Thinking about the hands of an elderly person, we almost inevitably imagine gnarled fingers, thinned in the phalanges, but as swollen in the joints. Few people think that this is not just a sign of the natural aging of the body, but a symptom of a real disease - osteoarthritis of the fingers. What's more, not everyone knows that this disease can "age" the hands at twenty-five or thirty, which also makes writing a simple note or turning 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 osteoarthritis of the fingers, if it has already begun - read below.
Deforming arthrosis of the fingers
The metacarpophalangeal and interphalangeal joints of a person undergo a constant load, because for a normal quality of life he has to perform fine motor movements every minute - from simple gripping movements (taking an apple, opening a door, holding a cutlery) to a lot small and complex (they determine a person's handwriting, his ability to sew and knit, play instruments and much more). The more intensely the fingers are loaded, the greater the wear of the cartilage tissue, which covers the heads of the phalangeal bones, forming the joint surface. This cartilage layer, washed by the synovial fluid, allows the bones not to rub against each other during movement, but to slide, as it were, and also plays the role of a natural shock absorber (for example, during d bump, without which it is impossible to type on the keyboard).
For various reasons, which we will discuss below, the interphalangeal cartilage is subject to wear and tear. Most often, the process occurs as follows:
- The porous cartilage tissue undergoes a load where the joint lubricant is "squeezed" from it, providing 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 break down. This leads to a decrease in its elasticity and functionality.
- Unable to resist friction, excessively dry cartilage begins to gradually wear away and become thinner, exposing the heads of the bones. As the joint surface is not fully capable of coping with the task at hand, bones, muscles and ligaments begin to experience the expected load on the cartilage - almost the entire orthopedic system of the finger or even the entire hand. To increase the joint surface area and prevent it from being erased further, 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 quite 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 activities with the same skill as before. At the same time, bone tissue does not have its own mechanism of protection against friction and therefore osteophytes periodically break down 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 down, another grows in its place - over time, the process only aggravates along with the dysfunction of the cartilage.
- Severe wear of 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 grip the cup with your fingers.
From arthritis, osteoarthritis, which is also called osteoarthritis or osteoarthritis (all synonyms), differs mainly in the destruction of the joint and the chronic course of the disease. While arthritis only implies the presence of an acute inflammatory process affecting the cartilage tissue. With arthrosis, the articular bag, 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 severe, appearing at night. While osteoarthritis makes itself felt during the day, in the early stages - not too pronounced aching pains.
The most common forms of osteoarthritis are considered at the moment: 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 prevented and osteoarthritis can be brought into permanent remission by maintaining the high-quality biomechanics of the hands.
Causes of arthrosis of the small joints of the hands
The risk group often includes people in the family who have already had diseases of osteoarthritis 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 hereditary. Additionally, the disease affects postmenopausal women about 10 times more often than their male peers.
The likelihood of osteoarthritis increases in relation to professional and domestic burdens: typists, surgeons, massage therapists, bakers, milkmen, 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 warming up in the workplace, excessive exercise with dumbbells;
- sleep disturbances and chronic stress;
- age-related hormonal changes;
- congenital defects of the hand;
- injuries to the hand, fingers and wrist joint;
- hypothermia, working with vibrating tools 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 patient's perception. Often, mild discomfort in the joints, increased muscle fatigue is attributed to fatigue and is ignored until constant excruciating pain appears. But the earlier the treatment is started, the more fully the functionality of the fingers will remain in old age and the better the quality of life will be in the following years.
First stage.The disease begins with a feeling of sore hands, numbness or tingling at times - manifested in excruciating pain. It becomes more difficult to carry out everyday activities: the fingers get tired faster, a dry, rough crunch appears in the joints (not to be confused with the "healthy" sound! ), Clicks when bending. I want to rest my hands. The pain is usually only felt during exercise. In a relaxed state, the fingers hurt for some time and cause discomfort. Rigidity of movements is increasingly observed, before exercises requiring manual dexterity, it is necessary to "warm up", stretch your fingers. The joints swell. In the presence of cardiovascular disease, the hands begin to respond to the change in weather.
Second phase.At this stage, there is a sharp narrowing of the joint space (up to 50%), the inflammatory process increases. The skin over the joints often becomes warm. The pain tends to be continuous and may not go away even at night. After work and in the morning, there is swelling, stiffness in the fingers. The phalanges thicken noticeably and the ligaments shorten, clumsiness in movements appears, as a result of which the manipulation of small objects (needles, threads, small coins and buttons) is more difficult. On the sides of the joints, the characteristic thickenings of the connective tissue appear (the so-called Heberden and Bouchard nodules), filled with synovial fluid - the cysts are especially clearly visible when viewed from the back of the palms. The tactile and thermal sensitivity of the fingers is significantly reduced. It becomes almost impossible to relax the hands without hot baths: the muscles are in constant tension. The amplitude of voluntary movements is noticeably 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 the dystrophy of the muscle tissue. Even simple daily activities, such as holding a cup, are practically inaccessible to the patient. He needs the help of others. The deformation 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 take a quick test and figure out if it's worth worrying, 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 help confirm or definitively refute the diagnosis.
Treatment of arthrosis of the fingers
Control of 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 pharmaceuticals, but also physical impact and even occupational therapy. Fighting chronic illness sometimes requires you to rethink your diet, daily routine, working conditions, and workplace organization.
Pharmacological treatment
Treatment of osteoarthritis of the fingers, as a rule, begins with the elimination of pain, for which immobilization of the hand with a splint or orthopedic bandage and analgesic compresses, creams and ointments is used. The rest mode helps to rehydrate the cartilage, restore its elasticity. In the presence of severe inflammation and edema, which disrupts the trophism (nutrition) of tissues, the doctor prescribes non-steroidal anti-inflammatory drugs (NSAIDs), which restore blood circulation in the fingers. According to the indications, steroid hormones are prescribed. Osteoarthritis caused by infectious arthritis requires topical administration of antibiotics.
Reception of chondroprotector has established itself as one of the most effective measures at any stage of the disease. Chondroitin sulfate and glucosamine must be consumed in courses, about 6 months a year - the effect appears after a few months and is long-lasting.
If the proposed treatment does not relieve pain, analgesics can be injected directly into the joint. Often, this procedure involves the use of special medicinal mixtures that also contain chondroprotector, hyaluronic acid, platelet-rich blood plasma (PRP therapy) and other means aimed at regenerating cartilage tissue and eliminating friction.
Surgery for arthrosis of the hands
In the last stages of the disease, according to the indications, an operation can be performed. As a rule, this is the washing of the joint and the elimination of osteophytes, the reconstruction or formation of a destroyed joint, its stabilization (fusion) or endoprosthesis (so far 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 performed only in the phase of remission, after the inflammation has subsided. The methods of the apparatus for the treatment of deforming arthrosis of the fingers include electrophoresis, shock waves, UHF, wrist, 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 condition of the ligaments, the metabolism of the hand and fingers, as well as 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;
- roll each finger into a slightly closed fist, like sharpening a pencil;
- quickly bend and straighten your fingers for 30 seconds, avoiding clenching them into a fist;
- join your palms and rest your fingertips against each other, pressing them well for 1-2 minutes.
It includes the treatment of arthrosis of the fingers and gymnastics. Use rubber balls and special wrist expanders, special cubes and other devices for developing fine motor skills while warming up. Modeling from clay or plasticine will not be superfluous. This will help maintain muscle tone and prevent large osteophytes from forming.
You can also take warm baths at home with water (it is worth adding sea salt, essential oils, herbal teas), paraffin or clean sand - heating the formulations will accelerate the elimination of decomposition products and provide quick 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 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. As a rule, meals rich in animal and vegetable collagen and other gelling substances are recommended for patients. Food should contain a minimum of "empty" calories and fully provide the body's daily need for vitamins, macro and microelements. It is imperative to drink enough water with electrolytes, such as mineral or isotonic drinks.