finger painOccurs when bones, joints, soft tissues, blood vessels, nerves are affected. It can be dull, acute, faint, intense, continuous, intermittent, short-term. Usually related to athletic activity, weather conditions and other factors. Concomitant external disturbances are possible: deformation, changes in color and temperature, edema. To determine the cause of finger pain, findings, external examinations, X-rays, and other methods are used. Rest, and sometimes pain medication, is recommended until a diagnosis is made.
Why do my fingers hurt
trauma
Finger injuries are characterized by moderate pain. The pain then gradually decreases in intensity. Edema, congestion, cyanosis, and bleeding are possible. Finger function is slightly impaired. The hematoma on the surface of the palm of the finger is moderately painful and the skin sloughs off, forming a cavity filled with black blood. For subungual hematoma, severe pain, twitching, throbbing, aggravated by lowering the brush. Partial or complete detachment of the nail plate is possible.
A broken finger can be accompanied by severe, explosive pain at the time of the injury. Afterwards, the pain lessened, but was still intense. The fingers become blue, swollen, and their function is severely impaired. Deformities, crepitus, pathological activity can be detected. Severe pain occurs when a finger is dislocated. The fingers are deformed, swollen, and spring resistance is determined when trying to move in the affected joint.
Frostbite occurs within the first few hours with mild, tingling pain. Then the pain syndrome intensifies, gaining a searing character. The fingers are swollen and cyanotic. Deep frostbite, distal insensitivity, cold fingers, pale, pain plaguing the boundaries of healthy tissue and affected tissue.
Infectious lesions
Panaritium is characterized by a rapid increase in pain, swelling, congestion, cyanosis, and abscess formation. Painful twitching, throbbing, sleep-deprived nights. In particular, intense pain is manifested in subungual panaritium and in the deep forms of the disease (bone, joint, tendon). For superficial forms of panaritium (cutaneous, periungual, subcutaneous, subungual), the general condition is mildly affected, with profound symptoms of poisoning, fever.
Chinga develops in people involved in cutting and processing marine wildlife carcasses, with minor injuries: scrapes, cuts, cracks. It presents as a dull, weak pain in the wound area, which is replaced by pain in the finger joints (usually the proximal joints) after 1-2 days. The pain intensifies, becomes painful, throbbing, and is accompanied by swelling, paleness, and cyanosis of the fingers.
arthritis
Finger joint pain in rheumatoid arthritis is symmetrical. 1st degree activity presents with mild arthralgia and rapid resolution of stiffness. In grade 2, pain is disturbed during rest and movement, and is associated with prolonged stiffness, limited movement, and redness. Grade 3 is characterized by persistent severe pain, persistent stiffness, swelling, and congestion. Movement is severely restricted.
Gouty arthritis of the fingers is more common in women. One or more joints may be affected. Pain is usually acute, severe, and accompanied by edema, congestion, impaired function, and elevated body temperature. Symptoms that have been resolved are rarely observed - mild pain and slight redness, and the general condition is satisfactory.
Psoriatic arthritis occurs suddenly or gradually. In the first case, the pain is moderate and growing, in the second - severe, intense. At the peak of the disease, typical pictures include pain that worsens at night and at rest, diminishes during the day, movement, swollen fingers, and purplish-blue skin. The distal interphalangeal joints are most commonly affected. Over time, multiple deformations occur.
In post-traumatic arthritis, one joint is affected. Multiple lesions are typical for infectious allergic forms of the disease that develop in the context of bacterial and viral infections. With professional peripheral arthritis, the most loaded joints of the fingers are involved in the process. Pain in all of the listed pathological forms worsened at night and diminished during the day, with morning stiffness, local swelling, and dyskinesia. During a longer process, deformation will be noticed.
Degenerative disease
In hand arthropathy, pain is initially indeterminate, periodic, and short-term. There is morning stiffness. Subsequently, the pain will intensify, become prolonged, and sometimes a burning sensation, with any movement, limiting daily activities and performing fine maneuvers. The Heberden and Bouchard nodes are formed. lateral deformation.
Ligament and Tendon Disorders
Patients with stenotic ligamentitis are concerned about pain on the palmar surface at the base of the affected finger. At first, the pain syndrome occurs only with pressure and small movements, and then remains still. The movement is limited, accompanied by clicks. Over time, flexion contractures develop, and after clicking, the arm is painful.
In the initial phase, de Quervain's disease presents with abduction pain and hyperextension of the index finger. Subsequent to any physical activity there is pain, pressure pain, and some patients feel restless even at rest. Typical irradiation of the distal phalanx or forearm from the side of the index finger.
Vascular muscular dystrophy
Raynaud's syndrome is caused by spasms of blood vessels, with paroxysmal numbness and cold fingers. The pain occurs in the second stage of the attack, and is characterized by rupture, accompanied by burning, fullness. The pain syndrome is short-term, replaced by a feeling of heat and redness at the distal end of the hand. Pathology occurs in a variety of diseases of various origins, including:
- Rheumatoid Arthritis;
- Systemic lupus erythematosus;
- scleroderma;
- Sharpe syndrome;
- anti-synthetase syndrome;
- Thromboangiitis obliterans of the upper extremity;
- Endocrinology, metabolism, occupational disease.
They talk about Raynaud's disease, which has a similar pain syndrome, in the absence of other conditions that cause it. This form is more common in women.
Erythromelalgia occurs independently or develops in patients with endocrine, neurological, or hematological disorders. It manifests as paroxysmal baking, burning pain, edema, and bloodshot fingers. Pain may spread from one limb to the other, or occur in the area of both limbs at the same time. Pain attacks are so intense that they interfere with any movement. Pain decreases with cooling and raising the hand and increases with warming and lowering the hand.
neuropathology
Pain in the fingers occurs when the nerve is damaged, spreads in the innervated area, has shooting or burning features, is accompanied by sensory disturbances, autonomic dystrophy. Possible neurological causes:
- Neuropathy of the median nerve.Pain localized to the volar side of fingers I-III, combined with inability to flex fingers, clenched fist, facing finger I.
- Carpal Tunnel Syndrome.A type of median nerve neuropathy caused by compression of nerve fibers in the wrist. Localization of pain - as in the previous case. Typical nocturnal episodes, pain relief when lowering arm, shaking brush.
- Neuropathy of the radial nerve.For lesions at the level of the forearm and wrist, pain is noted along the index finger and the back of the hand, sometimes spreading to the middle and ring fingers. Irradiation of the forearm and numbness of the back of the hand are characteristic.
- Ulnar nerve neuropathy.Pain is mainly confined to the elbow area, but can radiate to the hand, IV-V fingers. The pain syndrome usually intensifies in the morning.
tumor
Benign tumors that affect the bones of the fingers include chondromas and osteoid osteomas. Chondroma presents with a non-intense pain sensation, with unclear localization, and osteoid osteoma - severe pain in the affected area. Malignant tumors of the fingers are rare.
other reasons
Finger and hand pain is observed in patients with writing cramps, which accompany occupational neurosis, several other psychiatric and neurological disorders. Pain occurs when writing, working on a computer or typewriter. They were breaking, pulling, and accompanied by tremors, sudden weakness of the hands, and localized convulsions. In addition, finger soreness can be detected in the following pathologies:
- leukemia: Waldenström's macroglobulinemia.
- adrenal tumor: Aldosteronoma.
- complications of diabetes: Diabetic neuropathy.
- Vascular disease: Distal digital embolism due to subclavian artery occlusion.
- genetic disease: Fabry disease.
- childhood diseases: Neuroarthritis quality.
diagnosis
Traumatologist-Orthopedic surgeons work to determine the cause of finger pain. Diagnosis is based on conversations with patients, data from external examinations, and other research. Diagnostic procedures include:
- pollsPhysicians identify when and when pain syndromes and other symptoms first appear, characterize the dynamics of the disease, and factors that cause a patient's condition to improve or worsen. Study life history, family history.
- physical examinationA specialist assesses the appearance of the fingers, revealing deformities, inflammation, cracks, dry skin, temperature and color disturbances, swelling and other pathological manifestations. Check sensitivity, range of motion, and peripheral arterial pulses.
- radiography.It is performed in two projections, capturing the affected finger or the entire hand. Confirm the presence of fractures, dislocations, tumors, inflammatory and degenerative processes, and areas of destruction of deep panaritium form solid structures.
- Electrophysiological Research.They are performed for neuropathic pain to determine the extent of nerve damage, assess muscle condition and nerve conduction.
- lab testing. Used to determine inflammation, assess the general condition of the body, detect specific markers in collagen.
Patients were referred to endocrinologists, neurologists, vascular surgeons, and other specialists according to indication. Assign CT, MRI, and other instrument techniques. Biopsies of hard and soft structures for cytology or histology.
treat
first aid
In the event of trauma, a cold, elevated limb position is recommended. The hands are immobilized with splints or temporary materials such as planks. Brush up or use a scarf. For severe pain syndrome, analgesics are given and, in the absence of external injury, chloroethyl.
Helping the disease depends on the nature of the pathology - changes in the position of the limb, heating or conversely cooling can help. The most common measure is rest, however, in some disorders (carpal tunnel syndrome, arthritis) the pain syndrome is reduced while maintaining motor activity. Acute convulsive pain, obvious signs of inflammation, and whole body hyperthermia are reasons for urgent consultation with a specialist.
Conservative treatment
In the case of dislocations and fractures, local anesthesia is administered, reduction is performed, and a plaster cast is applied. Conservative management of traumatic and nontraumatic lesions of the fingers includes the following activities:
- protected mode. It is chosen taking into account the nature and severity of the disease. Possible advice on limiting loads, using orthopaedic equipment, applying plaster casts.
- medical treatement. Use of non-steroidal anti-inflammatory drugs, antibiotics, drugs to improve blood circulation, neurological drugs. Depending on the indication, blockade with corticosteroids.
- non-drug methods. Exercise therapy, massage, physiotherapy, manual therapy, kinesiotherapy are prescribed.
surgical intervention
Surgery is performed when conservative methods are ineffective to reduce time and improve long-term outcomes of treatment. Considering the characteristics of the lesion, the following treatments are performed:
- Hurt: Fixation of fractures and dislocations with knitting needles, excision of necrosis and amputation in case of frostbite.
- infectious disease: Drainage of open, panaritium, in some cases with severe lesions - amputation or joint dislocation.
- Tendon and Ligament Disorders: Dorsal ligament resection and adhesion resection for de Quervain disease, annular ligament resection for stenotic ligamentitis.
- tumor: Removal of neoplasia, bone resection.
- Nervous system disease: Nerve decompression.
After surgery, antibiotic therapy is prescribed. Patients undergo comprehensive rehabilitation aimed at maximizing hand function.