior during the illness, which will help to transfer it more easily:
- in no case do self-medication,
- reduce the load on the joints of the fingers,
- do daily exercises and stretching exercises, but without the load:
- objectively assess your condition, without fear and hysterics,
- punctually perform all doctor's appointments,
- you can not lift weights and make sudden movements, jump and run,
- Ensure a full night’s rest
- use special assistive devices to facilitate movements,
- to limit food and fluid intake - this is natural in acute conditions in the entire animal world.
In the video below, an exercise for arthritis of the hands:
Brief description of arthritis of the fingers
Arthritis of the fingers is an inflammatory disease that affects almost all articular structures. The synovial membranes, articular capsules, cartilage, ligament-tendon apparatus are involved in the pathological process. Arthritis varies in origin, severity, prognosis for recovery. Without treatment, the joints are completely destroyed, and the person becomes disabled.
Forms and stages of the disease
Arthritis of the fingers can be acute, subacute, chronic. The latter develops as a result of the patients ignoring the symptoms that arise at the initial stage of the development of the pathology. In orthopedics, rheumatology, and traumatology, arthritis is classified according to the location of the inflammation:
- monoarthritis - isolating the damage of one joint,
- oligoarthritis - simultaneous or sequential damage to 2-3 joints,
- polyarthritis - involvement of more than 3 finger joints in the inflammatory process.
There are also primary arthritis, developing as a result of injuries, infections, metabolic disorders, and secondary arising on the background of destructive changes in the bones, periarticular tissues.
|Stage of arthritis of the fingers||Characteristics|
|First (initial changes)||The appearance of weak discomfort, disappearing in a state of rest, quickly passing stiffness of movements|
|Second (increased inflammation)||Increased pain, cracking when flexing or unbending fingers, reduced range of motion, swelling of joints|
|Third (deformity of the joints)||Redness and swelling of the fingers, severe pain, both during the daytime and at night, stiffness of the joints|
|Fourth (ankylosis)||Joint fissure fusion resulting in complete or partial immobilization of joints, joint deformity|
Causes of health problems
Arthritis most often affects the fingers in the hands of older people because of the natural slowdown of recovery reactions, a decrease in collagen production. In young patients, the causes of inflammation of the joints are pathologies occurring in the body or previous injuries - fractures, torn ligaments, damage to muscles and tendons. The impetus for the development of arthritis can be various external and internal precipitating factors:
- non-specific infections resulting from the introduction into the body of staphylococci, streptococci, for example, acute tonsillitis,
- specific infections - tuberculosis, syphilis, gonorrhea, chlamydia, brucellosis,
- autoimmune pathologies, including psoriasis and gout,
- viral diseases - herpes, hepatitis B, mumps,
- genetic predisposition, incorrect work of the immune system.
Predisposing factors include increased loads on the fingers, the implementation of frequent monotonous movements, impaired blood circulation, changes in hormonal levels.
Signs and symptoms of pathology
The most pronounced symptoms of acute and subacute inflammation. The skin of the fingers swells, reddens, gets hot. The affected joint looks much larger than healthy. For severe inflammation characterized by numbness, tingling. Each flexion or extension of the articulation is accompanied by severe pain, clicking, crunching. Infectious pathology is especially difficult:
- body temperature may exceed subfebrile values (37.1—38.0 ° C),
- chills, cold sweat, fever,
- Gastrointestinal disorders occur in children and weakened adults.
Chronic arthritis is manifested by weak pains in remission, aggravated after physical exertion, hypothermia. The mobility of the metacarpophalangeal and interphalangeal joints is limited, and swelling and reddening of the skin are occasionally observed. During relapse, the severity of symptoms increases significantly.
The doctor may suspect arthritis on specific symptoms, anamnesis, results of functional tests. To confirm the diagnosis, X-ray examination is performed in standard and lateral projections or magnifying X-ray. According to indications are used:
- magnetic resonance imaging (MRI),
With the help of a puncture, synovial fluid is taken for its further study. Biochemical, serological studies allow to confirm or refute the rheumatic origin of arthritis, to establish the type of pathogenic microorganisms and their sensitivity to antibiotics in infectious pathologies.
How to treat finger arthritis
In case of arthritis of 1 or 2 severity, conservative methods are used - taking medications, conducting massage and physiotherapeutic procedures, massage, exercise therapy. For patients with severe, irreversible deformity of the metacarpophalangeal and interphalangeal joints, doctors immediately suggest resorting to surgical intervention: arthrotomy, endoprosthetic replacement, reconstructive arthroplasty.
General treatment rules
The treatment of pathologies of any origin is aimed at eliminating all the symptoms, their causes, preventing the involvement of healthy tissues and joints in the inflammatory process. Patients with acute arthritis are shown sparing motor mode. It is recommended to eliminate the increased load on the fingers, use elastic bandages or semi-rigid orthopedic devices to stabilize the articular structures, reduce the severity of pain.
In the treatment of arthritis used drugs of various clinical and pharmacological groups. When choosing medicines and their form, the doctor takes into account the type of pathology, the severity of its course, the severity of symptoms. For example, immunosuppressants are widely used in the treatment of rheumatoid or reactive arthritis. And with gout, patients are shown taking medications to dissolve uric acid crystals and remove them from the body.
|Preparations for the treatment of arthritis of the fingers||Name of drugs||Therapeutic effect|
|Nonsteroidal anti-inflammatory drugs (NSAIDs)||Diclofenac, Ibuprofen, Ketoprofen, Meloxicam, Indomethacin, Nimesulide||Reduce the severity of pain, arrest the inflammation of soft tissue structures|
|Glucocorticosteroids||Methylprednisolone, Triamcinolone, Diprospan, Dexamethasone, Kenalog||Weaken the inflammatory process, eliminate the most pronounced pain|
|Muscle relaxants||Mydocalm, Baklosan, Sirdalud||Relax spasmodic skeletal muscles|
|Preparations with vitamins of group B||Milgamma, Neyrobion, Pentovit, Neuromultivitis||Improve the innervation and nutrition of tissues, accelerate metabolism|
|Chondroprotectors||Artra, Dona, Hondroksid, Struktum, Terafleks, Alflutop||Partially repair damaged cartilage tissue|
|Anticoagulants, venoprotectors||Nicotinic acid, Euphyllinum, Xantinol nicotinate, Trental||Improve the blood supply of the joints with nutrients|
Diet and lifestyle for arthritis
The deterioration of psycho-emotional state can cause another recurrence of arthritis. Therefore, doctors recommends to observe the daily regimen, walk in the fresh air, get a good sleep. It is desirable to completely eliminate sausage and confectionery products, smoked meats, fatty meats, pastries made from wheat flour. It is necessary to eat more fresh fruits and vegetables, dairy products, cereal cereals.
Even "neglected" ARTHRITIS can be cured at home! Just do not forget to smear it once a day.
Every day you should drink at least 2.5 liters of liquid - clean water, saline mineral water, kissels, compotes, juices. With gout, you must completely abandon the fatty meat, rich soups, sorrel, spinach, alcohol.
Home-made ointments, tinctures, compresses should not be used in the acute and subacute period, especially if they contain ingredients with a warming effect (turpentine, golden mustache, black radish). Folk remedies are used only after the main therapy, at the stage of remission to eliminate occasional mild pain in the fingers.
In folk medicine, herbal teas are used to treat arthritis. They are prepared from medicinal plants that provide anesthetic, anti-inflammatory, mild diuretic effect. When used together, the therapeutic efficacy of herbs is greatly enhanced. The collection for the treatment of arthritis includes equal parts of dry chamomile flowers and calendula, corn silk, St. John's wort grass, roots of elecampane.
To prepare herbal tea, a tablespoon of dried plant raw materials is poured with 2 cups of boiling water. After an hour, filter and drink 3 tablespoons 3-4 times a day after meals.
Large raw tuber, peeled, crushed using a fine grater. The juice is slightly squeezed, and the mixture is distributed in thick layers on the fingers. Fix it with plastic wrap, woolen cloth and gauze bandage. Leave a compress for an hour.
Fresh cabbage leaf soaked in boiling water for a couple of minutes, dried and rubbed well between the palms until the juice appears. Put on one side a thin layer of low-fat sour cream. Apply the sheet to the sore fingers, fix the film, gauze bandage. The duration of the procedure is 1 hour.
In a mortar, grind to a tablespoon of thick flower honey, cosmetic almond oil and linseed oil. Add a few drops of thyme essential oil and 50 g of medical vaseline. The resulting liquid mass is transferred into a glass jar with a lid, stored in the refrigerator, rubbed into the fingers for pain.
Such treatment is usually practiced in traditional medicine for arthritis of large joints. The skin of the fingers is thin, the fat layer is practically absent, so the bite of even one bee can cause severe inflammation and the development of an allergic reaction. To use this method of therapy is possible only after consultation with the orthopedist or rheumatologist.
During the hirudotherapy session, up to 3 medical leeches are placed on the bioactive points of the fingers. After biting the skin, they inject saliva into the blood, saturated with substances with anti-inflammatory, anti-exudative, analgesic action. A total of 5–10 procedures with 2-3-day breaks can be recommended to patients.
Apis mellifika, brionium, Rus toxicodendron, Ledum, Fitolian, Colchicum are homeopathic remedies used in the treatment of rheumatoid, reactive, gouty arthritis. Ingredients in their composition are included in the minimum concentrations. This method of treatment allows you to "accustom" the body to the symptoms of pathology, not to react sharply to their appearance.
Professor Neumyvakin several decades ago proposed to treat arthritis with the help of 3% hydrogen peroxide. In 1/2 cup of warm water dissolve 2 drops of the drug and drink after a meal. Every 3 days the number of drops is increased by one, until they become 8. This method of treatment has its supporters and opponents, so a preliminary medical consultation is necessary. Sense in the external use of hydrogen peroxide in arthritis is not.
Forecasts and preventive recommendations
Infectious arthritis can be cured by antibiotic therapy. Relatively favorable outlook with its reactive form. Gouty, psoriatic, rheumatoid arthritis is not yet completely cured. The main task of doctors is to achieve sustainable remission.
Prevention of arthritis is to eliminate excessive loads on the fingers, timely treatment of pathologies that can provoke it, especially of infectious origin.
Drug treatment of arthritis of the fingers
The best results in treatment can be achieved in the case when the disease is in its initial stage. However, it is quite difficult to diagnose arthritis at the very beginning.
Drug therapy should be comprehensive, combining different groups of drugs, and be carried out under the strict supervision of a specialist. Otherwise, it will not only not bring the expected results, but also the time required for taking action will be lost.
- Acute inflammation will help remove nonsteroidal anti-inflammatory drugs.
This group includes ketone, ibuklin, voltaren, indomethacin, ibuprofen.
- Chondroprotectors — Structum, Artepan, Sustilac, Rumalon, Teraflex, Movex Active and others — are designed to establish metabolic processes in the joint. They are available in the form of tablets, ointments, creams, gels, capsules, solutions for intramuscular injections and intra-articular administration. Chondroprotectors have a positive effect on the division of cartilage cells, normalize metabolic processes, stimulate the synthesis of hyaluronic acid, prevent loss of calcium ions by bone tissue, reduce inflammation, and slow down the pathological processes in tissues. It should be understood that chondroprotectors are long-acting agents, they take many months to take. The most effective are injections of drugs, an additional effect has a simultaneous physical therapy procedures.
- Injections to improve the blood supply - Actovegin, Trental and others. Contribute to good nutrition of tissues in the joints, the course is 10 injections of the drug.
- In infectious arthritis caused by bacteria, it is necessary to take antibiotics: ceftriaxone, meranem, bigaflon.
The type of drug, the duration of the course, the frequency of administration and the dosage are selected by the doctor, depending on the overall clinical picture, the severity of the disease and comorbidities.
Physiotherapy for the treatment of joints
During the period of exacerbation, physiotherapeutic procedures are contraindicated, but when the process is brought under control and treatment is started, a combination of medicines and physiotherapy gives a good cumulative effect.
With arthritis of the joints of the fingers are shown:
- Magnetic therapy
- Manual therapy
- Exercise therapy
- Paraffin treatment
The choice of procedures and exercises depends on the cause of the disease. Infectious arthritis is treated with ultraviolet irradiation, electrophoresis, and ultrasound.
In case of gouty arthritis, it is recommended UV irradiation, UHF, mud therapy, electrophoresis with analgin, aspirin, novocaine.
Traumatic arthritis is treated with UHF, magnetic therapy, phonophoresis with hydrocortisone, after - paraffin treatment, mud, hydrogen sulphide and iodide-bromine baths.
Massage for arthritis of the fingers
Massage of hands and fingers will help relieve tension, improve blood circulation, reduce congestion in the joints.
To perform the massage, you should sit comfortably, leaning your back on the back of a chair or a wall.
- Relax your wrist and fingers, alternately tapping the fingers of both hands on a hard surface (table, floor, chair)
- Rub hands: rub against each other, spread fingers as wide as possible and rub hands, rub fingers, tips of pads with your thumb
- Put your right hand on the surface of the table. Use your left hand to gently raise the right hand and perform 15-20 rotational movements, first clockwise and then counterclockwise. The muscles should be relaxed, and neither shoulder nor forearm is involved in the process. Then the right hand performs similar active movements (without the help of the left).
- Just as with a brush, circular movements are performed with each finger - first passive, with the support of the left hand, then –active, without it.
- The movements are repeated symmetrically for the second hand, for the hand and for each finger.
During the self-massage session, breathing should be even and deep.
Therapeutic gymnastics: exercises for the fingers of the hands with arthritis
Physical therapy in case of arthritis includes a number of simple exercises, which make it possible to alleviate the condition and stimulate positive dynamics in treatment.
- Clenching and unclenching a fist - 10 times with each hand,
- Thumb pad alternately touch the pads, index, middle, ring finger, little finger. 10 times with each hand
- Put the brush on a hard surface, spread your fingers. Alternately, try to raise each finger, not lifting the rest from the surface. 10 times for each finger on both hands,
- The initial position, as in exercise number 3. Fingers lift and perform rotational movements in both directions. 10 times,
- Roll a pencil with a ribbed surface across the table from the tips of your fingers to the palm and back, roll the pencil between your palms on the weight,
- Starting position: hand on the table, elbow rests on a hard surface ("student pose")
- Alternately squeeze fingers into a fist - unclasp your palm, 10 times,
- Alternately bend and unclench one finger, the rest are clenched into a fist,
- Pull your fingers up, tilt them one way or the other to the maximum possible amplitude,
- Squeeze and unclench a tennis ball, fir or pine cone in your hand at any convenient time.
In the Moscow Region there is a Dr. Bubnovsky Center, the founder of which developed his own method of treating arthritis with the help of physical exercises.
On the website of the Center you can get acquainted with the services and read reviews of real patients.
Folk treatment of arthritis of the fingers
At home, you can alleviate the symptoms of arthritis with the help of popular recipes, but they cannot replace full-fledged medical therapy.
- 1 tsp apple vinegar add to 0.2 liters of water and take on an empty stomach 4-5 times a day. The course duration is 3-4 weeks,
- Cook green potato tubers, chop and make a compress of warm potato masses. Cover the top with cling film, diaper and leave overnight,
- Lubricate the skin of the hands with a greasy cream and apply gauze soaked in garlic juice,
- Birch leaves are poured with boiling water, insist 30-40 minutes, after which they are slightly warmed and used for hand baths.
Folk remedies help alleviate the condition and relieve pain, but do not stop the pathological processes in the joint.