pain in fingersoccurs when bones, joints, soft tissue, blood vessels, nerves are affected. It can be dull, sharp, weak, intense, constant, intermittent, short-term. There is often a connection with motor activity, weather conditions and other factors. Concomitant external disturbances are possible: deformations, changes in color and temperature, edema. To determine the cause of finger pain, the results of a survey, external examination, x-ray examination and other methods are used. Until the diagnosis is made, rest is recommended, sometimes taking painkillers.
Why do fingers hurt
traumatic injuries
A finger injury is characterized by moderate pain. Then the intensity of pain gradually decreases. Edema, hyperemia, cyanosis, hemorrhages are possible. Finger function is slightly impaired. Hematomas on the palmar surface of the fingers are manifested by moderate pain, skin detachment with the formation of a cavity filled with dark blood. With subungual hematomas, the pain is intense, spasmodic, throbbing, aggravated by lowering the brush. Partial or complete detachment of the nail plate is possible.
A broken finger is accompanied by sharp, explosive pain at the time of injury. Afterwards, the pain subsides a little but remains intense. The finger turns blue, swells, its functions are grossly violated. Deformity, crepitus, pathological mobility can be detected. When a finger is dislocated, there is a sharp pain. The finger is deformed, swollen, when trying to move in the affected joint, the spring resistance is determined.
With freezing in the first few hours, the pain is mild, tingling. Then the pain syndrome intensifies, acquires a burning character. The finger swells, becomes cyanotic. With deep frostbite, there is no tenderness in the distal parts, fingers are cold, pale, pain bothers at the border between healthy and affected tissues.
infectious lesions
Wheezing is characterized by pain, swelling, hyperemia, cyanosis, and rapidly enlarging abscess formation. Spasmodic, throbbing pains, depriving sleep at night. Especially painful sensations are expressed with subungual wharf and deep forms of the disease (bone, joint, tendon). With superficial forms of wheals (skin, periungual, subcutaneous, subungual), the general condition suffers a little, with profound symptoms of intoxication, fever.
Chinga develops in people engaged in cutting and processing the carcasses of marine game animals, it occurs with minor injuries: abrasions, wounds, cracks. It manifests as a dull, dull pain in the wound area, which after 1-2 days is replaced by pain in the finger joint (usually the proximal one). The pain grows, becomes painful, throbbing, complemented by swelling, pallor, cyanosis of the finger.
Arthritis
Finger joint pain in rheumatoid arthritis is symmetrical. 1 degree of activity is manifested by minor arthralgia, with rapidly disappearing stiffness. In grade 2, pain is disturbed at rest and during movement, combined with prolonged stiffness, limitation of movement, redness. Grade 3 is characterized by intense and constant pain, persistent stiffness, swelling, hyperemia. Movement is severely limited.
Gouty arthritis of the fingers is more common in women. One or more joints may be affected. The pain is usually sharp, sharp, combined with swelling, redness, impaired function, and an increase in overall temperature. Effaced symptoms are seen less often - minor pain and slight redness with a satisfactory general condition.
Psoriatic arthritis occurs suddenly or gradually. In the first case, the pain is moderate, increasing, in the second - sharp, intense. At the height of the disease, the typical picture includes pain, worse at night and at rest, weakening during the day, with movements, swelling of the fingers, bluish-purple discoloration of the skin. The distal interphalangeal joints are most often affected. Over time, various deformations appear.
In post-traumatic arthritis, a joint is affected. For infectious-allergic forms of the disease, developing against the background of bacterial and viral infections, multiple lesions are typical. With professional peripheral arthritis, the most heavily loaded joints of the fingers are involved in the process. Pain in all listed forms of pathology intensifies at night, weakens during the day, and is complemented by morning stiffness, local swelling, and difficulty in movement. With a long stroke, deformations are noticed.
degenerative pathologies
With osteoarthritis of the hands, the pain is initially indefinite, periodic, and short-term. There is morning stiffness. Subsequently, painful sensations intensify, prolong, sometimes burn, are noticed with any movement, limit daily activity and perform delicate operations. Heberden and Bouchard nodes are formed. Lateral deformations are formed.
Diseases of the ligaments and tendons
Patients suffering from stenosing ligamentitis are concerned about pain along the palmar surface at the base of the affected finger. At first, the pain syndrome appears only with pressure and small movements, then it remains at rest. Movements are limited, accompanied by a click. Over time, flexion contracture develops, after a click, pain is given to the arm.
In the initial phase, de Quervain's disease is manifested by pain during abduction, hyperextension of the first finger. Subsequently, painful and urgent pains occur with any physical activity, some patients are disturbed even at rest. Typical irradiation to the distal phalanx or forearm on the side of the first finger.
angiotrophoneurosis
Raynaud's syndrome is caused by vasospasm, accompanied by paroxysmal numbness, cold fingers. Pain occurs in the second phase of the attack, has a bursting character, is combined with a burning sensation, fullness. The pain syndrome is short-lived, replaced by a feeling of heat, redness of the distal parts of the hands. Pathology occurs in a variety of diseases of various origins, including:
- rheumatoid arthritis;
- systemic lupus erythematosus;
- scleroderma;
- Sharp syndrome;
- antisynthetase syndrome;
- thromboangiitis obliterans of the upper extremities;
- endocrine, metabolic, occupational pathologies.
In the absence of other diseases that cause this condition, they talk about Raynaud's disease with a similar pain syndrome. This form is more common in women.
Erythromelalgia occurs independently or is formed in patients with endocrine, neurologic, and hematologic diseases. It is manifested by paroxysmal attacks of cooking, burning pain, edema, hyperemia of the fingers. It is possible to spread pain from one limb to another or to occur simultaneously in the region of both limbs. The pain attacks are so intense that they interfere with any movement. Pain decreases with cooling and elevation of the hand, increases with warming and lowering of the hands.
neurological pathologies
Pain in fingers occurs when nerves are damaged, spreads in the zone of innervation, has a shooting or burning character, is supplemented by sensory disturbances, autonomic-trophic disorders. Possible neurological causes:
- Median nerve neuropathy.The pain is located on the palmar side of the I-III fingers, combined with the inability to bend the fingers, clench the hand into a fist, oppose the I finger.
- carpal tunnel syndrome.A type of median nerve neuropathy caused by compression of nerve fibers at the wrist. Pain location - as in the previous case. Typical nocturnal attacks, decreased pain when lowering the arms, shaking the brushes.
- Radial nerve neuropathy.With an injury at the level of the forearm and wrist, pain is noticed along the posterior surface of the first finger and hand, sometimes spreading to the second and third fingers. Radiation in the forearm, numbness in the back of the hand are characteristic.
- Ulnar nerve neuropathy.The pain is mainly located in the elbow joint area, but it can radiate to the hand, fingers IV-V. The pain syndrome usually intensifies in the morning.
tumors
Benign tumors that affect the finger bones include chondromas and osteoid osteomas. Chondromas are manifested by non-severe pain sensations with indistinct localization, osteoid osteomas - by sharp pains in the affected area. Malignant neoplasm of the fingers is rare.
other reasons
Pain in fingers and hand is seen in patients with writing spasm, which develops with occupational neurosis, some other mental and neurological disorders. Pain occurs when writing, working on a computer or typewriter. They are breaking, pulling, complemented by tremors, sudden weakness of the hand, local convulsions. In addition, pain in the fingers can be detected in the following pathologies:
- Leukemia: Waldenström's macroglobulinemia.
- Tumors of the adrenal glands: aldosteroma.
- diabetes complications: diabetic neuropathy.
- vascular diseases: distal digital embolism due to subclavian artery occlusion.
- hereditary diseases: Fabry disease.
- childhood illnesses: neuroarthritic diathesis.
Diagnosis
Traumatologists-orthopedists are involved in establishing the causes of finger pain. The diagnosis is made on the basis of a conversation with the patient, data from external examinations, additional studies. The diagnostics program includes:
- Survey. The doctor finds out when and under what circumstances the pain syndrome and other symptoms first appeared, determines the features of the dynamics of the development of the disease, factors that provoke an improvement or deterioration of the patient's condition. Studying life history, family history.
- Physical exam. The specialist evaluates the appearance of the fingers, reveals deformities, inflammation, cracks, dry skin, temperature and color disturbances, swelling and other manifestations of the pathology. Examines sensitivity, range of motion, pulse in peripheral arteries.
- X-ray.It is performed in two projections with the capture of the affected fingers or the entire hand. It confirms the presence of fractures, dislocations, tumors, inflammatory and degenerative processes, areas of destruction of solid structures in deep forms of wheal.
- Electrophysiological studies. They are performed for pain of neurological origin to clarify the level of nerve damage, assess the condition of muscles and nerve conduction.
- lab tests. Produced to determine inflammation, assess the general state of the body, detect specific markers in collagenosis.
According to the indications, patients are referred for consultation with an endocrinologist, neurologist, vascular surgeon and other specialists. Assign CT, MRI, other instrumental techniques. Perform a biopsy of hard and soft structures for cytological or histological examination.
Treatment
First aid
In case of traumatic injuries, the cold and elevated position of the limb is recommended. The hand is fixed with a splint or improvised materials (eg planks). The brush is lifted or a handkerchief is used. With a severe pain syndrome, an analgesic is administered, in the absence of external damage, chloroethyl is applied.
Help for diseases is determined by the nature of the pathology - a change in the position of the limb, heating or, conversely, cooling can help. The most common measure is rest, however, in some diseases (carpal tunnel syndrome, arthritis), the pain syndrome decreases while maintaining motor activity. Pains from sharp spasms, pronounced signs of inflammation, general hyperthermia are the reason for an urgent consultation with a specialist.
Conservative therapy
In case of dislocations and fractures, local anesthesia, reduction and plaster placement are performed. Conservative treatment of traumatic and non-traumatic pathologies of the fingers involves the following activities:
- protection mode. It is selected taking into account the nature and severity of the disease. Possible recommendations to limit the load, the use of orthopedic devices, the imposition of plaster.
- medical therapy. Non-steroidal anti-inflammatory drugs, antibiotics, drugs to improve blood circulation, neurotropic drugs are used. According to the indications, blocks with corticosteroids are performed.
- non-drug methods. Exercise therapy, massage, physical therapy, manual therapy, kinesio taping are prescribed.
surgical interventions
Operations are performed when conservative methods are ineffective, to reduce time and improve long-term treatment outcomes. Taking into account the characteristics of the lesion, the following is carried out:
- injuries: fixation of fractures and dislocations with knitting needles, necrectomy and amputation of fingers in case of frostbite.
- Infectious diseases: opening, drainage of the wharf, in case of serious injuries in some cases - amputation or disarticulation.
- Diseases of the tendons and ligaments: dorsal ligament dissection and excision of adhesions in Quervain's disease, annular ligament dissection in stenosing ligamentitis.
- neoplasms: removal of neoplasm, bone resection.
- neurological diseases: nervous decompression.
After surgery, antibiotic therapy is prescribed. Patients undergo comprehensive rehabilitation aimed at maximizing restoration of hand function.