Osteoarthritis of the hands begins when the wear of cartilage exceeds its regeneration. The rate at which cartilage tissue is produced depends on genetics, general health, lifestyle and environmental factors. But even despite regeneration, it tends to wear out - to a large extent, this is facilitated by monotonous loads on the small joints of the hand (working at a computer, machine, online games, writing text by hand, cutting food, wringing laundry, etc.). Degenerative processes in the articular surfaces over time lead to deterioration in mobility and even pain in the hands. Such complaints are observed in 10-15% of all humanity, especially in people over 45 years of age. And this problem is getting younger every year, increasingly affecting patients aged 25-30 years.
Let's look at what osteoarthritis of the hands is, the symptoms and treatment of the disease, the general prognosis, as well as methods for its prevention.
Osteoarthritis of the hands: what is it?
Osteoarthritis of the interphalangeal joints of the hands refers to a whole range of pathological conditions in which the joints of the fingers suffer. The dystrophic process leads to thinning and cracking of the cartilage, gradual destruction of connective tissue and, in later stages, to deformation of the joint. At the same time, the load on the ligaments and muscles of the hands increases - they are in chronic overstrain, which is expressed by pain, swelling, a reduction in the range of motion, as well as rapid fatigue and decreased performance. The shock-absorbing function of the joint capsule deteriorates, the cartilage ceases to retain the amount of moisture that it needs to maintain elasticity. In an effort to prevent further destruction of the joints, the body triggers the production of osteophytes - spine-like and other bone growths that limit mobility and injure adjacent tissues. This leads to chronic pain and inflammation. The metacarpophalangeal joint is poorly involved or not involved at all (unless there are generalized joint diseases or wrist injuries). In the early stages, the process is considered conditionally reversible, but in the absence of treatment, the changes become permanent, and the condition of patients can only be alleviated and maintained.
Osteoarthritis of the hands without treatment quickly spreads to all tissues of the hand - bone, cartilage and muscle. Undesirable, physically noticeable friction appears in the joints, their destabilization is observed, and the capillary supply of the hands deteriorates significantly. Fine motor skills are steadily deteriorating. For patients, performing the simplest household and professional duties becomes painful, grasping movements cause discomfort, handwriting changes, and irritability appears. In the early stages, irregularities and damage to the joint capsule, clearly visible on x-rays, appear. The last stages are characterized by loss of ability to work and complete disappearance of cartilage.
Pain syndrome
Pain is the most constant symptom of arthrosis. The most striking signs of pain with arthrosis are the connection with physical activity and the weather, night pain, starting pain and sudden sharp pain in combination with joint blockade. With prolonged exercise (walking, running, standing), the pain intensifies and subsides with rest. The cause of night pain in arthrosis is venous congestion, as well as increased intraosseous blood pressure. The pain also intensifies under the influence of unfavorable weather factors: high humidity, low temperature and high atmospheric pressure.
The most characteristic sign of arthrosis is starting pain - pain that occurs during the first movements after a state of rest and goes away while maintaining motor activity.
Causes of osteoarthritis of the hands
Experts distinguish several types of carpal arthrosis, among which the most common are professional (associated with everyday increased load on the joints and unfavorable working conditions), traumatic, autoimmune (as a consequence of rheumatoid arthritis) and others. The disease can be secondary and occur due to:
- diabetes mellitus and other metabolic and hormonal disorders;
- previous operations, fractures, dislocations, sprains;
- problems with peripheral arteries and other diseases that impair blood supply to the hands (cervical, thoracic osteochondrosis and others);
- a number of infectious diseases (for example, sickle anemia);
- frequent stress;
- severe or persistent hypothermia.
In addition to the genetic predisposition, which is usually observed in the patient’s relatives, the development of the disease is facilitated by a sedentary lifestyle, excessive stress (sports and household), and excess weight. If the patient already suffers from gout or arthritis, inflammatory diseases of the hand, the risk of arthrosis increases in this case every year.
Deforming osteoarthritis of the hands has a gender “preference”—women suffering from low estrogen levels due to hormonal imbalance or menopause are especially susceptible to it.
Age-related changes also provoke a degenerative process. The depletion of cartilage tissue and its gradual drying out is associated with reduced production of collagen and proteoglycan - these substances are responsible for the construction of cartilage cells and the preservation of nutrients in them.
Signs of deforming osteoarthritis of the hands
Carpal osteoarthritis begins unnoticed; only X-ray examination can reliably identify it before the onset of constant pain. Patients usually attribute short-term aches and slight discomfort in the fingers to fatigue - and therefore only every 5th person consults a doctor. Symptoms manifest themselves most clearly during climate change, hypothermia, stress, physical activity or lack of sleep. Gradually, the time intervals between episodes shorten and pain becomes an unfortunate norm of life for most patients. A characteristic crunching sensation appears in the fingers, the joints swell, making the hands appear knotty. Then stiffness increases (especially in the morning), mobility is limited, and deformation of the hand is observed. The movements become tight, bending the fingers resembles an exercise on a wrist expander. Cysts may form. The feeling of constant load corresponds to a real pathological process - small joints begin to bend, taking on an unusual shape, and the burden of decompensation falls on the muscles.
As a rule, the first joints to succumb to disease are the joints of the fingers located behind the nails (the last phalanx of the fingers), as well as the joints of the thumbs. Painless but noticeable thickenings appear on them - the so-called. Bouchard's nodes and Heberden's nodes - which are easy to notice on the back of the hand. Often the skin on them turns red and becomes hot.
Therapeutic prevention
Therapeutic and prophylactic gymnastics for the fingers will help maintain or restore the mobility of joints, which is recommended to be performed even with the most complex pathology. Before starting the exercises, you need to warm your joints in a saline solution, then lubricate your hands with warming ointment.
Set of exercises:
- flexion and extension of fingers into a fist;
- placing your palm on the table, we begin to beat a drum roll with your fingertips;
- resting your fingertips on a plane perpendicular to the table, we begin to form a fist with our hand, evenly sliding our palm along the surface of the table;
- we try to alternately connect the thumb with the index, middle, ring and little fingers;
- Having clasped our fingers together, we try to turn them in the opposite direction.
A set of exercises for the hands on video:
A manual expander is also recommended for therapeutic prophylaxis.
Stages of osteoarthritis of small joints of the hands
As a rule, treatment of osteoarthritis of small joints of the hands is delayed due to the slow progression of the disease. Symptoms increase gradually, which makes it difficult for the patient to objectively perceive their intensification. However, experts distinguish 3-4 stages of the disease, which make it possible to adjust therapy and make predictions about the course of the process with considerable reliability.
Osteoarthritis of the interphalangeal joints of the hands of the 1st degree is characterized by mild, barely noticeable pain, joint mobility is preserved and the patient may not suffer any restrictions in daily activities. The tissue around the affected joints begins to harden.
Osteoarthritis of the interphalangeal joints of the hands, grade 2, involves the presence of constant, but not too severe pain. The range of motion in the joint is reduced, and osteophytes, clearly visible on x-rays, appear, which prevent full movement. Towards the end of the stage, the fingers may become thinner because the muscles responsible for normal hand activity are no longer used and begin to atrophy. Against the background of this process, the joint nodes become especially noticeable and begin to crunch audibly when bending the fingers due to the narrowing of the lumen in the joint.
Osteoarthritis of the interphalangeal joints of the hands of the 3rd degree is expressed by severe pain and extreme difficulty in flexion movements. The number of osteophytes increases, almost completely limiting the mobility of the joint. The photographs show an extremely small amount of cartilage tissue. The atrophy of the muscles responsible for fine motor skills of the fingers is completed. Bone density increases, severe deformation and signs of osteosclerotic changes are noticeable.
Will physical therapy help?
Physiotherapeutic methods are good in the first and second stages of arthrosis. They reduce pain, strengthen periarticular muscles and increase mobility. Depending on the clinical picture and location of osteoarthritis, the patient may be prescribed a course of the following procedures:
- electrophoresis with individually selected medications;
- paraffin therapy (stimulates blood circulation in the joint);
- laser therapy (destroys osteophytes and prevents the formation of new ones);
- mud compresses (eliminate atrophic changes in tissues);
- acupuncture (reduces pain and restores muscle tone);
- massage and therapeutic exercises.
Most physiotherapeutic methods are allowed only during remission
For shoulder pain, this simple set of exercises will help improve joint mobility:
Which doctor treats osteoarthritis of the hands?
If symptoms are detected, you should consult a doctor to determine the stage and, if possible, the cause of the disease. You can contact a therapist, orthopedist or rheumatologist - they can conduct a visual examination or immediately refer you to a radiologist to confirm the diagnosis. Based on the collected medical history, the specialist prescribes an individual treatment plan. It depends on the degree of narrowing of the joint space, the presence of osteophytes and their number, the presence of deformation or osteosclerosis. It is also important to rule out other similar diseases - for example, rheumatoid arthritis, which is characterized by longer morning stiffness and so on. It is impossible to determine these criteria at home, so an examination by a specialized doctor is more mandatory than desirable. If osteoarthritis of the hands is secondary, tests or treatment of primary diseases may be required.
How to treat osteoarthritis of the hands
The treatment program for carpal osteoarthritis usually includes conservative methods, but sometimes the situation requires surgical intervention to eliminate deformities and osteophytes. In severe cases, intra-articular injections of glucocorticosteroids are also prescribed (no more than 3 courses per year) - they relieve pain and inflammation, improve mobility, but do not prevent the development of the disease and do not build up cartilage tissue. The main goal of therapy is to slow down destructive processes and relieve clinical manifestations that worsen the quality of life (so-called symptomatic treatment).
Treatment of osteoarthritis of the hands with drugs is carried out in several directions:
- pain relief (analgesics);
- relief of inflammation (NSAIDs) with systemic and local drugs;
- cartilage regeneration (chondroprotectors, sometimes in combination with risedronic acid);
- restoration of the elasticity of cartilage and replenishment of nutrients in it (taking rehydration, micro-, macronutrient and vitamin preparations, including calcium and vitamin D);
- according to indications - medical prosthetics using hyaluronic acid injections.
Rest is also indicated for patients. To redistribute the load and prevent joint deformation, it is recommended to wear orthoses.
Physiotherapeutic procedures include phonophoresis, electrophoresis, magnetic and shock wave therapy, radio wave and laser exposure, mud wraps, paraffin baths, massage (including self-massage - to relieve spasms, strengthen muscles and improve tissue nutrition), hand exercises with use of auxiliary means. It is recommended to use an ergonomic keyboard and avoid inconvenient working tools.
Osteoarthritis of the joints of the hands: treatment determines the prognosis
Timely diagnosis can prevent the development of the disease even if it is caused by genetic and age-related factors. For example, a “non-functioning” gene that is responsible for the production of type 2 collagen can be compensated by taking chondroprotectors - such as Artracam - which contain it in easily digestible forms.
If the disease is advanced to the last stage, the prognosis is unfavorable. Unlike osteochondrosis of large joints, when the interphalangeal joints are affected, endoprosthetics are rarely performed. Even the installation of an implant usually does not guarantee 100% restoration of functionality. Other operations - arthrodesis (fusion) and reconstruction of joints are also characterized by increased complexity.
The best prognosis is observed with the use of complex medication and physiotherapy for grade 1 osteoarthritis of the hand and grade 2 osteoarthritis of the hand joints. Lifelong use of over-the-counter chondroprotectors triggers regenerative processes in bone and cartilage tissue - this prevents further destruction of cartilage and, subject to other medical prescriptions, even helps to achieve lasting improvements.
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Expert recommendations
There is no miracle cure for deforming arthrosis. The disease has a disappointing tendency to worsen the situation when more and more joints are involved in the degeneration process. Existing therapeutic procedures of official or alternative medicine bring relief to the patient only for a few days or weeks.
If the effect of infiltration with corticosteroids or analgesic anti-inflammatory drugs is not enough to eliminate pain, then it is recommended to use orthopedic corrective agents to immobilize painful joints. During treatment, it is important to follow dietary standards.
Research-backed video on joint nutrition:
Recommendations for patients with deforming arthrosis:
- limit fat intake. Food products of plant origin should predominate in the diet;
- increase the consumption of vegetables and fruits, but exclude tomatoes, since this food product adversely affects the production of chondroitin and the main component of connective tissue of cartilage - collagen;
- eat more fish, nuts and other foods rich in polyunsaturated fatty acids;
- limit sugar and salt in the diet;
- do not include in your diet foods made from high-quality flour;
- vitamins B, D, E and folic acid are beneficial for joints. These components are found in beans, fermented milk products, white cabbage, bananas, lentils, wholemeal baked goods;
- Enzyme additives included in canned foods are prohibited;
- give up alcohol and high-calorie foods.
Therapeutic and preventive measures:
- compliance with the rules of personal and sanitary hygiene;
- maintaining a comfortable temperature regime for the joints;
- ensuring favorable working conditions;
- daily warm-up exercises for fingers. Physical therapy in a swimming pool has a good effect;
- saturating the body with calcium, magnesium, potassium and other mineral components that strengthen the structural integrity of the musculoskeletal and joint system, connective tissues of the body as a whole.
The complex of therapeutic measures for osteoarthritis is not only inpatient or outpatient treatment. Patients are recommended to undergo a course of health therapy in specialized sanatorium-resort institutions, for example, in Matsesta, Pyatigorsk, Tskhaltubo.
In case of the slightest discomfort in the articular segments, you should consult a doctor within 5-7 days. Take care of yourself and be healthy!