Thinking of the hands of an elderly person, one almost inevitably imagines gnarled fingers, thinned in the phalanges, but as 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 - osteoarthritis of the fingers. And even more, not everyone knows that this disease can "age" hands to twenty-five or thirty, which makes even writing a simple note or twisting a bottle cap become a painful and difficult task. How to maintain fine motor skills of the fingers, which is at risk and what to do with osteoarthritis of the fingers, if it has already started - read about it below.
Deforming osteoarthritis of the fingers
A person's metacarpophalangeal and interphalangeal joints are under constant stress, as for a normal quality of life they must perform fine motor movements every minute - from simple seizures (picking up an apple, opening a door, holding cutlery) to verysmall and complex (they determine a person's handwriting, ability to sew and knit, play instruments and much more). The more intensely the fingers are loaded, the more wear and tear is exposed to the cartilage tissue, which covers the heads of the phalangeal bones, forming the joint surface. This cartilage layer, washed away by the synovial fluid, allows the bones not to rub against each other when moving, but to somehow slide, and also acts as a natural shock absorber (for example, during the movements ofshock, otherwise it is impossible to type on the keyboard).
For a variety of reasons, which we'll discuss below, interphalangeal cartilage is prone to wear and tear. Most often, the process goes as follows:
- The porous cartilage tissue is subjected to a load in which the joint lubricant is "expelled", ensuring good joint mobility. Normally, after this, recovery occurs - the cartilage is 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 withstand friction, the overdried cartilage begins to gradually wear down and thin, exposing the heads of the bones. Since the joint surface does not fully cope with the task at hand, bones, muscles, and ligaments begin to take the load placed on the cartilage - almost the entire finger brace or even the entire hand. To increase the surface area of the joint surface and prevent it from further erasing, the body begins to "finish building" osteophytes in the affected area - bony growths that can be rounded and even pointed in shape. Popularly, this process is also called "salt deposition" which is not entirely correct, we are talking about the proliferation of bone tissue.
- The appearance of osteophytes leads to reduced mobility - the fingers bend less well, and it is no longer possible to cope with normal daily tasks as skillfully as before. At the same time, bone tissue does not have its own protective mechanism against friction, and as a result, osteophytes periodically break and damage adjacent tissues, causing pain and inflammation. In addition, microscopic cracks are formed, which reduces the strength of the bone and makes it brittle - therefore, with osteoarthritis and osteoarthritis, fractures of the fingers are not uncommon, even as a result of blowsnot too strong. When the osteophyte, which compensates for insufficient functioning of the joint, ruptures, another grows in its place - over time, the process only worsens the dysfunction of the cartilage.
- Severe wear and tear of the joint surfaces, changes in the shape of the bones lead to restructuring of the whole hand, chronic inflammation and pain. The brush is deformed to the point that you can no longer grip the cup with your fingers.
From arthritis, osteoarthritis, also called osteoarthritis or osteoarthritis (which are all synonyms), is distinguished mainly by the destruction of the joint and the chronic course of the disease. While arthritis only involves the presence of an acute inflammatory process affecting the cartilage tissue. With osteoarthritis, the articular bag, synovium, subchondral bone, as well as ligaments and muscles are involved in the degenerative-dystrophic process. In addition, with arthritis, the pain is usually sharp and intense, appearing at night. While osteoarthritis is felt during the day, in the early stages - not too pronounced aching pains.
The most common forms of osteoarthritis today are considered: rhizarthrosis, in which the thumb is involved, and polyarthrosis, which affects several interphalangeal joints at the same time.
Remember: in the early stages of the disease, bone destruction can still be avoided and osteoarthritis can be brought into 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 had arthritis of the fingers in the past. The density of cartilage tissue and the rate of metabolic processes it contains are genetically predetermined, and therefore the propensity to develop the disease can be hereditary. Additionally, the disease affects postmenopausal women about 10 times more often than their male peers.
The likelihood of osteoarthritis increases with professional and household loads - typists, surgeons, masseurs, bakers, milkmaids, turners and millers, pianists, athletes and other professionals who "work with their hands" often notice unpleasant symptoms sooner than others. .
The development of osteoarthritis 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 malformations of the hand;
- 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 (habit of drinking little);
- an unbalanced diet devoid of vitamins D, E, K and minerals.
Symptoms of osteoarthritis of the fingers
Symptoms and treatment for osteoarthritis of the finger joints can vary widely depending on the stage of the disease and the patient's perception. Often, slight discomfort in the joints, increased muscle fatigue are attributed to fatigue and are ignored until the onset of constant excruciating pain. But the earlier the treatment is started, the more the functionality of the fingers will remain complete in old age and the higher the quality of life will be in the following years.
First stage.The disease begins with a feeling of sore hands, numbness or tingling, sometimes - is manifested by throbbing pains. Daily chores become more difficult - fingers get tired faster, a dry, rough crunch appears in the joints (not to be confused with a "healthy" sound! ), Clicks when bending. I want to let my hands rest. Pain is usually only felt during exercise. In a relaxed state, the fingers hurt for a while and cause discomfort. Stiffness of movements is more and more often observed, before exercises that require manual dexterity, it is necessary to "warm up", to stretch the fingers. The joints become swollen. In the presence of cardiovascular disease, the hands begin to react to climate change.
Second step.At this stage there is a strong narrowing of the joint space (up to 50%), the inflammatory process increases. The skin of the joints often becomes 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 noticeably thicken and the ligaments shorten, awkwardness appears in the movements, which makes the handling of small objects (needles, threads, small coins and buttons) more difficult. On the sides of the joints, a characteristic thickening of connective tissue (called Heberden's and Bouchard's nodules), filled with synovial fluid, appears - the cysts are especially clearly visible when viewed from the backs of the palms. The tactile and thermal sensitivity of the fingers is greatly reduced. It becomes almost impossible to relax the hands without hot baths - the muscles are in constant tension. The range of voluntary movements is significantly reduced, spasms appear.
Third step.At 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 the simplest daily tasks - for example, holding a cup - are virtually inaccessible to the patient. He needs help from others. Deformation of the joints and changes in the shape of the hand are clearly visible. In advanced cases, necrotic tissue changes are possible.
If you want to take an express test and understand if it is worth worrying about, the article on Osteoarthritis Symptoms and Treatment will be helpful. However, the best solution would be to contact a rheumatologist or orthopedist as soon as possible - only clinical diagnostic methods will be able to definitively confirm or rule out the diagnosis.
Treatment of osteoarthritis of the fingers
Controlling osteoarthritis of the fingers at an early stage 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 pharmaceuticals, but also the physical impact and even occupational therapy. Fighting a chronic disease sometimes requires rethinking your diet, daily life, working conditions and organization.
Medical treatment
As a rule, the treatment of osteoarthritis of the fingers begins with the elimination of pain, for which immobilization of the hand with a splint or orthopedic bandage and pain relieving tablets, creams and ointments is used. The rest mode allows to rehydrate the cartilage, to restore its elasticity. In the presence of severe inflammation and edema, which disrupt the trophism (nutrition) of tissues, the doctor prescribes nonsteroidal anti-inflammatory drugs (NSAIDs), which restore blood circulation to the fingers. According to the indications, steroid hormones are prescribed. Osteoarthritis caused by infectious arthritis requires topical administration of antibiotics.
Reception of chondroprotectors has emerged as one of the most effective measures at all stages of the disease. Chondroitin sulfate and glucosamine should be consumed as a cure, about 6 months per 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. Often this procedure involves the use of special medicinal mixtures that also contain chondroprotectors, hyaluronic acid, platelet-rich blood plasma (PRP therapy) and other means aimed at regenerating cartilage tissue and eliminating friction.
Surgery for osteoarthritis of the hands
In the later stages of the disease, depending on the indications, an operation can be performed. As a rule, this is the flushing of the joint and the removal of osteophytes, the reconstruction or formation of a destroyed joint, its stabilization (fusion) or the stent (up topresent a rather unpopular measure in small joint surgery of the hands).
Physiotherapy treatment
In most cases, the disease responds well to conservative physiotherapy treatment - however, it is carried out only at the stage of remission, after the inflammation subsides. Device methods for treating deforming osteoarthritis of the fingers include electrophoresis, shock wave, UHF, pulse, magnetotherapy, and others. Acupuncture is also effective.
Therapeutic massages and self-massages are recommended for patients, which help to combat muscle tension and spasms, have a beneficial effect on the condition of the ligaments, the metabolism of the hand and fingers, as well as on the amplitudevoluntary movements. For self-massage, all you need to do is:
- rub your palms together until the skin is warm;
- rub each finger from base to tip;
- roll each finger in a slightly clenched fist, as if sharpening a pencil;
- bend and unfold your fingers quickly for 30 seconds, avoiding clenching them into fists;
- put your palms together and rest your fingers together, pressing them well for 1-2 minutes.
Includes the treatment of osteoarthritis of the fingers and gymnastics. Use rubber balls and special wrist extenders, special cubes and other devices for the development of fine motor skills during 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 prepare hot 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 process. removal of decomposition products and will provide rapid access to nutrients.
Diet for osteoarthritis of the fingers
Patients are advised to follow a non-strict diet that excludes smoked, too salty foods, alcohol, as well as foods containing artificial colors, steroids and preservatives. Diet is especially important in the treatment of metabolic osteoarthritis - in this case, it is entirely determined by the attending physician. As a rule, patients are advised to eat meals rich in animal and plant collagen and other gelling substances. Food must contain a minimum of "empty" calories and fully meet the daily needs of the body in vitamins, macro and microelements. It is imperative to drink enough water with electrolytes, such as mineral or isotonic drinks.