pain in fingersoccurs when bones, joints, soft tissues, blood vessels, and nerves are affected. It can be dull, acute, weak, intense, constant, intermittent, short-term. Often there is a connection with motor activity, weather conditions and other factors. Accompanying external disorders are possible: deformations, changes in color and temperature, edema. To determine the cause of pain in the fingers, the results of a survey, an external examination, an X-ray examination and other methods are used. Rest, sometimes taking pain medication, is recommended until the diagnosis is made.
Why do fingers hurt
traumatic injuries
A finger injury is characterized by moderate pain. Then the intensity of the pain gradually decreases. Edema, hyperemia, cyanosis, bleeding are possible. The function of the finger is slightly impaired. Hematomas on the palm 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, jerky, pulsating, and is 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. The pain then subsides somewhat, but remains intense. The finger turns blue, swells, its functions are grossly violated. Deformity, crepitation, pathological mobility can be noted. When a finger is dislocated, a stabbing pain is noted. The finger is deformed, swollen, when trying to move in the affected joint, the spring resistance is determined.
With frostbite in the first hours, the pain is mild and tingling. Then the pain syndrome intensifies, acquires a burning character. The finger swells, becomes cyanotic. With deep frostbite, there is no sensitivity in the distal parts, the fingers are cold, pale, pain interferes with the border between healthy and affected tissues.
Infectious lesions
Panaritium is characterized by rapidly increasing pain, swelling, hyperemia, cyanosis, abscess formation. Twitching, throbbing pains that deprive the night of sleep. Especially 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 dissection and processing of the carcasses of marine wildlife and appears with minor injuries: abrasions, wounds, cracks. It manifests itself as a 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 grows, becomes aching, throbbing, complemented by swelling, pallor, cyanosis of the finger.
arthritis
Pain in the finger joints in rheumatoid arthritis is symmetrical. 1 degree of activity is manifested by mild arthralgia, rapidly disappearing stiffness. At grade 2, the pain is disturbed at rest and with movement, combined with prolonged stiffness, limitation of movement, redness. Grade 3 is characterized by intense constant pain, persistent stiffness, swelling, hyperemia. Movement is severely restricted.
Gouty arthritis of the fingers is more common in women. One or more joints can be affected. The pain is usually acute, sharp, combined with edema, hyperemia, dysfunction and an increase in general temperature. Erased symptoms are observed less often - slight pain and slight redness with a satisfactory general condition.
Psoriatic arthritis comes on suddenly or gradually. In the first case, the pain is moderate and growing, in the second - sharp, intense. At the peak of the disease, the typical picture is pain, which worsens at night and at rest, weakens during the day, during movements, swelling of the fingers, purplish-bluish discoloration of the skin. The distal interphalangeal joints are most commonly affected. Several deformations occur over time.
In post-traumatic arthritis, one joint is affected. For infectious-allergic forms of the disease, developing against the background of bacterial and viral infections, multiple lesions are typical. In professional peripheral arthritis, the most stressed joints of the fingers are involved in the process. Pain in all the listed forms of pathology intensifies at night, weakens during the day and is complemented by morning stiffness, local swelling and difficulty moving. With a long course, deformations are noted.
Degenerative pathologies
With arthrosis of the hands, the pain is initially indefinite, periodic, short-term. There is morning stiffness. Subsequently, painful sensations intensify, prolong, sometimes burn, are noticed with any movements, limit daily activity, perform delicate operations. Heberden and Bouchard nodes are formed. Lateral deformations occur.
Diseases of the ligaments and tendons
Patients suffering from stenosing ligamentitis are concerned about pain along the palm at the base of the affected finger. At first, the pain syndrome occurs only with pressure and small movements, then it remains at rest. Movements are limited, accompanied by a click. Over time, a flexion contracture develops, after a click, pain in the arm appears.
In the initial stages, de Quervain's disease is manifested by pain during abduction, hyperextension of the first finger. Then, with any physical activity, aching, pressing pains appear, some patients are even disturbed at rest. Typical irradiation of the distal phalanx or forearm from the side of the index finger.
angiotrophoneurosis
Raynaud's syndrome is caused by vasospasm, accompanied by paroxysmal numbness and cold fingers. The pain appears in the second phase of the attack, has a crushing character, is associated with a burning sensation and fullness. The pain syndrome is short-term, replaced by a feeling of heat, redness of the distal parts of the hands. Pathology occurs in a variety of diseases of different 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 provoke this condition, they speak of 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, neurological, hematological diseases. It is manifested by paroxysmal attacks of cheeks, burning pains, edema, hyperemia of the fingers. It is possible for pain to be transmitted from one extremity to the other or to occur in both extremities at the same time. Pain attacks are so intense that they interfere with every movement. The pain decreases when cooling and raising the hand, increases when warming and lowering the hands.
Neurological pathologies
Pain in the fingers occurs when nerves are damaged, spread in the innervation zone, have a shooting or burning character, are supplemented by sensory disorders, autonomic-trophic disorders. Possible neurological causes:
- Median nerve neuropathy.The pain is localized on the palmar side of the I-III fingers, combined with the inability to flex the fingers, clench the hand and resist the I finger.
- carpal tunnel syndrome.A form of median nerve neuropathy caused by compression of nerve fibers at the wrist level. Localization of pain - as in the previous case. Typical nocturnal attacks, pain relief when lowering the arms, shaking the brushes.
- Radial nerve neuropathy.With a lesion at the level of the forearm and wrist, pain is noted along the back of the first finger and hand, sometimes spreading to the second and third fingers. Radiation in the forearm, numbness of the back of the hand are characteristic.
- Ulnar nerve neuropathy.The pain is localized mainly in the area of \u200b\u200bthe elbow joint, but can radiate to the hand, IV-V fingers. The pain syndrome often intensifies in the morning.
tumors
Benign tumors affecting the bones of the fingers include chondromas and osteoid osteomas. Chondromas are expressed by non-intense pain sensations with indistinct localization, osteoid osteomas - by severe pain in the affected area. Malignant neoplasms of the fingers are rare.
Different reasons
Pain in the fingers and hand is observed in patients with writer's cramp, which develops with occupational neurosis, some other mental and neurological disorders. Pain occurs when writing, working at a computer or typewriter. They break, pull, complemented by tremors, sudden weakness of the hand, local spasms. In addition, pain in the fingers can be noted with the following pathologies:
- leukemia: Waldenstrom's macroglobulinemia.
- tumors of the adrenal glands: aldosteroma.
- complications of diabetes: diabetic neuropathy.
- vascular diseases: distal digital embolism due to subclavian artery occlusion.
- hereditary diseases: Fabry disease.
- teething: neuroarthritic diathesis.
diagnosis
Traumatologists-orthopedists are engaged in determining the causes of pain in the fingers. The diagnosis is made on the basis of a conversation with the patient, external examination data, additional studies. The diagnostic program includes:
- opinion poll. 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 in the patient's condition. Study of life history, family history.
- Physical examination. The specialist assesses the appearance of the fingers, reveals deformities, inflammation, cracks, dry skin, temperature and color disorders, swelling and other manifestations of the pathology. Examines tenderness, range of motion, pulsation in the peripheral arteries.
- radiography.It is performed in two projections with capture of the affected fingers or the entire 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 carried out for pain of neurological origin in order to clarify the extent of nerve damage, to assess the condition of the muscles and nerve conduction.
- laboratory tests. Manufactured to determine inflammation, assess the general condition of the body, detect specific markers in collagenosis.
Depending on the indication, patients are referred for a consultation with an endocrinologist, neurologist, vascular surgeon, and other specialists. Assign CT, MRI and other instrumental techniques. Perform a biopsy of hard and soft structures for cytological or histological examination.
treatment
First aid
Cold elevation of the limb is recommended for traumatic injuries. The hand is fixed with a splint or improvised materials (e. g. boards). 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 used.
Help with diseases is determined by the nature of the pathology - changing the position of the limb, warming or, conversely, cooling can help. The most common measure is rest, but in some diseases (carpal tunnel syndrome, arthritis) the pain syndrome subsides while maintaining motor activity. Acute jerking pain, pronounced signs of inflammation, general hyperthermia are the reason for urgent consultation with a specialist.
Conservative therapy
For dislocations and fractures, local anesthesia is performed, reduction is performed and a plaster cast is applied. Conservative treatment of traumatic and non-traumatic pathologies of the fingers includes the following activities:
- protection mode. It is selected taking into account the type and severity of the disease. Possible recommendations for load limitation, use of orthopedic aids, application of a plaster cast.
- Medical therapy. Nonsteroidal anti-inflammatory drugs, antibiotics, drugs to improve blood circulation, neurotropic drugs are used. Depending on the indication, blockages with corticosteroids are carried out.
- Non-drug methods. Movement therapy, massage, physiotherapy, manual therapy, kinesio taping are prescribed.
Surgical interventions
Surgery is 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 performed:
- injuries: Fixation of fractures and dislocations with knitting needles, necrectomy and amputation of fingers for frostbite.
- infectious diseases: opening, drainage of panaritium, with severe lesions in some cases - amputation or disarticulation.
- Diseases of the tendons and ligaments: Dissection of the dorsal ligament and excision of adhesions in de Quervain's disease, dissection of the annular ligaments in stenosing ligamentitis.
- neoplasms: Removal of neoplasms, bone resection.
- neurological diseases: nerve decompression.
After the operation, antibiotic therapy is prescribed. Patients undergo extensive rehabilitation aimed at maximizing hand function recovery.