Treatment of osteoarthritis of the fingers: medications, ointments, physiotherapy

The hands perform the most important functions in the body of any person; if you can’t pick up a spoon, turn a page, or fasten the buttons on your jacket yourself, this becomes a real tragedy - this is precisely the state of affairs that osteoarthritis of the hands, ignored in the early stages, leads to. A feeling of helplessness is a direct road to irritation and depression. Therefore, doctors insist that treatment for osteoarthritis of the small joints of the hands should begin at its first manifestations.

A little about the causes of the disease

For the most part, osteoarthritis of the fingers is typical for older people. It affects the population that has crossed the forty-year mark. However, not all of them: many avoid the sad diagnosis. Doctors were able to identify factors contributing to the onset and development of this joint disease:

hormonal imbalances . They are inevitable in women who have entered menopause. Therefore, osteoarthritis of the small joints of the hands is more common in women at the onset of menopause than in men of the same age. They must exercise increased vigilance;
surgical intervention associated with hand injuries, even if it took place 10-20 years ago. Injuries suffered in the past and treated without surgery also contribute to the development of osteoarthritis of the fingers;
endocrine diseases ( primarily diabetes mellitus);
circulatory problems affecting the arms (not just the hands: the process can spread from the shoulders);
osteoarthritis of the fingers can begin due to specific working conditions . Microtraumas that accompany constant work on a computer or a loom have a bad effect on cartilage;
congenital pathologies of the corresponding parts of the body.

Even an unbalanced diet can provoke osteoarthritis of the interphalangeal joints of the hands or hasten the onset of its development. Impaired metabolism can also be safely included in the sad list: if collagen is produced in insufficient quantities, the joints will definitely become unusable in the foreseeable future.

But the majority of patients are still elderly people who have accumulated numerous problems with the functionality of the body as a whole, and cartilage tissue simply wears out from long-term use.

Reasons for the development of arthrosis of the fingers

Joint deformation is one of the main symptoms that the patient not only feels, but also sees. This pathological change develops over quite a long time, therefore, it is very important to seek help at the first manifestations of the disease. Causes of development of arthrosis of the hands and fingers

I can be

old age (60 years and older);
professional loads on the hands and fingers;
harmful production factors: cold, vibration and others;
injuries: bruises, dislocations, fractures;
hereditary pathologies of joints and connective tissues;
various metabolic disorders;
changes in hormonal levels, menopause;
infectious and chronic diseases, etc.

What to look for

What is positive about osteoarthritis (if there is anything to like about diseases) is its gradual development. It is impossible not to notice the appearance of joint problems; the main thing here is not to persuade yourself in the style of “everything will go away on its own.” After all, treatment of osteoarthritis of the fingers is more successful the earlier it is started. Doctors distinguish three stages of its progression.

initial stage

Joint pain is periodic, infrequent. They are clearly felt during physical strain on the hands, for example, when clenching fists and lifting heavy objects. Many patients feel a barely audible crunching sound coming from their joints.

Such symptoms are characteristic of several diseases , and it is difficult to clarify the diagnosis and make sure that you have osteoarthritis of the hands. But at this stage, treatment helps prevent further degradation of the joints. Therefore, you should go to the doctor at the first sign of discomfort.

Second stage

On it, pain occurs more often and becomes more acute. In the morning, the sensations are very intense, masked, gradually subsiding by the middle of the day, until they disappear completely. Towards the evening, as fatigue accumulates, the soreness will return, and will be accompanied in the late afternoon by inflammation, redness of the skin around the affected area, swelling or edema.

If you “caught” osteoarthritis of the hands at this stage, the treatment will still be effective , and you will not be left helpless. Although the process will take much longer, and full functionality of the fingers is unlikely to be restored. Close attention should be paid to the middle finger phalanges - they suffer more often than others. Pathology in the thumb joint is almost as common.

Hard case

Advanced disease leads to complete loss of fine motor skills. A patient who is careless with his hands cannot perform the simplest movements and is dependent on others. On the uppermost phalanges, Heberden's nodes are formed, on the middle ones - similar seals, named after Bouchard. Both varieties are formed “from the outside,” that is, on the back of the hand, are very painful (even with light touches) and severely limit the motor ability of the hand. The joints and the area around them become noticeably red, and there may be a local increase in temperature in the affected areas. The fingers themselves acquire an unnatural bend to the side and often lengthen compared to a healthy state, although only slightly.

Fortunately, people rarely bring themselves to such extensive defeat. Pain and decreased performance of the fingers force them to see a doctor at the latest - at the second stage of osteoarthritis.

Diagnostic techniques

Diagnosis in the presence of appropriate symptoms is carried out in a clinic. To receive professional diagnostic and treatment assistance, it is enough to have an appointment with a therapist, who, based on the results of the initial examination, will draw certain conclusions and refer the patient to a more specialized specialist.

There are 4 most effective diagnostic methods:

X-ray examination is the optimally accessible diagnostic method that allows you to assess the degree of change in the joint space and bone surfaces, etc. transformations, allowing you to draw a conclusion about the stage of the pathology.
Magnetic resonance imaging (MRI) is the best solution that allows you to visualize the condition of soft tissues (muscle frame, ligaments and tendons, as well as the surface of the joint capsule).
Laboratory blood testing - makes it possible to assess the general health of a person and test for the presence of rheumatoid markers.
Arthroscopic examination - a therapeutic and diagnostic operation allows you to penetrate into the articular cavity in a minimally invasive way and examine in detail the surfaces of the articular tissues. If necessary, it is possible to take a tissue fragment and a small amount of synovial fluid for analysis.

For reference

Osteoarthritis of the interphalangeal joints of the hands can only be accurately diagnosed using radiography. A biochemical blood test alone is not enough: inflammation does not cause an acceleration in the rate of erythrocyte deposition, which is characteristic of other joint diseases of a similar nature. If you notice thickening on the joints, suffer from morning pain in these areas, notice a decrease in the mobility of your fingers, ask for a referral for an x-ray, insist on consulting an orthopedist: your local physician rarely understands such nuances.

The following are used as agents that alleviate the course of polyosteoarthrosis:

physiotherapeutic procedures - to relieve swelling, stimulate blood circulation and metabolism, accelerate regeneration;
manual therapy - to reduce pain;
acupuncture – to restore mobility;
other rehabilitation measures (physical therapy, massage, orthopedic treatment, etc.).

Part of the treatment is a proper diet and giving up bad habits.

With a timely approach, even such a complex disease as polyosteoarthritis can be kept under control. The disease begins with pain in the spine and hands, and is manifested by deformation of one of the large joints - the knee or hip. Therefore, you should not ignore any pain symptoms or attribute them day after day to physical fatigue. It is impossible to completely cure arthrosis, and when it comes to multiple lesions, the future is at stake. Be vigilant and attentive, first of all, to yourself - then the disease will not have a chance!

Features of treatment

The course of therapy and treatment regimen are always determined by a specialist: osteoarthritis of the hands and the impact on it depend on the patient’s health status, existing chronic diseases, causes of joint problems, stage of the disease and a whole set of other factors.

The main set of medications for the treatment of joints:

anti-inflammatory agents . Nonsteroidal drugs (Nimesil or Diclofenac) are usually prescribed. Their task is to eliminate the inflammatory process, which will naturally lead to a reduction in pain;
chondroprotectors, which should improve the nutrition of the damaged cartilage and help it in the future recovery (Artron, Chondroxide). The drugs are effective only in the first two stages of osteoarthritis. In advanced forms, they are useless: the cartilage is destroyed, there is nothing to restore. You need to take chondoprotectors for a long time; short courses are ineffective;
vasodilators (Nikospan, Trental). The pathology that causes osteoarthritis of the hands also affects blood circulation; blood stagnation is simply inevitable.

These are the main directions. They may be supplemented with corticosteroids administered intra-articularly. These drugs do not affect the treatment of osteoarthritis, but they perfectly relieve pain and help eliminate inflammation more quickly. This step is relevant if the pain is severe, to the point of intolerance.

The doctor may also recommend accompanying products: gel, ointment, solution for compresses. Their effectiveness is not very great, since the skin has difficulty allowing foreign (or perceived as such) substances into the body. But as a concomitant therapy, external remedies should not be neglected.

Why is polyosteoarthritis dangerous?

Multiple joint lesions indicate serious disorders in the body. As a rule, the disease develops against the background of other pathological conditions, and does not become a consequence of an accidental injury, therefore the prognosis is always less favorable than with localized osteoarthritis of the elbow, knee or hip joint.

Among the most common complications is limited mobility of the limbs and spinal column. If the disease is not treated at all, the joints wear out to such an extent that every movement brings incredible pain. And since the lesions are multiple, disability is one step away.

Not only medicines

Medicines eliminate symptoms, reduce pain and inflammation, but alone they will not cope with their task soon. Physiotherapeutic techniques are very important in the treatment of osteoarthritis of the fingers. Recommended procedures:

electrophoresis : it avoids complications and allows the patient to carry out procedures at home (after detailed consultations and doctor’s recommendations). It becomes possible not only to improve metabolism and blood circulation in the affected joint, but also to deliver a mass of medications to it - from novocaine, zinc and sulfur to dimexide with analgin;
laser - its effects can only be obtained in a physiotherapy room. But the device relieves reflex muscle spasms, normalizes the permeability of cell membranes, stimulates tissue respiration and metabolism. The only limitation is that this technique is not applicable during the relapse period; you will have to wait for a stable remission;
cryotherapy. Cold applications to the affected joint become a real salvation when treatment of osteoarthritis of the fingers is limited to exacerbation of the disease. Their use stops the development of irritation in the joint capsule, relieves swelling, and facilitates treatment after the relapse ends.

UHF and magnetotherapy also give good results; methods provided by traditional medicine are effective. But in the latter case, coordination with the attending physician is required: “healer” approaches may conflict with the main course of treatment.

Key Treatment Approaches

It is impossible to diagnose the disease by clinical examination alone. Laboratory tests and x-rays of the affected joints are needed. The therapy is aimed at reducing the intensity of degenerative processes in cartilage tissue, restoring the functioning of affected joints, and relieving pain and inflammation.

Drug treatment includes:

chondroprotectors – for the restoration of cartilage tissue;
anti-inflammatory drugs - non-steroidal and intracapsular corticosteroids;
drugs to improve blood circulation.

If the focus of the disease is identified, it is possible to restore the synovial fluid with intra-articular injections of Noltrex, a synthetic drug with a prolonged action. The product is a liquid endoprosthesis that is well tolerated by the body and does not cause rejection, allergic reactions or infections. After two to three injections at weekly intervals, the damaged joint acquires normal biomechanics, which lasts for a year or longer.

Intra-articular injections quickly restore the biomechanics of an individual joint

About the benefits of physical therapy

Many patients diagnosed with osteoarthritis of the hands try to protect their limbs from any stress. On the one hand, the approach is correct - they should avoid lifting and carrying heavy objects, manually twisting clothes (the presence of an automatic washing machine saved us from such exercises), push-ups and other excessive force on the wrist. On the other hand, being too careful can also be harmful. After all, the joints are surrounded by muscles, and if the muscles are atrophied, then the joints take on an impact for which they are not prepared by nature.

Therefore, physical therapy should become a mandatory daily procedure. The most primitive actions - gentle turns of the fingers, warming up the hand with the other hand, squeezing and unclenching a rubber expander - will prevent irreversible consequences in your joints.

If, from the age of 25, you mechanically pay a little purely physical, without the participation of the mind, attention to such exercises, you will never know what osteoarthritis of the small joints of the hands is.

Osteoarthritis of the wrist joint treatment. Clinical picture of the disease

If treatment is not started on time, Heberden's and Bouchard's nodes may appear on the fingers.

Post-traumatic osteoarthritis develops gradually. Damage to the wrist joint is manifested by severe pain in the joint. At the first stage of this dislocation of the arthropathy focus, pain occurs as a result of prolonged stress on the joint. The nature of the pain in the first stage is aching, sometimes pulling. At rest there is no symptom, minor discomfort is possible. With the development of grade 1 osteoarthritis of the wrist joint, there is no limitation of mobility. As the disease progresses, the following symptoms appear:

swelling of the wrist;
the pain is monotonous.

Discomfort at the 2nd stage of development is formed in a clearly limited zone of connection of bone structures. The pain does not radiate to other parts of the limbs. As dystrophic pathology progresses, the range of movements decreases. In the absence of treatment, the disease reaches stages 3 and 4 of development, with partial or complete immobility of the joint. The pathology is actively developing, a crunching sound appears in the joints, reminiscent of clicks.

The disease can spread to the fingers, and Heberden's nodes appear, which are multiple in nature. Bumps that grow on the knuckles cause numbness and tingling in the fingertips. The consistency of the nodules is bone, they are painful. The joints begin to deform so much that it becomes noticeable from afar. The incidence of nodules increases with age. Such bumps can be found in ⅓ of people over 80 years of age. Heberden's nodes do not go away and cannot be treated with conservative methods, since they are the result of irreversible modifications of the hyaline articular cartilage and subchondral bone.

About nutrition

It is usually not possible to restore already deformed cartilage tissue in joints. But the degradation process can be stopped. And an adjusted menu will help with this. It will also prevent (together with moderate exercise and compliance with medical prescriptions) another relapse.

Recommendations to say goodbye to excess weight will not please anyone. But if you don’t want to literally be armless, you will still follow them. Extra pounds actively contribute to the development of osteoarthritis of the fingers (and not only them, there are enough vulnerable joints in the human body). For people who have problems with cartilage tissue, doctors strongly recommend increasing the dose of dairy products in the diet: this is the most natural source of calcium in the most absorbable form by the body. Ladies over 50 should drink milk in liters, and eat cottage cheese in kilograms - it is good for well-being, and for bones, and for cartilage.

It’s also stupid to give up meat, even in the name of a figure. It contains a lot of protein, without which the body cannot survive. You just need to take lean pieces. And you definitely need to serve buckwheat or lentils as a side dish - this is a true treasure trove of microelements!

Jellied meat is especially useful for joint sufferers . It should be consumed not only on holidays. It would be a good idea to listen to the recommendations of nutritionists and give up excess sugar, tomatoes, black pepper, and yolks - they are frankly harmful for osteoarthritis. Vigilance and moderation should be the motto of every person with osteoarthritis of the interphalangeal joints of the hands.

Diagnostics

Diagnosis of osteoarthritis (deforming arthrosis) based on a combination of clinical and instrumental data. In modern medicine, there are certain diagnostic criteria for this disease, both clinical and instrumental. The clinical criteria are: The presence of pain in the joints, mainly at the end of the day or at the beginning of the night; pain, as a rule, also occurs during physical activity and regresses after a little rest and joint deformation is visually determined (including due to Heberden’s and Bourchard’s nodes). X-ray manifestations of osteoarthrosis are: decreased joint space, the presence of sclerotic changes in the bone tissue, the presence of bone growths (osteophytes). Certain features are characteristic of some forms of osteoarthrosis (coxarthrosis). The following clinical manifestations are characteristic of coxarthrosis: decreased range of motion in the hip joint (decreased external rotation) and pain during internal rotation; stiffness in the joint in the morning for no more than an hour; patients over 50 years of age.

Laboratory examinations show abnormalities in the presence of complications (for example, with synovitis, the ESR may increase and in biochemical parameters with synovitis, the amount of fibrin seromucoid sialic acids increases).

X-ray research methods usually provide sufficient information about the presence of degenerative changes in the joint. Depending on the x-ray picture, the classification of osteoarthritis is carried out:

0 absence of radiological signs of osteoarthritis
Stage 1 – cystic restructuring of the bone tissue structure, the appearance of small osteophytes, signs of linear osteosclerosis
Stage 2 osteosclerosis, more pronounced and signs of narrowing of the joint space appear.
Stage 3: severe osteosclerosis, osteophytes become large, and the joint space narrows significantly.
Stage 4 osteophytes are more massive, the joint space is practically not visualized, the deformation of the epiphyses of the bones is flattened.

X-ray examination of joints.

To diagnose osteoarthritis, an analysis of a biopsy of synovial fluid is often prescribed, which allows one to determine the presence of signs of degeneration or an inflammatory process.

MRI and CT are prescribed when detailed visualization of morphological changes and differential diagnosis with other joint diseases is necessary