Thinking of the hands of an elderly person, we almost inevitably imagine gnarled fingers, thinned at the phalanges, but as swollen at 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 - osteoarthritis of the fingers. What's more, not everyone knows that this disease can "age" hands in their 25s or 30s, making even writing a simple note or twisting a bottle cap a painful and difficult task. How to maintain fine motor skills of the fingers, who is at risk and what to do with arthrosis of the fingers, if it has already startedread about it below.
Deforming arthrosis of the fingers
The metacarpophalangeal and interphalangeal joints of a person experience a constant load, because for a normal quality of life they have to perform fine motor movements every minute, from simple grasping (taking an apple, opening a door, holding a silverware) to very little ones. and complex (they determine a person's handwriting, her ability to sew and knit, play instruments, and much more). The more intensively the fingers are loaded, the more wear and tear is exposed to the cartilage tissue, which covers the heads of the phalanx 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 glide, so to speak, and also plays the role of a natural shock absorber (for example, during shock movements, without which is impossible to type on the keyboard).
For various reasons, which we will discuss below, interphalangeal cartilage is subject to wear and tear. Most of the time, the process occurs as follows:
- The porous cartilage tissue is subjected to a load in which the joint lubricant is "squeezed out", providing good joint mobility. Normally, after this, recovery occurs: the cartilage is once again saturated with moisture in a calm state. But if the load is excessive or the nutrition of the cartilage is disturbed, it begins to dry out and crack. This leads to a decrease in its elasticity and functionality.
- Unable to resist friction, the resected cartilage gradually begins to wear down and thin, exposing the heads of the bones. Since the articular surface does not fully cope with the task at hand, the bones, muscles and ligaments begin to experience the load provided by the cartilage, almost the entire finger brace, or even the entire hand. To increase the area of the joint surface and prevent further effacement, the body begins to "finish building" osteophytes in the affected area, bony growths that can be rounded and spike-like in shape. Popularly, this process is also called "salt deposition", which is not entirely correct, because we are talking about the proliferation of bone tissue.
- The appearance of osteophytes leads to a decrease in mobility: the fingers bend worse and it is no longer possible to cope with normal daily tasks as dexterously as before. At the same time, bone tissue does not have its own protective mechanism against friction, and therefore osteophytes periodically shed and damage adjacent tissues, causing pain and inflammation. In addition, microscopic cracks are formed that reduce the strength of the bone and make it brittle; therefore, with osteoarthritis 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, breaks, another grows in its place; Over time, the process only worsens along with cartilage dysfunction.
- Severe wear and tear on the joint surfaces, changes in the shape of the bones lead to restructuring of the entire hand, chronic inflammation and pain. The brush is deformed to the point that you can't even grasp the cup with your fingers.
From arthritis, osteoarthritis, which is also called osteoarthritis or osteoarthritis (all of which are synonymous), differs mainly in the destruction of the joint and the chronic course of the disease. While arthritis involves only the presence of an acute inflammatory process that affects cartilage tissue. With osteoarthritis, the joint bag, the synovium, the subchondral bone, as well as the ligaments and muscles are involved in the degenerative-dystrophic process. Also, with arthritis, the pain is usually sharp and severe, appearing at night. Although osteoarthritis makes itself felt during the day, in the early stages, pain is not too pronounced.
The most common forms of osteoarthritis are considered at this time: rhizarthrosis, in which the thumb is involved, and polyarthrosis, which affects 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 the high-quality biomechanics of the hands.
Causes of osteoarthritis of the small joints of the hands.
The risk group often includes family members who have already had arthrosis of the fingers. The density of cartilage tissue and the speed of metabolic processes in it are genetically predetermined, and therefore the propensity to develop the disease can be inherited. Additionally, the disease affects postmenopausal women about 10 times more often than their male peers.
The probability of osteoarthritis increases in relation to professional and domestic burdens: typists, surgeons, masseurs, bakers, milkmaids, turners and millers, pianists, athletes and other professionals who "work with their hands" often notice unpleasant symptoms before others.
The development of arthrosis of the fingers is facilitated by:
- rapid wear and / or insufficient regeneration of cartilage tissue;
- metabolic disorders, endocrine system problems, systemic autoimmune diseases (diabetes mellitus, rheumatoid arthritis, gout);
- lack of normal rest and warm-up in the workplace, excessive exercise with dumbbells;
- sleep disturbances and chronic stress;
- age-related hormonal changes;
- congenital hand defects;
- injuries to the hand, fingers, and wrist joint;
- hypothermia, work with vibrating instruments and other unfavorable factors;
- septic and specific infectious diseases (tuberculosis, chlamydia, syphilis);
- allergic reactions;
- chronic dehydration (the habit of drinking little);
- an unbalanced diet lacking in vitamins D, E, K, and minerals.
Symptoms of arthrosis of the fingers.
Symptoms and treatment of arthrosis of the finger joint can vary significantly depending on the stage of the disease and the perception of the patient. Mild joint discomfort and increased muscle fatigue are often attributed to fatigue and ignored until constant excruciating pain appears. But the sooner treatment is started, the greater the functionality of the fingers in old age and the higher the quality of life in the following years.
First stage.The disease begins with a sensation of pain in the hands, numbness or tingling, sometimes manifesting itself in shooting pains. It becomes more difficult to perform daily tasks: the fingers tire faster, a dry and harsh crunch appears in the joints (not to be confused with a "healthy" sound! ), Clicking when bending. I want my hands to rest. The pain is usually felt only during exercise. In a relaxed state, the fingers hurt for some time and cause discomfort. The stiffness of the movements is observed more and more often, before the exercises that require manual dexterity, there is the need to "warm up", to stretch the fingers. The joints become inflamed. In the presence of cardiovascular diseases, the hands begin to respond to the changing climate.
Second stage.At this stage, there is a strong narrowing of the joint space (up to 50%), the inflammatory process increases. The skin over the joints is often hot. The pain tends to be continuous and may not stop even at night. After work and in the morning, there is swelling, stiffness of the fingers. The phalanges are noticeably thickened and the ligaments are shortened, clumsiness appears in the movements, making the manipulation of small objects (needles, threads, small coins and buttons) more difficult. On the sides of the joints, a characteristic thickening of the connective tissue appears (the so-called Heberden and Bouchard nodules), filled with synovial fluid; cysts are especially clearly visible when viewed from the back of the palms. The touch and temperature sensitivity of the fingers is greatly reduced. It is almost impossible to relax your hands without hot baths: the muscles are in constant tension. The amplitude of voluntary movements is markedly reduced, spasms appear.
Third stage.In the last stage of the disease, the fingers practically do not bend, ankylosis and persistent contractures may appear. The pain is constant, debilitating, and often causes depression in patients. The phalanges of the fingers between the joints become thinner due to dystrophy of muscle tissue. Even simple everyday tasks, for example holding a cup, are practically inaccessible to the patient. You need the help of others. Deformation of the joints and changes in the shape of the hand are clearly visible. In advanced cases, necrotic changes in tissues are possible.
If you want to take a quick test and understand if it is worth worrying, the article on the symptoms and treatment of osteoarthritis will help 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 arthrosis of the fingers.
Controlling 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, therapy is complex, multi-vector: it includes not only the use of pharmaceuticals, but also physical impact and even occupational therapy. Fighting a chronic illness sometimes requires rethinking your diet, daily routine, working conditions, and workplace organization.
Drug treatment
Treatment of osteoarthritis of the fingers, as a rule, begins with the elimination of pain, for which immobilization of the hand with an orthopedic splint or bandage and analgesic tablets, creams and ointments is used. Rest mode helps rehydrate cartilage, restore its elasticity. In the presence of severe inflammation and edema, disrupting the trophism (nutrition) of the tissues, the doctor prescribes non-steroidal anti-inflammatory drugs (NSAIDs), which restore blood circulation in the fingers. As directed, steroid hormones are prescribed. Osteoarthritis caused by infectious arthritis requires topical administration of antibiotics.
The reception of chondroprotectors has established itself as one of the most effective measures at any stage of the disease. Chondroitin sulfate and glucosamine should be consumed in courses, approximately 6 months a year; the effect appears after a few months and is long-term.
If the proposed treatment does not relieve pain, pain relievers can be injected directly into the joint. Often this procedure involves the use of special medicinal mixtures that also contain chondroprotectants, hyaluronic acid, platelet-rich blood plasma (PRP therapy) and other means aimed at regenerating cartilage tissue and eliminating friction.
Surgical intervention for osteoarthritis of the hands.
In the later stages of the disease, as indicated, an operation can be performed. As a rule, it is about redness of the joint and removal of osteophytes, reconstruction or formation of a destroyed joint, its stabilization (fusion) or endoprosthesis (so far a rather unpopular measure in the surgery of small joints of the hands).
Physiotherapy treatment
In most cases, the disease responds well to conservative physiotherapy treatment; however, it is carried out only in the remission stage, after the inflammation has subsided. Apparatus methods for treating deforming osteoarthritis of the fingers include electrophoresis, shock waves, UHF, pulse, magnetotherapy, and others. Acupuncture is also effective.
Therapeutic massage and self-massage are recommended to patients, which helps to combat muscle tension and spasms, has a beneficial effect on the state of the ligaments, the metabolism of the hand and fingers, as well as the range of movements volunteers. For self-massage, it is enough:
- rub the palms of the hands until the skin is warm;
- rub each finger from base to tips;
- wrap each finger into a slightly closed fist, as if sharpening a pencil;
- bend and stretch your fingers quickly for 30 seconds, avoiding clenching them into fists;
- bring your palms together and support your fingertips, pressing well for 1-2 minutes.
It includes the treatment of arthrosis of fingers and gymnastics. Use rubber balls and special wrist expanders, special cubes, and other fine motor development devices during warm-ups. Modeling from clay or plasticine will not be superfluous. This will help maintain muscle tone and prevent large osteophytes from forming.
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 formulas will accelerate the removal of breakdown products and provide quick access to nutrients.
Diet for arthrosis of the fingers.
Patients are advised to follow a non-strict diet to exclude smoked, overly salty foods, alcohol, as well as foods with artificial colors, steroids, and preservatives. Diet is especially important in the treatment of metabolic osteoarthritis; in this case, it is completely determined by the attending physician. As a general rule, patients are advised to eat meals rich in animal and plant collagen and other gelling substances. Food should contain a minimum of "empty" calories and fully provide the body's daily needs for vitamins, macro and microelements. It is imperative that you drink enough water with electrolytes, such as mineral or isotonic drinks.