Pain in the fingers

Pain in the fingersoccurs when bones, joints, soft tissues, blood vessels and nerves are affected. It can be dull, sharp, weak, intense, constant, intermittent, of short duration. Often there is a connection with motor activity, weather conditions and other factors. Concomitant external disturbances are possible: deformations, color and temperature changes, 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 painkillers.

Why do 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. Finger function 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 black blood. With subungual hematomas, the pain is intense, jerky, pulsating, aggravated by lowering the brush. Partial or complete detachment of the nail plate is possible.

A broken finger is accompanied by intense explosive pain at the time of injury. Subsequently, the pain decreases somewhat, but remains intense. The finger turns blue, swells, its functions are grossly violated. Deformity, crackling, 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 hours, the pain is mild, tingling. Then the pain syndrome intensifies, acquires a burning character. The finger swells, becomes cyanotic. With deep frostbite, there is no tenderness in the distal parts, the fingers are cold, pale, pain disturbs the border between healthy and affected tissues.

Infectious lesions

Panaritium is characterized by a rapid increase in pain, swelling, hyperemia, cyanosis and abscess formation. Jerky, lancinating pains, depriving the night of sleep. Particularly painful sensations are expressed with subungual panaritium and deep forms of the disease (bone, joint, tendon). With superficial forms of panaritium (cutaneous, periungual, subcutaneous, subungual), the general condition suffers slightly, with deep symptoms of intoxication, fever.

Chinga develops in people involved in the cutting and processing of sea game carcasses, occurs with minor injuries: abrasions, wounds, cracks. It is manifested by dull, weak 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, supplemented by swelling, pallor, cyanosis of the finger.

Arthritis

Pain in the finger joints in rheumatoid arthritis is symmetrical. 1 degree of activity is manifested by minor arthralgia, stiffness quickly disappearing. At grade 2, the pain is disturbed at rest and during movement, associated with prolonged stiffness, limitation of movement, redness. Grade 3 is characterized by constant intense pain, persistent stiffness, swelling, hyperemia. Travel is severely restricted.

Gouty arthritis of the fingers is more common in women. One or more joints may be affected. The pain is usually acute, acute, associated with edema, hyperemia, impaired function and an increase in general temperature. Erased symptoms are observed less often - minor pain and slight redness with a general satisfactory condition.

Psoriatic arthritis comes on suddenly or gradually. In the first case, the pain is moderate, increasing, in the second - sharp, intense. At the height of the disease, the typical picture includes pain, worse at night and at rest, weakening during the day, with movement, swelling of the fingers, purplish-bluish discoloration of the skin. The distal interphalangeal joints are most commonly affected. Over time, multiple deformations appear.

In post-traumatic arthritis, a joint is affected. For infectious-allergic forms of the disease, developing against the background of bacterial and viral infections, multiple lesions are typical. With occupational peripheral arthritis, the most loaded joints of the fingers are involved in the process. Pain in all listed forms of pathology intensifies at night, weakens during the day and is complemented by morning stiffness, local swelling and difficulty in movement. With a long course, deformations are noted.

Degenerative pathologies

With arthrosis of the hands, the pain is initially indefinite, periodic, short-lived. There is morning stiffness. Subsequently, painful sensations intensify, prolong, sometimes burning, are noted at all movements, limit daily activity and perform delicate operations. The Heberden and Bouchard nodes are formed. Lateral deformations are formed.

Diseases of ligaments and tendons

Patients with stenosing ligamentitis are concerned about pain along the volar 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. Movements are limited, accompanied by a click. Over time, a flexion contracture develops, after a click, pain is given to the arm.

At the initial stage, de Quervain's disease is manifested by pain during abduction, hyperextension of the first finger. Subsequently, aching, pressing pains occur with any physical activity, some patients are disturbed even at rest. Typical irradiation of the distal phalanx or forearm on the side of the first finger.

Angiotrophoneurosis

Raynaud's syndrome is caused by vasospasm, accompanied by paroxysmal numbness, cold fingers. Pain occurs in the second phase of the attack, has a snapping character, is associated with a burning sensation, fullness. The pain syndrome is short-lived, replaced by a feeling of warmth, 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 and 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 is manifested by paroxysmal bouts of cooking, burning pain, edema, hyperemia of the fingers. It is possible to spread the pain from one limb to another or to occur simultaneously in the region of both limbs. The pain attacks are so intense that they interfere with any movement. The pain decreases with cooling and raising the hand, increases with warming and lowering the hands.

Neurological pathologies

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

• Median nerve neuropathy.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, a decrease in pain when lowering the arms, shaking the brushes.
• Radial nerve neuropathy.With a lesion in the forearm and wrist, pain is noted along the back surface of the first finger and hand, sometimes extending to the second and third fingers. Irradiation of the forearm, numbness of the back of the hand are characteristic.
• Ulnar nerve neuropathy.The pain is localized mainly in the region of the elbow joint, but can radiate to the hand, fingers IV-V. 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 not intense pain sensations with indistinct localization, osteoid osteomas - by sharp pains in the affected area. Malignant neoplasia of the fingers is rare.

Other reasons

Finger and hand pain are observed in patients with a writing spasm, which develops with occupational neurosis, some other mental and neurological disorders. Pain occurs when writing, working on a computer or typewriter. They snap, pull, supplemented by tremors, sudden hand weakness, local convulsions. In addition, pain in the fingers can be detected in the following pathologies:

• Leukemia: Waldenstrom's macroglobulinemia.
• Adrenal gland tumors: aldosterome.
• Complications of Diabetes: diabetic neuropathy.
• Vascular diseases: distal digital embolism by occlusion of the subclavian artery.
• hereditary diseases: Fabry disease.
• childhood diseases: neuro-arthritic diathesis.

Diagnostic

Traumatologists-orthopedists are engaged in establishing the causes of pain in the fingers. The diagnosis is made on the basis of a conversation with the patient, external examination data, 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 life history, family history.
• Physical examination. The specialist assesses the appearance of the fingers, reveals deformities, inflammation, cracks, dry skin, temperature and color disturbances, swelling and other manifestations of pathology. Examines tenderness, range of motion, pulsation in peripheral arteries.
• X-ray.It is performed in two projections with 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 panaritium.
• Electrophysiological studies.They are performed for pain of neurological origin in order to specify the level of nerve damage, to assess the state of the muscles and nerve conduction.
• Laboratory tests. Product to determine inflammation, assess the general state of the body, detect specific markers in collagenoses.

According to indications, patients are referred for consultation with an endocrinologist, neurologist, vascular surgeon and other specialists. Assign CT, MRI, other instrumental techniques. Perform a biopsy of hard and soft structures for cytological or histological examination.

Processing

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, boards). The brush is raised or a scarf is used. With an intense pain syndrome, an analgesic is administered, in the absence of external damage, chloroethyl is applied.

Help with 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, a reduction is performed and a plaster cast is applied. Conservative treatment of traumatic and non-traumatic pathologies of the fingers involves the following activities:

• Method of protection. It is selected taking into account the nature and severity of the disease. Possible recommendations for limiting the load, the use of orthopedic devices, the imposition of a cast.
• medical therapy. Nonsteroidal anti-inflammatory drugs, antibiotics, drugs to improve blood circulation, neurotropic drugs are used. According to indications, blockades with corticosteroids are performed.
• Non-drug methods. Exercise therapy, massage, physiotherapy, manual therapy, kinesio taping are prescribed.

Surgical interventions

Operations are performed when conservative methods are ineffective, in order to reduce time and improve the long-term results of treatment. Taking into account the characteristics of the lesion, proceed as follows:

• injuries: fixation of fractures and dislocations with a knitting needle, necroctomy and amputation of fingers in the event of chilblains.
• Infectious diseases: opening, drainage of the panaritium, in case of severe lesions in some cases - amputation or disarticulation.
• Diseases of the tendons and ligaments: dissection of the dorsal ligament and excision of adhesions in de Quervain's disease, dissection of the annular ligaments in stenosing ligamentitis.
• Tumors: ablation of neoplasia, bone resection.
• Neurological diseases: nerve decompression.

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