Pain in the fingers

Pain in the fingersoccurs when bones, joints, soft tissues, blood vessels, nerves are affected. It can be dull, acute, weak, intense, constant, intermittent, short-lived. There is often a link to motor activity, weather conditions and other factors. Concomitant external disturbances are possible: deformities, changes in color and temperature, edema. To determine the cause of pain in the fingers, the results of a study, external examination, x-ray examination and other methods are used. Until the diagnosis is made, rest is recommended, sometimes taking sedatives.

Why it hurts your fingers

Traumatic injuries

Finger injury is characterized by moderate pain. Then the intensity of the pain gradually decreases. Edema, hyperemia, cyanosis, hemorrhage are possible. Finger function is slightly impaired. Hematomas on the palm surface of the fingers are manifested by moderate pain, detachment of the skin with the formation of a cavity filled with dark blood. With subungual hematomas, the pain is intense, crackling, throbbing, aggravated by lowering the brush. Partial or complete detachment of the nail plate is possible.

A broken finger is accompanied by severe explosive pain at the time of injury. Subsequently, the pain decreases somewhat but remains strong. The finger becomes blue, swells, its functions are severely violated. Deformity, crepitus, pathological motility can be detected. When a finger is moved, sharp pain is noticed. The toe is deformed, swollen, when you try to move on the affected joint, the spring resistance is determined.

With frosts in the first hours the pain is mild, tingling sensation. Then the pain syndrome intensifies, acquires a burning character. The finger swells, becomes cyanotic. With deep frosts, there is no tenderness in the distal parts, the fingers are cold, pale, the pain disturbs at the border between healthy and affected tissues.

Infectious lesions

Panaritium is characterized by rapidly increasing pain, swelling, hyperemia, cyanosis, abscess formation. Crunching, throbbing pain that deprives the night of sleep. Particularly strong painful sensations are expressed with subungual panaritium and deep forms of the disease (bone, joint, tendon). With superficial forms of panaritium (skin, periungual, subcutaneous, subungual), the general condition suffers slightly, with deep symptoms of intoxication, fever.

Chinga develops in people involved in the cutting and processing of carcasses of marine game animals, occurs with minor injuries: scratches, wounds, cracks. It appears as dull, weak pain in the wound area, which after 1-2 days is replaced by pain in the finger joint (usually the proximal one). The pain increases, becomes painful, throbbing, filled with swelling, pallor, cyanosis of the finger.

Arthritis

Pain in the knuckles in rheumatoid arthritis is symmetrical. 1 degree of activity is manifested by slight arthralgia, stiffness that disappears quickly. In grade 2, pain is disturbed at rest and during movement, combined with prolonged stiffness, restriction of movement, redness. Grade 3 is characterized by persistent severe pain, persistent stiffness, swelling, hyperemia. Movement is very limited.

Gouty arthritis of the fingers is more common in women. One or more joints may be affected. The pain is usually acute, sharp, combined with edema, hyperemia, impaired function, and an increase in general temperature. Deleted symptoms are observed less frequently - slight pain and slight redness with a generally satisfactory condition.

Psoriatic arthritis appears suddenly or gradually. In the first case, the pain is moderate, increasing, in the second - sharp, intense. At the peak of the disease, the typical picture includes pain, aggravated at night and at rest, weakening during the day, with movement, swelling of the fingers, purple-bluish tint of the skin. The distal interphalangeal joints are most often affected. Over time, numerous deformations appear.

In post-traumatic arthritis, a joint is affected. For infectious-allergic forms of the disease, which develop against the background of bacterial and viral infections, multiple lesions are typical. With occupational peripheral arthritis, the busiest finger joints 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 course, deformations are observed.

Degenerative pathologies

With osteoarthritis of the hands, the pain is initially indeterminate, periodic, short-lived. There is stiffness in the morning. Subsequently, the painful sensations intensify, prolong, sometimes burn, are noticed with every movement, restrict daily activity, and perform delicate operations. The Heberden and Bouchard nodes are formed. Lateral deformations are formed.

Diseases of the ligaments and tendons

Patients suffering from stenotic 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, the flexion contracture develops, after a click, the pain is given to the arm.

In the initial stage, de Quervain's disease is manifested by pain during abduction, hyperextension of the first finger. Subsequently, painful, pressing pains appear with every physical activity, some patients even bother at rest. Typical radiation to the distal phalanx or forearm from the side of the first finger.

Angiotrophonurosis

Raynaud's syndrome is caused by vasospasm, accompanied by paroxysmal numbness, cold fingers. The pain appears in the second stage of the attack, has a fracture 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 pathology.

In the absence of other diseases that provoke this condition, they talk about Raynaud's disease with a similar pain syndrome. This form is more common in women.

Erythromelagia occurs independently or is formed in patients with endocrine, neurological, hematological diseases. Appears with paroxysmal attacks of burning, burning pain, edema, hyperemia of the fingers. It is possible for pain to spread 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 every movement. The pain decreases with cooling and raising the hand, increases with warming and lowering the hands.

Neurological pathologies

Pain in the fingers appears when the nerves are damaged, spread to the innervation zone, have a firing or burning character, are complemented by sensory disturbances, autonomic-trophic disorders. Possible neurological causes:

• Middle nerve neuropathy.The pain is localized on the palm side of the fingers I-III, combined with the inability to bend the fingers, to shake the hand in the fist, to oppose the finger I.
• carpal tunnel syndrome.A type of moderate nerve neuropathy caused by compression of nerve fibers at the level of the wrist. Localization of pain - as in the previous case. Typical night attacks, reduction of pain during lowering of the arms, shaking of the brushes.
• Radial nerve neuropathy.With a lesion at the level of the forearm and wrist, pain is noticed along the back surface of the first finger and hand, sometimes spreading to the second and third finger. Radiation to the forearm, numbness of the back of the hand are characteristic.
• Ulnar nerve neuropathy.The pain is localized mainly in the area of the elbow joint, but can radiate to the hand, fingers IV-V. The pain syndrome often intensifies in the morning.

Tumors

Benign tumors that affect the bones of the fingers include chondromas and osteoid osteomas. Chondromas are manifested by non-intense pain sensations with unclear localization, osteoid osteoma - with sharp pain in the affected area. Malignant neoplasia of the fingers is rare.

Other reasons

Pain in the fingers and hand is observed 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 break, retract, fill with 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.
• Adrenal gland tumors: aldosteroma.
• Complications of diabetes: diabetic neuropathy.
• Vascular diseases: digital distal embolism due to occlusion of the subclavian artery.
• hereditary diseases: Fabry disease.
• Childhood diseases: neuro-arthritic diathesis.

Diagnosing

Orthopedic traumatologists are engaged in determining the causes of pain in the fingers. Diagnosis is made on the basis of a conversation with the patient, data of external examination, additional studies. The diagnostic program includes:

• Survey. The doctor finds out when and under what circumstances pain syndrome and other symptoms first appeared, determines the characteristics of the dynamics of the development of the disease, the factors that provoke an improvement or deterioration of the patient's condition. Study of life history, family history.
• Physical examination. The specialist evaluates the appearance of the fingers, detects deformities, inflammations, cracks, dry skin, temperature and color disorders, swelling and other manifestations of pathology. Examines sensitivity, range of motion, pulsation in peripheral arteries.
• Radiography.It is performed in two projections with the capture of the affected fingers or the whole hand. Confirms the presence of fractures, dislocations, tumors, inflammatory and degenerative processes, areas of destruction of solid structures in deep panaritium forms.
• Electrophysiological studies.They are performed for pain of neurological origin to clarify the level of nerve damage, to assess muscle condition and nerve conduction.
• Laboratory tests. Produced to determine inflammation, to assess the general condition of the body, to detect specific markers in collagenoses.

According to the indications, patients are referred for a 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, elevated position of the limbs is recommended. The hand is fixed with a splint or improvised materials (for example, planks). The brush is raised or a scarf is used. With an intense pain syndrome, an analgesic is given, in the absence of external damage, chloroethyl is applied.

Aid for diseases is determined by the nature of the pathology - a change in the position of the limbs, warming or, conversely, cooling can help. The most common measure is rest, however, in some diseases (carpal tunnel syndrome, arthritis), the pain syndrome is reduced by maintaining motor activity. Acute constriction pain, 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 is performed, reduction is performed and plaster is placed. Conservative treatment of traumatic and non-traumatic pathologies of the fingers includes the following activities:

• Defensive way. It is selected taking into account the nature and severity of the disease. Possible recommendations for load limitation, use of orthopedic devices, placement of a cast.
• Medical therapy. Non-steroidal anti-inflammatory drugs are used, antibiotics, drugs to improve blood circulation, neurotropic drugs. According to the indications, blockades with corticosteroids are performed.
• Non-drug methods. Exercise therapy, massage, physiotherapy, manual therapy, kinesio taping are described.

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, it is performed as follows:

• INJURY: fixation of fractures and dislocations with knitting needles, necrectomy and amputation of fingers in case of freezing.
• Infectious diseases: opening, drainage of the panaritium, in case of severe lesions in some cases - amputation or articulation.
• Diseases of the tendons and ligaments: dorsal ligament dissection and adhesion excision in de Quervain's disease, annular ligament dissection in stenotic ligament.
• Neoplasia: neoplasia removal, bone resection.
• Neurological diseases: nervous decompression.

After surgery, antibiotic therapy is prescribed. Patients undergo a comprehensive rehabilitation aimed at maximizing the restoration of hand functions.