Thinking of the hands of an elderly person, we almost inevitably imagine bumpy fingers, thinned in the phalanges, but as if they were swollen in the joints. Few people think that this is not just a sign of the body's natural aging, but a symptom of a real disease - arthrosis of the fingers. And even more than that, not everyone knows that this disease can "age" hands at the age of twenty-five or thirty, which even writing a simple note or twisting a cork becomes a painful and difficult task. How to maintain fine finger motilitydangers and what to do with osteoarthritis of the fingers, if it has already begun - read about it below.
Deforming arthrosis of the fingers
Metacarpophalangeal and interphalangeal joints of a person experience a constant load, because for a normal quality of life he must perform fine motor movements every minute - from simple grabs (take an apple, open the door, hold cutlery) to very small and complex (determine a person's handwriting, his ability to sewand knitting, playing instruments and more). The more intensely the fingers are loaded, the more wear is exposed to the cartilaginous tissue, which covers the heads of the phalangeal bones, forming the articular surface. This cartilaginous layer, washed away by synovial fluid, allows the bones not to rub against each other when moving, but to slide, as well as to play the role of a natural shock absorber (for example, during impact movements without which it is impossible to type on the keyboard).
For various reasons, which we will discuss below, interphalangeal cartilage is subject to wear. The most common procedure is as follows:
- The porous cartilage tissue is subjected to a load in which the joint lubricant is "squeezed" out of it, providing good joint mobility. Usually after that recovery occurs - the cartilage is again saturated with moisture at rest. it begins to dry and crack. This leads to a decrease in its elasticity and functionality.
- Unable to resist friction, the dried cartilage begins to gradually wear out and thin, exposing the bone heads. Because the articular surface does not fully cope with the task, bones, muscles, and ligaments begin to experience the load provided for cartilage — almost the entire orthopedic apparatus of the finger or even the entire hand. To increase the surface area of the joint surface and prevent its further erasure, the body begins to "refine" osteophytes in the affected area - bone growths that can have rounded and even clustered shapes. In the people, this process is also called "salt deposition", which is not completely true, because we are talking about the proliferation of bone tissue.
- The appearance of osteophytes leads to a decrease in mobility - the fingers bend less and it is no longer possible to deftly cope with the usual daily obligations as before. At the same time, bone tissue does not have its own mechanism of protection against friction, so osteophytes occasionally break and damage adjacent tissues, causing pain and inflammation. In addition, microscopic cracks appear which reduce the strength of the bone and make it brittle - therefore in arthrosis and osteoarthritis, finger fractures are not uncommon, even from not too strong blows. When the osteophyte, which compensates for the insufficient function of the joint, is interrupted, another one grows in its place - over time, the process only worsens along with the cartilage dysfunction.
- Strong wear of joint surfaces, changes in bone shape lead to restructuring of the whole hand, chronic inflammation and pain. The brush is deformed to such an extent that it is completely incapable of even grasping the cup with its fingers.
From arthritis, arthrosis, which is also called osteoarthritis or osteoarthritis (they are all synonyms), differs primarily in the destruction of the joint and the chronic course of the disease. While arthritis implies only the presence of an acute inflammatory process that affects the cartilage tissue. In arthrosis, the joint sac, synovium, subchondral bone, as well as ligaments and muscles are involved in the degenerative-dystrophic process. Also, with arthritis, the pain is usually sharp and strong, appearing at night. Although osteoarthritis is felt during the day, in the early stages - not too pronounced excruciating pain.
They are currently considered the most common forms of arthrosis: rhizarthrosis involving the thumb and polyarthrosis involving several interphalangeal joints at once.
Remember: in the early stages of the disease, bone destruction can still be prevented and osteoarthritis can lead to permanent remission while maintaining high-quality hand biomechanics.
Causes of osteoarthritis of the small wrists
The risk group often includes people in the family who have already had arthrosis of the fingers. The density of cartilage tissue and the speed of metabolic processes in it are genetically determined in advance, so the tendency to develop the disease can be hereditary. Also, the disease affects postmenopausal women about 10 times more often than their peers.
The likelihood of osteoarthritis increases with occupational and household workloads - typists, surgeons, masseurs, bakers, dairies, turners and milling machines, pianists, athletes and other professionals who "work with their hands" often notice unpleasant symptoms earlier than others.
The development of arthrosis of the fingers is facilitated by:
- rapid wear and / or insufficient regeneration of cartilage tissue;
- metabolic disorders, problems with the endocrine system, systemic autoimmune diseases (diabetes mellitus, rheumatoid arthritis, gout);
- lack of normal rest and warm-up in the workplace, excessive exercise with dumbbells;
- sleep disorders and chronic stress;
- age-related hormonal changes;
- congenital hand defects;
- hand, finger and wrist injuries;
- hypothermia, work with vibrating instruments and other adverse factors;
- septic and specific (tuberculosis, chlamydia, syphilis) infectious diseases;
- allergic reactions;
- chronic dehydration (the habit of drinking little);
- unbalanced diet without vitamins D, E, K and minerals.
Symptoms of osteoarthritis of the fingers
The symptoms and treatment of osteoarthritis of the finger joint can vary significantly depending on the stage of the disease and the perception of the patient. Mild joint discomfort, increased muscle fatigue are often attributed to fatigue and are neglected until constant nauseating pain occurs. But the sooner treatment is started, the functionality of the fingers will remain fully in old age and a higher quality of life will be in the years to come.
The first phase.The disease begins with a feeling of sore hands, numbness or tingling, sometimes - manifested by excruciating pain. It is becoming increasingly difficult to perform daily duties - fingers get tired faster, dry and rough crunch appears in the joints (it should not be confused with "healthy" sound! ), Clicks when bending. I want to rest my hands. Pain is usually felt only during exercise. In a relaxed state, the fingers hurt for a while and cause discomfort. Rightness of movement is more and more often noticed, before exercises that require manual dexterity, it is necessary to "warm up", stretch the fingers.
Second phase.In this phase, there is a strong narrowing of the joint space (up to 50%), the inflammatory process increases. The skin over the joints often becomes hot. The pain tends to be continuous and cannot stop even at night. After work and in the morning there is swelling, numbness of the fingers. The phalanges noticeably thicken, and the ligaments shorten, awkwardness appears in the movements, which makes it difficult to manipulate small objects (needles, threads, small coins and buttons). Characteristic thickenings of connective tissue (so-called Heberden's and Bouchard's nodules) appear on the sides of the joints, filled with synovial fluid - the cysts are especially clearly visible when viewed from the back of the palms. Tactile and temperature sensitivity of the fingers is significantly reduced. It is almost impossible to relax your hands without warm baths - the muscles are in constant tension. The amplitude of voluntary movements is noticeably reduced, cramps appear.
The third phase.In the last phase of the disease, the fingers practically do not bend, ankylosis and permanent contractures can appear. The pain is constant, exhausting and often causes depression in patients. The phalanges of the fingers between the joints become thinner due to the dystrophy of the muscle tissue. Even simple daily tasks - for example, holding a glass - are practically inaccessible to the patient. He needs the help of others. Deformities of the joints and changes in the shape of the hand are clearly visible. In advanced cases, necrotic changes in the tissues are possible.
If you want to do an express test and figure out if it’s worth worrying about, an article on the symptoms and treatment of osteoarthritis will be helpful to you. However, the best solution would be to contact a rheumatologist or orthopedist as soon as possible - only clinical diagnostic methods will help to finally confirm or refute the diagnosis.
Treatment of osteoarthritis of the fingers
Suppressing arthrosis of the fingers in the early stages allows you to completely eliminate the external symptoms of the disease that affect the quality of life. However, the therapy is complex, multi-vector - it includes not only the use of pharmaceutical products, but also physical impact, and even occupational therapy. Fighting a chronic illness sometimes requires a review of diet, daily routine, working conditions and workplace organization.
Drug treatment
Treatment of osteoarthritis of the fingers, as a rule, begins with the removal of pain, for which the immobilization of the hand with a splint or orthopedic bandage and analgesic tablets, creams and ointments is used. The rest regime helps to rehydrate the cartilage, restoring its elasticity. In the presence of severe inflammation and edema that disrupt tissue trophism (nutrition), the doctor prescribes nonsteroidal anti-inflammatory drugs (NSAIDs) that restore blood circulation in the fingers. According to the indications, steroid hormones are prescribed. Osteoarthritis caused by infectious arthritis requires topical administration of antibiotics.
Chondroprotector intake has been established as one of the most effective measures at any stage of the disease. Chondroitin sulfate and glucosamine must be consumed in courses, approximately 6 months a year - the effect appears after a few months and is long-lasting.
If the proposed treatment does not relieve the pain, analgesics can be injected directly into the joint. This procedure often involves the use of special drug mixtures that also contain chondroprotectors, hyaluronic acid, platelet-rich blood plasma (PRP-therapy) and other means aimed at restoring cartilage tissue and removing friction.
Surgical intervention due to arthrosis of the hand
In the last stages of the disease, according to the indications, surgery can be performed. It is usually rinsing of the joint and removal of osteophytes, reconstruction or formation of the destroyed joint, its stabilization (fusion) or endoprosthetics (so far quite unpopular measure in operations of small wrist joints).
Physiotherapy treatment
In most cases, the disease responds well to conservative physiotherapy treatment - however, it is performed only in the remission phase, after the inflammation subsides. Hardware methods of treating deforming arthrosis of the fingers include electrophoresis, shock wave, UHF, pulse, magnetotherapy and others. Acupuncture is also effective.
Patients are recommended therapeutic massage and self-massage, which helps fight tension and muscle cramps, has a beneficial effect on the condition of the ligaments, metabolism in the hands and fingers, as well as on the amplitude of voluntary movements. For self-massage it is enough:
- rub your palms until the skin is warm;
- rub each finger from base to tips;
- wrap each finger in a slightly clenched fist, like sharpening a pencil;
- bend and flex your fingers quickly for 30 seconds, avoiding squeezing them into fists;
- fold your palms and rest your fingertips against each other, pressing them well for 1-2 minutes.
It includes treatment for osteoarthritis of the fingers and gymnastics. Use rubber balls and special expanders for joints, special cubes and other devices to develop fine motor skills in warm-ups. Modeling from clay or plasticine will not be superfluous. This will help maintain muscle tone and prevent the formation of large osteophytes.
You can also make warm baths at home with water (it is worth adding sea salt, essential oils, herbal teas), paraffin or clean sand - heating the formulations will speed up the removal of decomposition products and allow quick access to nutrients.
Diet for osteoarthritis of the fingers
Patients are advised to follow a strict diet that excludes smoked, salty foods, alcohol, as well as foods with artificial colors, steroids, preservatives. Diet is especially important in the treatment of metabolic arthrosis - in this case it is completely determined by the attending physician. Patients are generally advised to eat meals rich in animal and plant collagen and other gelling substances. Food should contain at least "empty" calories and fully meet the body's daily need for vitamins, macro and micronutrients. It is imperative that you drink enough water with electrolytes, such as mineral or isotonic drinks.