Normally, a person’s fingers bend freely into a fist and straighten. This function is carried out thanks to two sets of tendons: flexors (on the side of the palm) and extensors (on the back of the hand). When the fingers do not bend, this indicates inflammation of the tendons.
The flexor tendons are smooth white bands of tissue that begin in the forearm and end at the wrists and fingers. The tendons pass through tunnels, the shell of which is lined with lubricating tissue and is called the synovium.
Problems with bending the fingers are caused precisely by inflammation of the synovial membrane, enlargement of the tendons, thickening or narrowing of the membrane itself, usually in the palm area, closer to the fingers.
Reasons for fingers not bending
- Stenosing tenosynovitis . The disease is a common problem with finger movement, especially when the thumb does not bend. The disorder is technically described as having a “finger on the trigger.” Stenotic means narrowing of the tunnel or tubular structure (tendon sheath). Tenosynovitis is the name given to inflammation of the tendon.
- Tendinitis . Tendon swelling is a result of a person's own tendency for fluid to collect around tendons and joints. This may be aggravated by repetitive movements or strenuous activities. In this case, the bend of the fingers (flexor tendon) becomes irritated, causing pain, swelling and stiffness.
- Hammer finger . This is a disease in which the terminal joint of the finger does not straighten, which is caused by damage to the tendon. Occurs as a result of a hard blow. In most cases, treatment requires constant wearing of splints for 6-8 weeks.
- Deformation like a boutonniere . It occurs as a result of injury to the tendon in the middle joint of the finger. If the injury is not treated promptly, the deformity progresses and becomes permanent. With this disorder, most often the middle finger of the hand does not bend.
- Arthrosis and types of arthritis . These diseases weaken the flexor tendons and are not due to injury. The disorder occurs due to pathologies of the cartilage tissue of the surfaces of the joints. A person simply notices that his fingers bend poorly.
Symptoms
Symptoms accompanying the condition when the fingers cannot bend:
- pain in the area of the inflamed tendon;
- inability to bend one or more joints at once;
- the finger does not bend;
- numbness at the tip of the finger;
- redness and swelling in the joints of the fingers or palm;
- the finger is pulsating;
- discomfort in the area where the fingers attach to the palm;
- It hurts to clench your hand into a fist.
When symptoms continue for several months without treatment, it can lead to finger stiffness and loss of normal flexion function.
Ligamentite
Ligamentite
is a disease of the tendons responsible for bending the fingers. In the initial stage of the disease, the fingers are fully extended, but this action is accompanied by a clicking sound. As the disease progresses, it becomes difficult for a person to perform such a simple action. Stenosing ligamentitis blocks the joints, leading to the fact that the fingers are always in a half-bent state.
Kinds
Stenosing ligamentitis is of two types.
Nutt's disease is also known as snapping finger syndrome. The characteristic sound occurs as a result of enlargement of the annular digital ligament.
De Kerwin's disease has a second name - “mother's wrist”. With this disease, the ligaments of the thumb are affected as a result of increased load on it or hormonal imbalance. The pathology manifests itself as severe pain in the thumb and creaking sounds when moving. Tension occurs in the tendon, which is damaged by the disease.
The pathology is also classified according to the degree of damage to the tendons; in total, four stages are distinguished.
Causes
Factors that provoke the development of ligamentitis can be different. The disease is often caused by:
- injuries;
- bad heredity;
- inflammatory diseases of the joints;
- excessive load on the hands;
- hormonal imbalances, diabetes.
This disease is often diagnosed in people involved in music, sports, seamstresses, and plasterers. Representatives of professions whose work involves a constant, same type of load on the hands.
Symptoms and signs of ligamentitis
The main symptom of ligamentitis is difficulty bending and straightening your fingers. When they move, clicking sounds occur. Joints often swell. If left untreated, a person may completely lose the ability to move their fingers.
At the first stage of the disease, the joint sometimes clicks, and pain appears periodically.
On the second, you have to make an effort to bend and straighten your fingers, and pain occurs more often.
On the third or fourth stage, the affected finger loses the ability to bend and straighten, and the hands lose functionality.
Which doctor treats
Ligamentitis is treated by a hand surgeon (if surgery is required) or an orthopedist.
Important! The decision about what treatment will be - conservative or surgical - is made based on the stage of the disease.
Diagnostic methods
When a patient first seeks medical help, the doctor examines the affected limbs and conducts tests to determine the type of disease and its stage. If necessary, additional examinations are prescribed:
- Ultrasound.
- MRI.
- .
Treatment methods
Ligamentitis is treated conservatively on an outpatient basis. But therapy must be carried out under the supervision of a doctor. It involves physiotherapeutic procedures, massage, and hand exercises. People suffering from this disease are also prescribed compresses and rubbing ointments with gels.
Hydrocortisone injections into problem joints help well in such cases. A special fixing bandage is applied at night.
If conservative treatment does not produce results, surgery is prescribed. Surgical intervention relieves pain in the joint, completely eliminates pinching, and makes it possible to quickly restore the hands affected by the disease.
The operation is performed in a hospital at a medical center and is considered uncomplicated. Before this, it is necessary to undergo tests and test for possible allergies to medications, especially to anesthesia.
results
The results of treatment largely depend on the stage of the disease at which it was started. The earlier therapy starts, the higher the chances of returning full mobility to the fingers.
Rehabilitation and lifestyle restoration
At the rehabilitation stage, it is important to follow all medical recommendations, especially if surgery has been performed. Loads on joints should be dosed. Medicines prescribed by a doctor must be taken according to schedule, and do not exceed or reduce the dosage without permission.
On a note! Physiotherapeutic procedures may be prescribed for faster recovery after surgery.
Lifestyle with ligamentitis
People suffering from ligamentitis need to reconsider their lifestyle. They are required to comply with occupational hygiene rules. Avoid overloading your joints, remember to take breaks from work, and change activities periodically. The listed recommendations should also be followed when playing sports. It is important to avoid overloading the ligaments.
Get diagnosed in a clinic with modern equipment, identify ligamentitis at an early stage, and start therapy in a timely manner.
On site you can do CT, MRI, ultrasound, and get advice from experienced doctors. Track.
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Treatment
If your fingers cannot bend, then it is preferable to use non-surgical treatment methods to rehabilitate tendon disorders:
- Avoid physical activity on irritated tendons for 2-3 weeks;
- apply ice to a finger that does not bend for up to 15 minutes;
- use non-steroidal anti-inflammatory drugs, such as naprosyn, aspirin, ketoprofen;
- steroid injections into the area around the tendon. The injection places a small amount of cortisone in the area of inflammation. This reduces swelling and can get rid of the problem forever. Success rates are 60% in most cases. However, you should not use more than two injections in one finger, because this can lead to tendon rupture;
- If your fingers are difficult to bend and fix, and also painful to straighten, it is useful to use a splint. It is installed on the middle phalanx of the finger and keeps the ends of the tendon from separating.
De Quervain's tenosynovitis
The thumb is the most active; almost no movement can be made without it. The tendons of the abductor pollicis muscle and the extensor muscle are located in the same canal. When the tendon becomes inflamed, it narrows, which irritates the pain receptors.
De Quervain's syndrome is also called "mother's wrist." This is due to the fact that it is quite often diagnosed in women who do monotonous and monotonous housework every day or carry small children in their arms.
What is De Quervain's tenosynovitis?
The disease is an inflammation that affects the tendon of the thumb, which in turn provokes inflammation of the synovial membranes between the thumb and wrist. As the pathology progresses, the tendons increase in volume, rub against the wall of the tendon sheath (when the thumb moves), and become injured. The muscles do not fit into the synovial sheath, so the tendon moves along it in jerks, which reduces the function of the entire hand.
Causes
The reasons for the development of tenosynovitis are not fully understood. Perhaps this is a reaction of the tendons to increased pressure in the big toe area.
In addition to the significant and prolonged load on the wrist joint, experts identify the following provoking factors for the development of de Quervain’s tenosynovitis:
- arthrosis; — congenital anatomical structures of bones and muscles; - inflammation of the joint; - hand injury; - hormonal changes that are characteristic of pregnancy, the period after childbirth, and menopause.
De Quervain's tenosynovitis is most often diagnosed in people who, by the nature of their work, perform repetitive movements - milkmaids, gardeners, hairdressers, pianists, golfers.
Symptoms and signs
The main complaint of patients with de Quervain's tenosynovitis is pain, which is localized in the wrist on the side of the radius. It may radiate into the forearm, especially when trying to straighten or squeeze the thumb. The pain is aching, twitching, and intensifies when performing grasping and twisting movements.
During examination, swelling and increased sensitivity in the area of the styloid process of the radius may be observed. Also noticeable is an incomplete range of motion in the first carpal joint, thickening of the first dorsal compartment, and crepitus. Some patients complain of paresthesia and weakness.
Which doctor treats you?
Inflammation of the tendons is treated by an orthopedist. The doctor will conduct diagnostics, establish an accurate diagnosis and prescribe treatment only based on the tests.
Our clinic has all the necessary diagnostic facilities for diagnosing de Quervain’s tenosynovitis - ultrasound, CT, MRI. Thanks to our highly qualified specialists, in most cases, only a physical examination of the patient is sufficient to identify this disease.
Visual examination allows you to find differences between the condition of both hands, and with the help of palpation you can determine the location of the lesion. To confirm the diagnosis, our doctors may conduct a test - the patient is asked to place his palms on the edge with the inside facing each other and move his fingers. The difference in finger bending can reach 80 degrees.
Our specialists also conduct the Finkelstein test. The patient is asked to make a fist with the thumb under the other fingers. Then the doctor moves the hand towards the little finger. If there is a lesion, the patient will feel a sharp pain at the site of inflammation.
Treatment methods
Treatment of de Quervain's tenosynovitis involves complex therapy. If you consult a doctor in a timely manner, the orthopedist can prescribe conservative treatment, which in 50% of cases gives a positive result.
Conservative therapy is as follows:
—
Limiting the load
on the affected area.
The thumb can be fixed with a bandage so that it is in a semi-bent position in relation to the second and third fingers. The doctor may also recommend wearing a cut at the first metacarpophalangeal joint. In some cases, a plaster cast or plastic splint is applied for more rigid immobilization. All these measures do not cure the disease, but only have a gentle effect on the joint and stop the progression of tendon damage. - Medicines
. To reduce the intensity of pain, the doctor can prescribe short courses of non-steroidal anti-inflammatory drugs; sometimes injections of hydrocortisone are necessary, and if the pain is very severe, a novocaine blockade is given.
If conservative treatment does not give positive dynamics, the doctor suggests surgical intervention. It is indicated if there is bilateral damage. The operation is performed under local anesthesia and consists of removing the affected ligament and eliminating the adhesive process. After the operation, the patient can return to their normal lifestyle after 2 weeks.
results
Timely treatment allows you to quickly and effectively cope with the disease, significantly improve the patient’s quality of life and prevent the development of serious complications.
Rehabilitation and lifestyle restoration
Rehabilitation after treatment of de Quervain's tenosynovitis consists of joint development (physical therapy) and physiotherapeutic techniques - ultrasound, paraffin, laser, shock wave therapy.
Lifestyle with De Quervain's tenosynovitis
You can avoid relapses of inflammation of the tendon sheath by following preventive measures:
— timely treatment of infectious pathologies; — dosed load on the tendons; - if there is a risk of overexertion, use orthoses or fixing bandages; - strengthening the immune system.
Hand pain is a very common problem with which patients turn to orthopedists. Often, after an examination, the patient may hear a diagnosis of de Quervain’s tenosynovitis. Do not be afraid of such a loud name for the pathology; this disease rarely leads to dangerous consequences, and in most cases responds well to treatment.
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