Pain in the fingersit occurs when bones, joints, soft tissues, blood vessels, nerves are affected. It can be dull, sharp, faint, intense, constant, intermittent, short-lived. Often there is a connection with motor activity, weather conditions and other factors. Concomitant external ailments are possible: deformations, changes in color and temperature, edema. To determine the cause of pain in the fingers, 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 pain relievers.
Why fingers hurt
Traumatic injuries
A finger injury is characterized by moderate pain. Then the intensity of the pain gradually decreases. Edema, hyperemia, cyanosis, hemorrhages are possible. The function of the finger is slightly impaired. Hematomas on the palmar surface of the fingers are manifested by moderate pain, peeling of the skin with the formation of a cavity filled with dark blood. With subungual hematomas, the pain is intense, jerky, throbbing, aggravated by the lowering of 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 the injury. Thereafter, the pain subsides slightly, but remains intense. The finger turns blue, swells, its functions are severely violated. Deformities, crepitus, pathological mobility can be detected. When a finger is dislocated, sharp pain is noted. The finger is deformed, swollen, when trying to move in the affected joint, the resistance of the spring is determined.
With frostbite 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 freezing, there is no sensitivity in the distal parts, the fingers are cold, pale, the pain bothers at the boundary between the healthy and affected tissues.
Infectious lesions
Panaritus is characterized by pain, swelling, hyperemia, cyanosis, rapidly increasing abscess formation. Jerky, throbbing pains, depriving the night of sleep. Particularly painful sensations are expressed with subungual panaritus 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 cutting and processing marine game carcasses, it manifests itself with minor injuries: abrasions, wounds, cracks. It manifests itself as dull, faint 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
Finger joint pain in rheumatoid arthritis is symmetrical. 1 degree of activity is manifested by minor arthralgia, stiffness that disappears quickly. At 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 acute, acute, combined with edema, hyperemia, impaired function and an increase in general temperature. Erased symptoms are less frequent: mild pain and slight redness with satisfactory general condition.
Psoriatic arthritis occurs suddenly or gradually. In the first case, the pain is moderate, growing, in the second - acute, intense. At the height of the disease, the typical picture includes soreness, aggravated at night and at rest, weakening during the day, with movements, swelling of the fingers, purple-bluish discoloration of the skin. Distal interphalangeal joints are most often affected. Over time, more deformations appear.
In post-traumatic arthritis, one 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 professional peripheral arthritis, the most stressed joints in the fingers are involved in the process. Pain in all forms of the listed pathology intensifies at night, weakens during the day and is complemented by morning stiffness, local swelling and difficulty in movement. With a long path, deformations are noted.
Degenerative pathologies
With arthrosis of the hands, the pain is initially indefinite, periodic, short-term. There is morning stiffness. Subsequently the painful sensations intensify, prolong, sometimes burning, 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 with 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. The movements are limited, accompanied by a click. Over time a flexion contracture develops, after a click pain is given to the arm.
In the initial stage, de Quervain's disease is manifested by pain during abduction, hyperextension of the first toe. Subsequently, with any physical activity, aching and pressing pains occur, some patients are disturbed even at rest. Typical irradiation to the distal phalanx or forearm from the side of the first finger.
Angiotrophoneurosis
Raynaud's syndrome is caused by vasospasm, accompanied by paroxysmal numbness, cold fingers. The pain manifests itself in the second stage of the attack, has a breaking character, is combined with a burning sensation, 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 various origins, including:
- rheumatoid arthritis;
- systemic lupus erythematosus;
- scleroderma;
- Sharp's syndrome;
- antisynthetase syndrome;
- thromboangiitis obliterans of the upper limbs;
- 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 and hematological diseases. It manifests itself with paroxysmal attacks of cooking, burning, edema, hyperemia of the fingers. It is possible to spread the pain from one limb to the other or to manifest itself in the region of both limbs at the same time. Attacks of pain are so intense that they interfere with any movement. Pain decreases with cooling and raising of the hand, increases with warming and lowering of the hands.
Neurological pathologies
Pain in the fingers occurs when the nerves are damaged, spreads to the innervation zone, has a shooting or burning character, is complemented by sensory disturbances, autonomic-trophic disorders. Possible neurological causes:
- Neuropathy of the median nerve.The pain is localized 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. Localization of pain - as in the previous case. Typical nocturnal attacks, decreased pain when lowering the arms, waving the brushes.
- Neuropathy of the radial nerve.With an injury to the forearm and wrist, pain is noted along the back surface of the first finger and hand, sometimes spreading to the second and third fingers. Characteristic are the irradiation in the forearm, the numbness of the back of the hand.
- Neuropathy of the ulnar nerve.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 affecting the finger bones include chondromas and osteoid osteomas. Chondromas are manifested by non-intense pain sensations with indistinct localization, osteoid osteomas - with sharp pains in the affected area. Malignant neoplasm 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, pull, supplemented by tremor, sudden weakness of the hand, local convulsions. Also, pain in the fingers can be detected in the following pathologies:
- Leukemia: Waldenström's macroglobulinemia.
- Tumors of the adrenal glands: aldosteroma.
- Complications of diabetes: diabetic neuropathy.
- Vascular diseases: distal digital embolism due to occlusion of the subclavian artery.
- hereditary diseases: Fabry disease.
- Childhood diseases: neuro-arthritic diathesis.
Diagnostics
Traumatologists-orthopedists are engaged in establishing the causes of pain in the fingers. Diagnosis is made on the basis of a conversation with the patient, data of external examinations, additional studies. The diagnostic program includes:
- Investigation. 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, the factors provoking an improvement or deterioration in the patient's condition. Studying the history of life, family history.
- Physical examination. The specialist assesses the appearance of the fingers, reveals deformities, inflammation, cracking, dry skin, changes in temperature and color, swelling and other manifestations of pathology. He examines sensitivity, range of motion, pulsation in peripheral arteries.
- X-ray.It is performed in two projections with the 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 forms of panaritus.
- Electrophysiological studies. They are performed for pain of neurological origin to clarify the level of nerve damage, assess the condition of the muscles and nerve conduction.
- Laboratory tests. Produced to determine inflammation, assess the general condition of the body, 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 the hard and soft structures for cytological or histological examination.
Treatment
First aid
In case of traumatic injuries, a cold and elevated position of the limb 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 a severe pain syndrome, an analgesic is given, 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, warming 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. Sharp pains, 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 a plaster cast is applied. The conservative treatment of traumatic and non-traumatic pathologies of the fingers involves the following activities:
- Protective mode. It is selected taking into account the nature and severity of the disease. Possible recommendations for load limitation, the use of orthopedic devices, the imposition of a plaster cast.
- 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-pharmacological methods. Physical therapy, massage, physiotherapy, manual therapy, kinesio taping are prescribed.
Surgical interventions
Operations are performed when conservative methods are ineffective, to reduce time and improve long-term results of treatment. Taking into account the characteristics of the lesion, the following is done:
- Injuries: fixation of fractures and dislocations with knitting needles, necrectomy and amputation of the fingers in case of frostbite.
- Infectious diseases: opening, drainage of the panaritus, in case of severe injuries in some cases - amputation or disarticulation.
- Diseases of tendons and ligaments: dissection of the dorsal ligament and excision of adhesions in de Quervain's disease, dissection of annular ligaments in stenosing ligamentitis.
- Neoplasms: removal of neoplasms, bone resection.
- Neurological diseases: nervous decompression.
After surgery, antibiotic therapy is prescribed. Patients undergo a complete rehabilitation aimed at maximizing the restoration of hand functions.