Osteoarthritis of the fingers - a disease of musicians or not

Thinking of an adult's hands, we almost inevitably imagine nodular 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. Moreover, not everyone knows that this disease can "age" the hands of twenty-five or thirty, which makes even writing a simple note or twisting the cap of a bottle to become a painful and difficult task. fingers, who is at risk and what to do with osteoarthritis of the fingers, if it has already begun - read about it below.

Deforming arthrosis of the fingers

The metacarpophalangeal and interphalangeal joints of a person are under constant strain, because for a normal quality of life he must make fine motor movements every minute - from simple grips (take an apple, open a door, hold cutlery) to very small and complex (they determinea person's handwriting, his ability to sew and knit, play instruments and much more). The more intensely the fingers are loaded, the more wear is exposed to the cartilage tissue that covers the heads of the phalanx bones, forming the joint surface. This cartilage layer, washed by synovial fluid, allows the bones not to rub against each other when moving, but to slide, and to act as a natural shock absorber (for example, during shock movements, without which it is impossible to writeon the keyboard).

For various reasons, which we will discuss below, the interphalangeal cartilage is subject to wear. Most often the process is as follows:

1. The porous cartilage tissue undergoes a load, during which the lubrication of the joints is "squeezed" from it, ensuring good mobility of the joints. Usually after that recovery occurs - the cartilage is again saturated with moisture in a relaxed state. disturbed, it begins to dry and crack. This leads to a decrease in its elasticity and functionality.
2. Unable to withstand friction, the dried cartilage gradually begins to wear out and thin, exposing the bone heads. As the joint surface does not fully cope with the task at hand, the bones, muscles and ligaments begin to experience the strain on the cartilage - almost the entire orthopedic apparatus of the finger or even the entire hand. To increase the area of the joint surface and prevent further erasure, the body begins to "complete the formation" of osteophytes in the affected area - bone growths, which may have a rounded and even spike-like shape. This process is also popularly called"salt deposition", which is not entirely correct, since we are talking about the spread of bone tissue.
3. 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 the osteophytes periodically tear off and damage the neighboring tissues, causing pain and inflammation. In addition, microscopic cracks are formed, which reduce the strength of the bone and make it fragile - therefore in 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 off, another grows in its place - over time, the process only worsens along with the cartilage dysfunction.
4. Severe wear on the joint surfaces, changes in the shape of the bones lead to restructuring of the whole arm, chronic inflammation and pain. The brush is deformed to the point where it is impossible to even hold the mug with your fingers.

From arthritis, osteoarthritis, which is also called osteoarthritis or osteoarthritis (they are all synonymous), differs mainly in the destruction of the joint and the chronic course of the disease. While arthritis only suggests the presence of an acute inflammatory process affecting the cartilage tissue. In osteoarthritis, the joint sac, synovium, subchondral bone, as well as ligaments and muscles are involved in the degenerative-dystrophic process. Also, in arthritis, the pain is usually sharp and strong, appearing at night. While osteoarthritis is felt during the day, in the early stages - not too pronounced pain.

Currently, the most common forms of osteoarthritis are being considered: rhizarthrosis, which affects the thumb, and polyarthrosis, which affects several interphalangeal joints simultaneously.

Remember: in the early stages of the disease, bone destruction can still be prevented and osteoarthritis can be brought into permanent remission, while maintaining high-quality biomechanics of the hands.

Causes of osteoarthritis of small joints of the hands

The risk group often includes people in the family who have already had osteoarthritis of the fingers. The density of cartilage tissue and the rate of metabolic processes in it are genetically determined and therefore the tendency 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 osteoarthritis increases in connection with professional and domestic 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 osteoarthritis 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, rheumatoid arthritis, gout);
• lack of normal rest and warm-up at work, excessive exercise with dumbbells;
• sleep disorders and chronic stress;
• age-related hormonal changes;
• congenital defects of the hands;
• injuries to the hand, fingers and wrist;
• hypothermia, working with vibrating instruments and other adverse factors;
• septic and specific (tuberculosis, chlamydia, syphilis) infectious diseases;
• allergic reactions;
• chronic dehydration (the habit of drinking little);
• unbalanced diet without vitamins D, E, K and minerals.

Symptoms of osteoarthritis of the fingers

The symptoms and treatment of osteoarthritis of the fingers can vary greatly depending on the stage of the disease and the patient's perception. Often mild joint discomfort, increased muscle fatigue are attributed to fatigue and are ignored until constant excruciating pain occurs. But the sooner treatment is started, the more complete the functionality of the fingers will remain in old age and the higher the quality of life in the coming years.

First stage.The disease begins with a feeling of pain in the hands, tingling or numbness, sometimes - manifested in shooting pains. Performing daily duties becomes more difficult - fingers get tired faster, dry and rough crunch appears in the joints (not to be confused with "healthy" sound! ), Snap when bending. I want to rest my hands. The painIt is usually felt only during training. In a relaxed state the fingers hurt for a while and cause discomfort. The joints become swollen, and in the presence of cardiovascular disease, 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 above the joints often becomes hot. The pain tends to be prolonged and may not stop even at night. After work and in the morning there is swelling, stiffness of the fingers. The phalanges become significantly thicker and the ligaments shorten, clumsiness appears in the movements, which makes the handling of small objects (needles, threads, small coins and buttons) more difficult. Characteristic thickenings of the connective tissue (so-called Heberden's and Bouchard's nodes) appear on the sides of the joints, filled with synovial fluid - the cysts are especially clearly visible when viewed from the back of the palms. The tactile and temperature sensitivity of the fingers is significantly reduced. It becomes almost impossible to relax your arms without warm baths - the muscles are in constant tension. The amplitude of voluntary movements is significantly reduced, spasms occur.

Third stage.In the last stage of the disease the fingers practically do not bend, ankylosis and permanent contractures can 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 the muscle tissue. Even simple daily tasks - such as holding a glass - are virtually inaccessible to the patient. He needs the help of others. Deformation of the joints and changes in the shape of the arm are clearly visible. In advanced cases, necrotic tissue changes are possible.

If you want to do an express test and find out if it's worth worrying about, the article on the symptoms and treatment of osteoarthritis will be useful. 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 refute 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, the therapy is complex, multi-vector - it includes not only the use of pharmaceutical products, but also physical impact and even occupational therapy. Fighting a chronic illness sometimes requires a rethinking of diet, daily life, working conditions and workplace organization.

Medication treatment

Treatment of osteoarthritis of the fingers, as a rule, begins with the removal of pain, which uses immobilization of the hand with a splint or orthopedic bandage and analgesic tablets, creams and ointments. The rest regime helps to rehydrate the cartilage, restore its elasticity. In the presence of severe inflammation and swelling that disrupt tissue trophism (nutrition), the doctor prescribes nonsteroidal 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 antibiotics.

The intake 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, about 6 months a year - the effect manifests itself 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 drug mixtures, which 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, surgery can be performed. As a rule, this is reddening of the joint and elimination of osteophytes, reconstruction or formation of a destroyed joint, its stabilization (fusion) or endoprosthesis (so far quite unpopular measure in surgery of small joints of the hands).

Physiotherapeutic treatment

In most cases, the disease responds well to conservative physiotherapy treatment - however, it is carried out only in remission, after the inflammation subsides. Hardware methods for treating deforming osteoarthritis of the fingers include electrophoresis, shock wave, UHF, pulse, magnetic therapy 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 tendons, 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 is warm;
• rub each finger from the base to the tips;
• wrap each finger in a slightly clenched fist, like sharpening a pencil;
• bend and unfold your fingers quickly for 30 seconds, avoiding clenching your fists;
• put your palms together and support your fingertips together, pressing them well for 1-2 minutes.

Includes treatment of osteoarthritis of the fingers and gymnastics. Use rubber balls and special wrist expanders, special cubes and other devices to develop fine motor skills when warming up. 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 hot 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 food. substances.

Diet for osteoarthritis of the fingers

Patients are advised to follow a strict diet, which excludes smoked, too 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 determined entirely by the attending physician. As a rule, patients are recommended dishes rich in animal and plant collagen and other gelling substances. Food should contain a minimum of "empty" calories and provide the body's full daily need for vitamins, macro-and micronutrients. It is mandatory to drink enough water with electrolytes, such as mineral or isotonic drinks.