Thinking of an elderly person’s hands, we almost inevitably imagine scratched fingers, diluted in the phalanx, but as if they are swollen at the joints. Few people think that this is not just a sign of natural aging of the body, but a symptom of a real disease - osteoarthritis of the fingers. And even more, not everyone knows that this disease can "age" the hands either in twenty-five or thirty, which makes even writing a simple note or twisting a bottle cap a painful taskand difficult. How to maintain excellent finger motor skills, who is at risk and what to do with osteoarthritis of the fingers, if it has already started - read about it below.
Osteoarthritis of the fingers
A person's metacarpophalangeal and interphalangeal joints experience a constant load, because for a normal quality of life he has to make fine motor movements every minute - from simple clamping ones (take an apple, open a door, hold a cutlery) tovery small and complex ones (they define a person's handwriting, his ability to sew and knit, play instruments and much more). The more the fingers are loaded, the more the ear is exposed to the cartilage tissue, which covers the phalanx bone heads, forming the surface of the article. This cartilaginous layer, washed by the synovial fluid, allows the bones not to rub against each other when moving, but to slide, so to speak, and also acts as a natural shock absorber (for example, during shocking movements, without whichit is impossible to type on the keyboard).
For various reasons, which we will discuss below, the interphalangeal cartilage is subject to consumption. Most often, the process occurs as follows:
- The porous cartilage tissue undergoes a load in which the joint lubricant is "squeezed" by it, ensuring good joint mobility. Normally, after that, recovery occurs - the cartilage is again saturated with moisture in a calm state. But if the load is excessive or the cartilage nutrition is broken, it starts to dry out and crack. This leads to a decrease in its elasticity and functionality.
- Unable to resist friction, the dried cartilage gradually begins to be consumed and becomes thinner, exposing the bone heads. Since the articular surface does not fully cope with the task in question, the bones, muscles, and ligaments begin to experience the anticipated load on the cartilage - almost the entire orthopedic apparatus of the finger or even the entire hand. To increase the area of the articular surface and prevent it from being further erased, the body begins to "finish building" osteophytes in the affected area - bone growths that may have a rounded and even rivet-like shape. In the people, this process is otherwise called "salt deposition", which is not completely accurate, 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 skillfully as before. At the same time, bone tissue does not have its own mechanism of protection against friction, and therefore osteophytes break down and periodically damage adjacent tissue, causing pain and inflammation. In addition, microscopic cracks form, which reduce the strength of the bone and make it brittle - therefore, with osteoarthritis and osteoarthritis, fractures of the fingers are not uncommon, even from not very 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 worsens along with the cartilage dysfunction.
- Heavy wear of articular surfaces, changes in bone shape lead to restructuring of the whole hand, chronic inflammation and pain. The brush is deformed to the point of complete inability to catch even the mug with the fingers.
From arthritis, osteoarthritis, which is also called osteoarthritis or osteoarthritis (all of which are synonymous), differs mainly in the destruction of joints and the chronic course of the disease. Whereas arthritis means only the presence of an acute inflammatory process affecting the cartilage tissue. With osteoarthritis, articular bags, synovium, subchondral bones, 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. While osteoarthritis makes itself sensitive during the day, in the early stages - pain not too pronounced.
The most common forms of osteoarthritis at the moment are considered: rhizarthrosis, which involves the thumb, 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 to permanent remission by maintaining high quality hand biomechanics.
Causes of osteoarthritis of the small joints of the hands
The risk group often includes people in the family who have already had osteoarthritis. The density of cartilage tissue and the rate of metabolic processes in it are genetically predetermined, and therefore the tendency to develop the disease may be hereditary. Also, the disease affects postmenopausal women about 10 times more often than their male peers.
The possibility of osteoarthritis increases with regard to occupational and domestic workloads - typists, surgeons, masseurs, bakers, milkmaids, turners and mills, pianists, athletes and other professionals who "work with their hands" often notice unpleasant symptoms sooner than later. others.
The development of osteoarthritis of the fingers is facilitated by:
- rapid wear and / or insufficient cartilage tissue regeneration;
- metabolic disorders, problems with the endocrine system, systemic autoimmune diseases (diabetes mellitus, rheumatoid arthritis, gout);
- lack of rest and normal warmth in the workplace, excessive exercise with dumbbells;
- sleep disorders and chronic stress;
- age-related hormonal changes;
- congenital defects of the hands;
- injuries to the hand, fingers and ankle;
- hypothermia, work with vibrating instruments and other adverse factors;
- septic and specific (tuberculosis, chlamydia, syphilis) infectious diseases;
- allergic reactions;
- chronic dehydration (habit of drinking little);
- an unbalanced diet that lacks vitamins D, E, K and minerals.
Symptoms of osteoarthritis of the fingers
The symptoms and treatment of osteoarthritis of the finger joints can vary significantly depending on the stage of the disease and the patient's perception. Often, mild joint discomfort, increased muscle fatigue is attributed to fatigue, and is ignored until persistent excruciating pain appears. But the sooner treatment begins, the more fully the functionality of the fingers will remain in old age and the higher will be the quality of life in subsequent years.
The first phase.The disease begins with a feeling of pain in the hands, numbness or tingling, sometimes - manifested in shooting pain. It becomes more difficult to perform daily tasks - fingers get tired faster, dry and sharp crisis appears in the joints (not to be confused with "healthy" noisy! ), Clicks when you bend over. I want to give my hands a break. The pain is usually felt only during exercise. In a relaxed state, the fingers ache for some time and cause discomfort. Stiffness of movements is observed more and more often, before exercises that require manual dexterity, there is a need for "warm-up", to stretch the fingers. The joints swell. In the presence of cardiovascular disease, the hands begin to respond to changing weather.
Second phase.At this stage, there is a strong narrowing of the joint space (up to 50%), the inflammatory process increases. The skin over the joints often heats up. The pain tends to be constant and may not even stop at night. After work and in the morning, there is swelling, stiffness of the fingers. The phalanges thicken considerably and the ligaments shorten, awkwardness appears in motion, due to which the manipulation of small objects (needles, threads, small coins and buttons) is more difficult. On the sides of the joints, the characteristic thickening of the connective tissue (the so-called Heberden and Bouchard joints) appears, filled with synovial fluid - the cysts are especially visible when viewed from the back of the palms. The sensitivity of touch and temperature of the fingers is greatly reduced. It becomes almost impossible to relax your hands without a warm bath - the muscles are in constant tension. The amplitude of voluntary movements is significantly reduced, spasms appear.
The third stage.In the last stage of the disease, the fingers practically do not bend, persistent ankylosis and contractures may appear. The pain is persistent, debilitating, and often causes depression in patients. The phalanges of the fingers between the joints become thinner due to dystrophy of the muscle tissue. Even simple daily tasks - for example, holding a cup - are virtually inaccessible to the patient. He needs the help of others. The deformation of the joints and the changes in the shape of the hand are clearly visible. In advanced cases, necrotic changes in tissues are possible.
If you want to do an express test and find out if it is worth worrying about, the article on the symptoms and treatment of osteoarthritis will be useful for you. However, the best solution would be to contact a rheumatologist or orthopedist as soon as possible - only clinical diagnostic methods will help to definitively confirm or disprove the diagnosis.
Treatment of osteoarthritis of the fingers
Controlling osteoarthritis 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 involves not only the use of pharmaceutical products, but also physical impact, even occupational therapy. Fighting a chronic illness sometimes requires rethinking diet, daily routine, working conditions and workplace organization.
Medication 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 bandage or bandage and analgesic tablets, creams and oils are used. Resting mode helps rehydrate the cartilage, restoring its elasticity. In the presence of severe inflammation and edema, which disrupt tissue trophism (nutrition), the doctor prescribes non-steroidal 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 local administration of antibiotics.
The reception of chondroprotectors has been established as one of the most effective measures at every stage of the disease. Chondroitin sulfate and glucosamine should be consumed in courses, about 6 months a year - the effect appears after a few months and is long-term.
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.
Surgical intervention for osteoarthritis of the hands
In the later stages of the disease, according to the indications, an operation can be performed. As a rule, this is the redness of the joints and the elimination of osteophytes, the reconstruction or formation of a broken joint, its stabilization (fusion) or endoprosthetics (so far a rather unpopular measure in the operation of small joints of the hands).
Physiotherapy treatment
In most cases, the disease responds well to conservative physiotherapy treatment - however, it is only performed in the remission phase, once the inflammation has subsided. Apparatus methods for treating deforming osteoarthritis 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 to combat muscle tension and spasms, has a beneficial effect on the condition of the ligaments, metabolism in the hand and fingers, as well as the amplitude of voluntary movements. For self-massage, it is enough:
- rub your palms until the skin heats up;
- rub each finger from the base to the tips;
- roll each finger into a slightly clenched fist, as if sharpening a pencil;
- bend and release the fingers quickly for 30 seconds, avoiding squeezing them into fists;
- place the palms together and support the fingertips against each other, pressing them well for 1-2 minutes.
Includes treatment of toe osteoarthritis and gymnastics. Use rubber balls and special joint extenders, special cubes and other equipment to develop excellent motor skills in the heat. 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 to it), paraffin or pure sand - heating the formulations will speed up the elimination of decay products and provide accessfast in nutrients.
Diet for osteoarthritis of the fingers
Patients are advised to follow a non-strict diet that excludes smoked, highly salty foods, alcohol, as well as foods with artificial colors, steroids, preservatives. Diet is especially important in the treatment of metabolic osteoarthritis - in this case, it is completely determined by the attending physician. As a rule, patients are advised to eat a meal rich in animal and plant collagen and other digestive substances. Food should contain a minimum of "empty" calories and fully meet the body's daily need for vitamins, macro and micronutrients. It is essential to drink plenty of water with electrolytes, such as mineral or isotonic drinks.