Thinking about the hands of an elderly person, we almost inevitably imagine gnarled fingers, thinned in the phalanges, but as if swollen in 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 so, not everyone knows that this disease can "age" hands at both twenty-five and thirty years, which makes even writing a simple note or twisting a bottle cap becomes 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 begun - read about this 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 he has to make fine motor movements every minute - from simple grasping ones (take an apple, open a door, hold a cutlery) to very small and complex ones (they determine the handwriting of a person, histhe ability to sew and knit, play tools, and much more). The more intensely the fingers are loaded, the more wear is exposed to the cartilage tissue, which covers the heads of the phalangeal bones, forming the articular surface. This cartilaginous layer, washed by synovial fluid, allows the bones not to rub against each other when moving, but to slide, as it were, and also plays the role of a natural shock absorber (for example, during shock movements, without which it is impossible to type on the keyboard).
For various reasons, which we will discuss below, interphalangeal cartilage is subject to wear and tear. Most often, the process occurs as follows:
- The porous cartilaginous tissue undergoes a load in which the joint lubricant is, as it were, "squeezed out" 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 crack. This leads to a decrease in its elasticity and functionality.
- Unable to resist friction, overdried cartilage begins to gradually wear out and become thinner, exposing the heads of the bones. Since the articular surface does not fully cope with the task at hand, bones, muscles and ligaments begin to experience the load provided for the cartilage - almost the entire orthopedic apparatus of the finger or even the whole hand. To increase the area of the articular surface and prevent it from being erased further, the body begins to "finish building" osteophytes on the affected area - bone growths that can have a rounded and even spike-like shape. Popularly, this process is also called "salt deposition", which is not entirely correct, becausewe 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 duties as deftly as before. At the same time, the bone tissue does not have its own mechanism of protection against friction, and therefore osteophytes periodically break off and damage the adjacent tissues, causing pain and inflammation. In addition, microscopic cracks are formed, which reduce the strength of the bone and make it fragile - therefore, with arthrosis 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 off, another grows in its place - over time, the process only aggravates along with cartilage dysfunction.
- Severe wear of the articular surfaces, changes in the shape of the bones lead to the restructuring of the entire hand, chronic inflammation and pain. The brush is deformed to the point of complete inability to even grasp the mug with your fingers.
Arthrosis, which is also called osteoarthritis or osteoarthritis (all of which are synonyms), differs from arthritis primarily by the destruction of the joint and the chronic course of the disease. While arthritis implies only the presence of an acute inflammatory process affecting the cartilage tissue. In arthrosis, the degenerative-dystrophic process involves the articular bag, synovium, subchondral bone, as well as ligaments and muscles. Also, with arthritis, the pain is usually sharp and severe, appearing at night. While arthrosis makes itself felt during the day, in the early stages - not too pronounced aching pains.
The most common forms of arthrosis at the moment are considered: rhizarthrosis, in which the thumb is involved, and polyarthrosis, which affects several interphalangeal joints at once.
Remember: in the early stages of the disease, the destruction of bones can still be prevented and arthrosis can be brought into permanent remission while maintaining high-quality biomechanics of the hands.
Causes of arthrosis of small joints of the hands
The risk group often includes people whose family has already had diseases of arthrosis of the fingers. The density of cartilage tissue and the rate of metabolic processes in it are genetically predetermined, and therefore the propensity to develop the disease can be hereditary. Also, the disease affects postmenopausal women about 10 times more often than their male peers.
The likelihood of arthrosis increases in connection 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 earlier than others.
The development of arthrosis of the fingers is facilitated by:
- rapid wear and / or insufficient regeneration of cartilage tissue;
- metabolic disorders, problems with the endocrine system, systemic autoimmune diseases (diabetes mellitus, rheumatoid arthritis, gout);
- lack of normal rest and warm-up at 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 (tuberculosis, chlamydia, syphilis) infectious diseases;
- allergic reactions;
- chronic dehydration (the habit of drinking little);
- an imbalanced diet lacking vitamins D, E, K and minerals.
Symptoms of arthrosis of the fingers
Symptoms and treatment of finger joint arthrosis can vary significantly depending on the stage of the disease and the patient's perception. Often, slight discomfort in the joints, increased muscle fatigue is attributed to fatigue and is ignored until constant excruciating pain appears. But the sooner the treatment is started, the more fully the functionality of the fingers will remain in old age and the higher the quality of life will be in subsequent years.
First stage.The disease begins with a feeling of aching hands, numbness or tingling, sometimes - manifests itself in shooting pains. It becomes more difficult to carry out everyday duties - fingers get tired faster, dry and rough crunch appears in the joints (not to be confused with "healthy" sonorous! ), Clicks when bending. I want to give my hands a rest. Pain is usually felt only during exercise. In a relaxed state, the fingers ache for some time and cause discomfort. Stiffness of movements is more and more often observed, before exercises that require manual dexterity, there is a need to "warm up", to stretch the fingers. The joints become swollen. In the presence of cardiovascular diseases, the hands begin to respond to changing weather.
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 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, clumsiness appears in the movements, due to which manipulation of small objects (needles, threads, small coins and buttons) is more difficult. On the sides of the joints, characteristic thickening of the connective tissue (the so-called Heberden's and Bouchard's nodules), filled with synovial fluid, appear - the cysts are especially clearly visible when viewed from the back of the palms. The tactile and temperature sensitivity of the fingers is greatly reduced. It becomes almost impossible to relax your hands without warm baths - the muscles are in constant tension. The amplitude of voluntary movements is noticeably reduced, spasms appear.
Third stage.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 muscle tissue dystrophy. Even simple everyday tasks - for example, holding a cup - are practically inaccessible to the patient. He needs 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 the tissues are possible.
If you want to take an express test and understand whether it is worth worrying, the article on the symptoms and treatment of osteoarthritis will be useful to 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 deny 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 the hand is immobilized with a splint or orthopedic bandage and analgesic tablets, creams and ointments. Resting mode helps to rehydrate the cartilage, restore its elasticity. In the presence of severe inflammation and edema, which disrupt the trophism (nutrition) of tissues, the doctor prescribes non-steroidal anti-inflammatory drugs (NSAIDs), which restore blood circulation in the fingers. According to indications, steroid hormones are prescribed. Osteoarthritis caused by infectious arthritis requires topical administration of antibiotics.
Reception of chondroprotectors 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-term.
If the proposed treatment fails to relieve 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 arthrosis of the hands
In the last stages of the disease, according to indications, an operation can be performed. As a rule, this is flushing of the joint and elimination of osteophytes, reconstruction or formation of a destroyed joint, its stabilization (fusion) or endoprosthetics (so far a rather unpopular measure in 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 stage of remission, after the inflammation has subsided. Apparatus methods of treating deforming arthrosis 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 fight 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 together until the skin is warm;
- rub each finger from the base to the tips;
- roll each finger in a slightly clenched fist, like sharpening a pencil;
- bend and unbend your fingers quickly for 30 seconds, avoiding clenching them into fists;
- put your palms together and rest your fingertips against each other, pressing them well for 1-2 minutes.
Includes the treatment of arthrosis of the fingers and gymnastics. Use rubber balls and special wrist expanders, special cubes and other devices for the development of fine motor skills in 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 to it), paraffin or clean sand - heating the formulations will accelerate the elimination of decay products and provide quick access to nutrients.
Diet for arthrosis of the fingers
Patients are advised to follow a non-strict diet that excludes smoked, too salty foods, alcohol, as well as food 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, patients are advised 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 need for vitamins, macro- and microelements. It is imperative that you consume enough water with electrolytes, such as mineral or isotonic drinks.