Joint painthe fingers are an indispensable sign of any joint pathology in which the structural elements of these joints are damaged. First, the pain of these joints may be associated with various autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, etc.), in which immune factors damage their own joint tissues.
The next main reason you can startpaininjuries to the finger joints (bruises, dislocations, bone fractures, ligament damage). Pain in these joints can also be triggered by degenerative changes in their joint tissues. This is often observed in osteoarthritis.
Anatomy of hand joints
All joints of the hand are usually divided into the following groups:
- wrist joint;
- wrist joints;
- carcinomaxarpal joints;
- interparpal joints;
- metacarpophalangeal joints;
- interphalangeal joints.
The wrist joint is the proximal (upper) wrist line (three-headed, moon-shaped, scaphoid bones) and the distal parts of the radius and ulna. The ulna is not directly connected to the bones of the wrist but to the distal (lower) articular disc. This structure separates the cavity of the wrist from the distal (lower) the radioulinum joint.
The wrist joints are represented by three types of joints. The first type includes joints located between the upper bones (navicular, moon-shaped, triangular, pea-shaped) or the bottom line (hook-shaped, capitate, trapezoidal, bone-trapezoidal). These joints are called intercarpal joints. The second type is called the carpal middle joint. This joint is S-shaped and is formed by joining the bones of the upper and lower rows of the wrist. The third type is the pisiform bone joint. Through this joint, the triangular bone is connected to the pisiform bone.
Carcinomaxarpal joints connect the wrist and metacarpal bones. These joints are formed by the contact of the proximal ends (reasons) the second row of the metacarpals and the distal sections of the carpal bones. The carpometacarpal joints contain two main joints. The first is the carpometacarpal joint of the thumb. It is formed when the first metacarpal bone and the trapezoidal bone meet.
The second joint is the common carpometacarpal joint for the other carpometacarpal joints between the second, third, fourth, fifth metacarpal bone and the location of the trapezoid, capitate, hook-shaped bones and, in part, the trapezoidal bone. The carpometacarpal joint of the thumb separates from the common carctacarpal joint. As a result, more active movements are possible in it compared to other carpometacarpal joints (which are part of the common carpometacarpal joint), which are considered inactive. Carcinomaxarpal joints are filled with strong joint capsules and tapes (dorsal and palm carpometacarpal ligaments).
The lateral surfaces of the second, third, fourth, and fifth metacarpal bones contact each other to form intercarpal joints. These joints have separate joint capsules that approach and join the carpometacarpal joint capsules. In addition to the capsule, these joints have a ligament device represented by the interosseous metacarpal ligaments and the dorsal and palmar metacarpal ligaments. The intercarpal joints are classified as the sitting joints of the hand because the joint surfaces of the bones that make up these joints are flat.
Metacarpophalangeal joints are distal (Lower) the end of the metacarpal bones and the proximal (upper) areas of the first walls of the fingers. Each toe of the upper limb has its own metacarpophalangeal joint. Thus, there are five metacarpophalangeal joints in each arm.
Interphalangeal joints are formed by connecting adjacent phalanges of each finger. Large (first) has only one interphalangeal joint, as this finger has only two phalanges (proximal and distal). The fingers of both hands have two interphalangeal joints.
The first is localized between the first (proximal) and the second (average) and the proximal (to the top) interphalangeal joint. The second link is established by the middle (second) and the last one (distal) finger bells. The second interphalangeal joints are called distal interphalangeal joints. The interphalangeal joints are strengthened by the collateral and palmar ligaments. These joints belong to block joints in which movements are only possible around the frontal plane (extension and bending).
What structures can ignite in the joints of the hands?
Inflammation is a typical pathological process that characterizes tissues and organs that have been damaged for any reason. It is worth noting that in most cases, individual diseases (such as gout, rheumatoid arthritis, etc.) or injury to the joints of the hand to one degree or another affects not only the joint but also the periarticular (nerves, muscles, tendons, subcutaneous fat, skin) structure.
The following joint structures can become inflamed in the joints of the hands:
- articular cartilage;
- subchondral bone tissue;
- joint capsule;
- joint ligaments.
Causes of pain in the joints of the hands and fingers
The main cause of pain in the joints of the hands and fingers is mechanical injury (fractures, displacements, bruises, etc. ) and systemic autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, psoriasis, etc.). In addition to these causes, pain in the joints of the hand can cause metabolic disorders (such as gout, osteoarthritis).
There are the following main causes of pain in the joints of the hands and fingers:
- bruised hands and fingers;
- fracture of the bones of the hand;
- hand movement;
- damage to the ligaments of the hand;
- rheumatoid arthritis;
- Kienbeck's disease;
- reactive arthritis;
- psoriatic arthritis;
- systemic lupus erythematosus.
Crushed hands and fingers
Bruising is a type of closed injury in which soft tissue damage occurs (muscles, tendons, nerves, skin) and there are no wounds at the site where the main effect of the traumatic factor was directed. Bruises on the soft parts of the hands and fingers are very rare in themselves (separately) from bruises on the joints of the hands and fingers. Therefore, this type of injury causes mixed symptoms, indicating both joint and periarticular damage to the hand (periarticular) fabrics. Bruising of the hand and fingers usually occurs when the hand falls, a blunt object is injured, or is squeezed or pinched.
Bruising of the wrist zone often leads to damage to the main trunk of the middle, radial, ulnar nerves (which innervate the area of the hand and fingers), which is immediately manifested by loss of skin sensitivity and, in some cases, even loss of motor functions of the fingers.
Inflammatory edema of the joint and periarticular structures results from the dilation of the many vessels that supply them with blood. This edema is one of the inflammatory reactions that occur in response to tissue damage resulting from injury.
Fracture of the bones of the hand
The cause of pain in the joints of the hand can often be different fractures of the bones, as these bones are directly involved in the formation of the joint surfaces. Depending on the anatomical position of the damaged bone, all fractures are divided into three main groups. The first group includes fractures of the wrist bones. The second contains fractures of tubular metacarpal bones. The third group includes fractures of the phalanges of the fingers.
The most common sites of injury to the wrist of the hand are the lunar and scaphoid bones. Fracture of these bones occurs when it falls on the hand and causes pain in the middle of the wrist and carp. Pain syndrome can also be observed at the site of anatomical localization of these bones.
The most common fracture of the metacarpal bone ends is the fracture of the base of the first metacarpal bone (the one adjacent to the wall bones of the thumb bones). This injury causes swelling and pain in the area of the base of the first metatarsal and in the part of the carpometacarpal joint that is directly adjacent to it. In the event of such a fracture, the thumb is shortened, bent and placed on the palm. His movements are limited.
Fracture of the walls of the hand is accompanied by deformation, decreased length of the fingers, loss of function, sharp pain and swelling in the interphalangeal joints and periarticular tissues. Fracture of the walls of the fingers as the pieces of bone move, palpation (by touch), they can identify their convex shapes on the palm surface of the hand, and on their backs, on the contrary, a fossa or retraction. These debris are usually motile, with subcutaneous bleeding often found nearby (blood clots).
Dislocation is a pathological condition in which parts of the bones that make up a joint extend beyond its anatomical boundaries, thus manifested by the complete or partial loss of function of that joint. In addition to impaired joint function in dislocations, there are also severe pain in the affected joint area, swelling and local temperature rise. With the movements of the hand, the appearance of swelling is explained not only by the presence of inflammation in the damaged periarticular tissues as well as in the structures of the joint, but also by the protrusion of the bone formed from this joint.
The most common types of hand movements
|Name of displacement||Dislocation mechanism||Which joint is affected?|
|True hand dislocation||The joint surfaces of the wrist bones move relative to the joint surface of the beam toward the palm or the back of the hand.||
|Perilunar dislocation||The wrist and other bones of the hand move relative to the moon and its radius points to the back of the hand.||
|Displacement of the scaphoid||In this dislocation, the scaphoid bone moves parallel to the radial side (in the same plane) to nearby wrists. Sometimes it may move to the radial side of the palm, i. e. , the palm side of the trapezoidal bone, less often to the same side of the trapezoidal bone.||
|Lunate displacement||The lunar bone slides toward the palm, leaving the space for this bone empty. It gradually occupies the capitate bone, which penetrates here from the second row of bone in the wrist. This dislocation is a complication of self-reduction of perilunar dislocation.||
|Displacement of the first metacarpal bone||The joint surface of the base of the first metacarpal bone moves upwards relative to the joint surface of the trapezoidal bone (next time) and in the same plane as the wrists. Thus, your thumb is pulled slightly backwards and towards the wrist joint.||
|Displacement of the walls of the fingers||There is displacement of the fingers in the metacarpophalangeal joints and the interphalangeal joints. First, the joint surface of the proximal phalanx of the fingers (with the whole finger) relative to the articular surface of the metacarpal bones. With the second, there is a displacement between the bones of the phalanges of the finger. Dorsal and palm dislocations of the phalanges of the fingers are usually found.||
Alteration of the ligaments of the hand
The defeat of the ligaments as well as the bruising of the hand are called closed traumatic injuries. This pathology occurs mainly with excessive extension of the hand and fingers in any direction. The main types of wrist lesions are stretching and cracking. Stretched in the damaged area is a slight razvlecheniya and partial rupture of connective tissue fibers. When the ligaments rupture, the entire ligament is split into two unconnected ends.
The main types of tears in the hand bands are:
- rupture of the radial collateral band of the wrist;
- rupture of the ulnar collateral ligament of the wrist;
- rupture of intercarpal ligaments;
- rupture of the lateral ligaments of the metacarpophalangeal joints;
- rupture of the lateral ligaments of the interphalangeal joints.
Rheumatoid arthritis is a disease in which a person’s immune system damages the body’s own tissues. In other words, rheumatoid arthritis is an autoimmune pathology. This disease is also systemic as it affects many tissues (muscles, joints, blood vessels, etc.) and bodies (heart, kidneys, lungs, etc.) in the body.
Despite the fact that rheumatoid arthritis is a systemic disease, the joints suffer to a greater extent, while damage to other tissues and organs is pushed into the background. Almost all types of hand joints can be affected by this disease (radiocarpal, carpometacarpal, metacarpophalangeal, interphalangeal joints). Defeat is usually symmetrical (those. the same joints are affected) swelling and pain in both hands accompanied by damaged joints. In the morning, as you get out of bed, there is some stiffness in the affected joints that can last for about 1 hour and then disappear without a trace.
Quite often, in rheumatoid arthritis near the affected joints of the hand (more often metacarpophalangeal, interphalangeal joints) rheumatic nodules appear. These are rounded formations that are located under the skin. These formations, on the other hand, most commonly occur on the posterior side. They are thick to the touch, inactive and painless. Their number may vary.
Kienbeck disease is a pathology in which the lunate carpal bone of the hand is affected. The disease develops as a result of prolonged physical overload of the palm. Usually professionals in the construction professions - plasterers, masons, carpenters, etc. - occur between. Excessive physical exertion of the palm most often damages this bone as it occupies a central position in the wrist joint. In Kienbeck’s disease, it most often affects one hand and is usually the main (right-handers injure their right hand, left-handers - left).
Reactive arthritis is a pathology of immunopathological genesis in which the body's own immune system attacks various joints in the body and therefore develops autoimmune inflammation. Unlike other autoimmune diseases (such as rheumatoid arthritis, systemic lupus erythematosus, which are suspected to be of infectious origin) in reactive arthritis is clearly related to previous infection (and especially intestinal or urogenital) and the development of joint lesions.
Furthermore, with this pathology, lymph nodes may grow and fever may appear. With the transition of reactive arthritis to chronic form, patients may show signs of kidney disease, heart disease, weight loss, muscle wasting, bursitis (inflammation of the periarticular sacs), tendovaginitis (inflammation of the tendon sheath) and so on.
Gout is a disease based on the accumulation of uric acid and its deposition in the form of salts in the joints. Uric acid is the end product of the exchange of purine and pyrimidine bases. They serve as the basis for DNA and RNA molecules, certain energy compounds (adenosine triphosphate, adenosine monophosphate, etc.) and vitamins.
Gout pain occurs primarily in the small joints of the lower and upper limbs. Moreover, in 50% of all clinical cases, the disease begins with the first metatarsal joint of the legs. On the hands, the interphalangeal joints of the fingers are usually affected, less often the wrist joints. Gout usually affects one or more joints in one limb, and sometimes joints in other limbs are also affected.
Arthritis of psoriasis is a pathology in which various joints become inflamed in the background of psoriasis. The development of psoriasis is based on a violation of the interaction between immune cells and skin cells, which results inand especially in the skin) there are autoimmune reactions that cause inflammation.
Synovitis is an inflammation of the synovial membrane of the joints, which is damaged by its tissues and abnormal fluid accumulates in the affected joints. Synovitis is not a separate disease but a complication of other diseases. Endocrine, allergic, infectious, autoimmune pathologies, hand injuries, etc. may occur.
Osteoarthritis is a disease in which the processes of normal cartilage tissue formation are disrupted in various joints. These processes are influenced by certain external and internal predisposing factors. There may be permanent joint injuries, prolonged physical activity (at work, at home, while playing sports), heredity, other joint diseases, etc.
The joints of the fingers hurt with this pathology because the periarticular (periarticular) tissue inflammation occurs, nerves are affected. A characteristic feature of osteoarthritis is the relationship between pain and physical activity. Joint pain occurs primarily during and / or after severe physical exertion and resolves at rest or at rest.
Systemic lupus erythematosus
Systemic lupus erythematosus is an autoimmune pathology in which the immune system produces autoimmune antibodies that attack various structures in cells and tissues. In particular, it produces so-called antinuclear antibodies, which damage cell nuclei and DNA and RNA molecules. In lupus erythematosus, various tissues and organs are affected - skin, blood vessels, heart, pleura, pericardium, kidney, joints, etc.
Systemic lupus erythematosus is constantly associated with other non-joint symptoms such as weakness, weight loss, fever (increased body temperature). However, the most important are the special symptoms without which the diagnosis of lupus erythematosus cannot be made. These specific signs of photodermatitis (dermatitis caused by sunlight), discoid rash (appearance on the skin of the neck, chest of red papules), lupoid butterfly (appearance of red spots on the skin near the nose), erosion in the oral cavity, kidney damage (glomerulonephritis), serositis (inflammation of serous membranes) and so on.
Diagnosis of the causes of pain in the joints of the hand
The diagnosis and treatment of the causes of pain in the joints of the hand is primarily dealt with by a traumatologist and rheumatologist. To diagnose such causes, these doctors are mainly clinical (collection of medical history, external examination, palpation, etc.), radius (radiography, computed tomography) and laboratory (general blood test, biochemical blood test, etc.) research methods.
Depending on the cause of hand joint pain, all diagnostics can be divided into the following stages:
- diagnosis of traumatic hand injuries (bruises, dislocations, fractures, ligament damage);
- diagnosis of rheumatoid arthritis;
- diagnosis of Kienbeck's disease;
- diagnosis of reactive arthritis;
- diagnosis of gout;
- diagnosis of psoriasis arthritis;
- diagnosis of synovitis;
- diagnosis of osteoarthritis;
- diagnosis of systemic lupus erythematosus.
Diagnosis of traumatic hand injuries
In case of hand injuries, consult a traumatologist. The main diagnostic methods used in medical practice to identify traumatic hand injuries (fractures, displacements, band injuries, bruises), external examination, medical history, radiation research methods (radiography, computed tomography).
Collecting anamnestic data allows the physician to identify events that have led or could have led to hand injury. In addition, the patient's symptoms are clarified by collecting a medical history. External examination of the hand can detect edema, hematoma, its deformation, restriction of joint mobility. With the help of palpation, the doctor reveals the presence of pain, violation of the anatomical shape of the joint, damage to the ligaments. Radiation research methods (radiography, computed tomography) allows the diagnosis to be confirmed, as mechanical damage to the anatomical structure of the hand is clearly visible when used.
Treatment of pathologies that cause inflammation of the joints of the hand
To treat the causes of pain in the joints of the hands and fingers, doctors first prescribe various medicines (anti-inflammatory, analgesic, anti-rheumatic drugs, etc.). In some cases, the use of these funds is combined with physiotherapy procedures. Traumatic hand injuries are most often treated with surgery or drywall is applied to the affected upper limb.
First-aid external NSAIDs may be used to relieve pain and inflammation. The drug selectively blocks COX-2 and acts directly on the source of the pain. Due to its special texture, it is quickly absorbed, leaves no traces on clothes, and has a pleasant scent.
Depending on the pathology that causes inflammation in the joints of the hand, each treatment can be divided into the following parts:
- treatment of traumatic hand injuries (bruises, dislocations, fractures, ligament damage);
- treatment of rheumatoid arthritis;
- treatment of Kienbeck's disease;
- treatment of reactive arthritis;
- gout treatment;
- treatment of psoriasis arthritis;
- treatment of synovitis;
- treatment of osteoarthritis;
- treatment of systemic lupus erythematosus.