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 connection with motor activity, weather conditions and other factors. Accompanying external disturbances are possible: deformations, changes in color and temperature, edema. To determine the cause of pain in the fingers, the results of surveys, external examinations, X-rays and other methods are used. Until the diagnosis is made, rest is recommended, sometimes taking painkillers.

Why do my fingers hurt

Traumatic injuries

Finger injury is characterized by moderate pain. Then the intensity of the pain gradually decreases. Edema, hyperemia, cyanosis, bleeding are possible. Finger function is slightly impaired. Hematomas on the palmar surface of the fingers are manifested by moderate pain, separation of the skin with the creation of a cavity filled with dark blood. In subungual hematomas, the pain is intense, twitching, pulsating, intensified by lowering the brush. Partial or complete separation of the nail plate is possible.

The fracture of the finger was accompanied by severe explosive pain at the time of the injury. After that, the pain decreases somewhat, but remains intense. The finger is blue, swollen, its functions are grossly impaired. Deformity, crepitus, pathological mobility can be detected. When the finger is dislocated, sharp pain is noticed. 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 hours, the pain is weak, burning. Then the pain syndrome intensifies, takes on a burning character. The finger swells, becomes cyanotic. With deep frostbite, there is no sensitivity in the distal parts, the fingers are cold, pale, the pain bothers you on the border of healthy and affected tissue.

Infectious lesions

Panaritium is characterized by rapidly growing pain, swelling, hyperemia, cyanosis, abscess formation. Pains that twitch, pulsate, deprive the night of sleep. Particularly strong are the painful sensations expressed in subungual panaritium and deep forms of the disease (bone, joint, tendon). In superficial forms of panaritium (cutaneous, periungual, subcutaneous, subungual), the general condition is mild, with deep symptoms of intoxication, fever.

Chinga develops in people who cut and process the corpses of sea game, it occurs with minor injuries: scratches, wounds, cracks. It manifests as dull, weak pain in the wound area, which after 1-2 days is replaced by pain in the finger joint (usually proximal). The pain grows, becomes painful, pulsating, complemented by swelling, pallor, cyanosis of the finger.

Arthritis

Pain in the finger joints in rheumatoid arthritis is symmetrical. Grade 1 activity is manifested by minor arthralgia, stiffness that disappears quickly. In the 2nd degree, the pain is disturbed at rest and during movement, in combination with prolonged stiffness, restricted movement, redness. Grade 3 is characterized by intense constant 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 increase in general temperature. Deleted symptoms are less common - less pain and mild redness with a satisfactory general condition.

Psoriatic arthritis occurs suddenly or gradually. In the first case the pain is moderate, growing, in the second - sharp, intense. At the peak of the disease, the typical picture includes pain, intensified at night and at rest, weakening during the day, with movements, swelling of the fingers, purple-bluish skin color. Distal interphalangeal joints are most commonly affected. Multiple deformations appear over time.

In post-traumatic arthritis, one joint is affected. For infectious-allergic forms of the disease, which develop in the background of bacterial and viral infections, multiple lesions are typical. In occupational peripheral arthritis, the most stressed finger joints are involved in the process. The pain in all these forms of pathology intensifies at night, weakens during the day, and is supplemented by morning stiffness, local swelling and difficulty moving. Deformations are observed at long flow.

Degenerative pathologies

In osteoarthritis of the hand, the pain is initially indefinite, periodic, short-lived. There is morning stiffness. After that, the painful sensations intensify, prolong, sometimes burn, are noticed with any movements, limit daily activity and perform delicate operations. Heberden and Bouchard nodes are formed. Lateral deformations occur.

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. In the beginning, the pain syndrome occurs only with pressure and small movements, and then it remains at rest. Movements are limited, clicked. Over time, flexion contracture develops, after a click, pain is given to the hands.

In the initial phase, de Quervain's disease is manifested by pain during abduction, hyperextension of the first finger. After that, during any physical activity, there are pains, pains that press, some patients are upset even at rest. Typical radiation to the distal phalanx or to the forearm on the side of the first finger.

Angiotrophoneurosis

Raynaud's syndrome is caused by vasospasm, followed by paroxysmal numbness, cold fingers. The pain occurs in the second phase of the attack, it has a refractive character, it is combined with tingling and fullness. The pain syndrome is short-lived, replaced by a feeling of heat, redness of the distal parts of the hands. Pathology occurs in various diseases of various origins, including:

• rheumatoid arthritis;
• systemic lupus erythematosus;
• scleroderma;
• Sharp's syndrome;
• antisynthetic 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, neurological, hematological diseases. It is manifested by paroxysmal attacks of burning, burning, edema, hyperemia of the fingers. It is possible that the pain spreads from one limb to the other or that it occurs simultaneously in the area of both limbs. The attacks of pain are so intense that they interfere with every movement. The pain is reduced by cooling and raising the hand, increasing by warming up and lowering the arms.

Neurological pathologies

Pain in the fingers occurs when the nerves are damaged, spreads in the zone of innervation, has the character of shooting or burning, it is supplemented by sensory disorders, autonomic-trophic disorders. Possible neurological causes:

• Middle nerve neuropathy.The pain is localized on the palmar side of the I-III fingers, combined with the inability to bend the fingers, squeeze the fist into the fist, oppose the first finger.
• carpal tunnel syndrome.A type of median 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 when lowering hands, shaking of brushes.
• Radial nerve neuropathy.In lesions at the level of the forearm and wrist, the pain occurs along the back surface 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 is characteristic.
• Ulnar nerve neuropathy.The pain is localized mainly in the area of the elbow joint, but can radiate to the fist, IV-V fingers. 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 painful feelings of unclear localization, osteoid osteomas - sharp pains in the affected area. Malignant neoplasia of the fingers is rare.

Other reasons

Pain in the fingers and hands 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, recede, are supplemented by trembling, sudden weakness of the hand, local cramps. In addition, pain in the fingers can be detected in the following pathologies:

• Leukemia: Waldenstrom's macroglobulinemia.
• Tumors of the adrenal glands: aldosterone.
• Complications of diabetes: diabetic neuropathy.
• Vascular diseases: distal digital embolism due to subclavian artery occlusion.
• hereditary diseases: Fabry disease.
• Children's diseases: neuro-arthritic diathesis.

Diagnosis

Traumatologists-orthopedists are engaged in determining the cause of pain in the fingers. The diagnosis is made on the basis of conversations with the patient, data from external examinations, additional studies. The diagnostic program includes:

• Poll. The doctor discovers when and under what circumstances the pain syndrome and other symptoms first appeared, determines the characteristics of the dynamics of the disease, the factors that cause improvement or deterioration of the patient's condition. Study of life history, family history.
• Overview. The specialist evaluates the appearance of the fingers, detects deformities, inflammation, cracks, dry skin, temperature and color, swelling and other manifestations of pathology. It 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. It confirms the presence of fractures, dislocations, tumors, inflammatory and degenerative processes, areas of destruction of solid structures in deep forms of panaritium.
• Electrophysiological studies. They are performed for pain of neurological origin in order to clarify the degree of nerve damage, assess the condition of the muscles and nerve conduction.
• Laboratory tests. Produced to determine inflammation, assess the general condition of the organism, detect specific markers in collagenosis.

According to the indications, patients are referred for consultations with endocrinologists, neurologists, vascular surgeons 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, a cold, elevated limb position is recommended. The hand is fixed with a splint or improvised materials (for example, planks). The brush is lifted or a scarf is used. In case of intense pain syndrome, an analgesic is given, and in the absence of external damage, chloroethyl is used.

Help with the disease is determined by the nature of the pathology - it can help to change the position of the limbs, warming up or, conversely, cooling. The most common measure is rest, but in some diseases (carpal tunnel syndrome, arthritis) the pain syndrome is reduced while maintaining motor activity. Acute twitching pains, pronounced signs of inflammation, general hyperthermia are the reason for urgent consultation with a specialist.

Conservative therapy

In case of dislocations and fractures, local anesthesia is performed, reduction is performed and plaster is applied. Conservative treatment of traumatic and non-traumatic finger pathologies includes the following activities:

• Protective mode. It is selected taking into account the nature and severity of the disease. Possible recommendations for load limitation, use of orthopedic aids, imposition of plaster.
• Medical therapy. Non-steroidal anti-inflammatory drugs, antibiotics, drugs to improve blood circulation, neurotropic drugs are used. Corticosteroid blockades are indicated.
• Drug-free methods. Physiotherapy, massage, physiotherapy, manual therapy, kinesio taping are prescribed.

Surgical interventions

Surgeries are performed when conservative methods are ineffective, in order to shorten the time and improve long-term treatment results. Taking into account the characteristics of the lesion, the following is carried out:

• Injuries: fracture fixation and dislocation with knitting needles, necrectomy and finger amputation in case of frostbite.
• Infectious diseases: opening, drainage of panaritium, in case of severe lesions in some cases - amputation or disarticulation.
• Tendon and ligament diseases: dissection of the dorsal ligament and excision of adhesions in de Quervain's disease, dissection of the annular ligaments in stenotic ligamentitis.
• Neoplasms: removal of neoplasia, bone resection.
• Neurological diseases: nerve decompression.

After the operation, antibiotic therapy is prescribed. Patients undergo comprehensive rehabilitation aimed at maximum restoration of hand function.