Osteoarthritis of the hands is one of the most common types of joint damage. Deforming osteoarthritis (DOA) is the most common disease of the articular cartilage, occurring mainly in people of elderly and senile age. The disease is observed in 10-15% of the total population, it is diagnosed in half the cases in people over 60 years old.
The lesion of the joint is characterized by dystrophic and degenerative changes that cause impairment of cartilage function, its structure and functioning. The disease ranks first among rheumatological pathologies, accounting for 60–70%. Most often, osteoarthritis affects the interphalangeal joints of the hands, hip, knee, ankle joints, etc.
Osteoarthritis of the hands is a progressive disease, inevitably leading to the defeat of all components of the joint: synovial membranes, synovial fluid, cartilage, subchondral bone areas, ligaments, capsule, periarticular muscles.
One of the first symptoms appears pain, aggravated by the progression of the pathology, in the final stages continuously disturbing the patient, even at night. Then limb deformity joins in the joints, specific nodules of Heberden and Bouchard appear, morning stiffness, physical activity is disturbed.
Reasons for the development of DOA
Depending on the etiological factor, DOA is divided into primary and secondary.
In the primary (cryptogenic) DOA, the causes of the disease are not fully understood, but it is known that this form is characterized by the most frequent lesion of the distal and proximal interphalangeal joints of the hands with the appearance of specific nodules of Heberden and Bouchard.
Secondary DOA develops for a number of reasons, including:
- injuries such as dislocation or fracture of the carpal bones,
- previous surgical interventions,
- joint dysplasia
- inflammatory processes in the joint (autoimmune, bacterial, parasitic or viral etiology).
It is known that DOA, including DOA of the hands, is not inherited. However, with the inheritance of certain diseases, the risk of osteoarthritis is sharply increased.
These include hereditary mutation of type 2 collagen, joint dysplasia, hereditary metabolic pathology or the structure of cartilage tissue, etc.
The following conditions may increase the risk of DOA:
- dysmetabolic and dyshormonal conditions that disturb trophism, blood supply and innervation of tissues (for example, diabetes mellitus, pathologies of the thyroid and parathyroid glands, post menopausal period, gout, hemochromatosis, etc.),
- increased load on hands, etc.
Pain syndrome, signaling pathology in the joint, appears one of the first symptoms, characterized by different intensity and mechanism, depending on the severity.
There are several types of pain when DOA brushes:
Type of pain
The most frequent, occurs during exercise and subsides at rest, usually during a night's sleep. The mechanical type of pain appears one of the first and indicates a decrease in the depreciation abilities of cartilage and bone podhryaschevyh structures
Continuous dull night pain
It occurs due to venous stasis and increased intraosseous pressure. This type usually appears in the first half of the night.
Short-term, lasting no more than 15–20 minutes, occur after a period of rest and pass during physical activity. The mechanism of this type of pain is due to the presence of the articular mouse (detritus - fragments of cartilage and bone destruction, deposited on the articular surface). At the first movements, the detritus is pushed into the twists of the articular sac, with which the cessation of pain is associated
Due to the development of reactive synovitis - aseptic inflammation of the synovial membrane and spasm of adjacent muscles
As the disease progresses, morning stiffness, deformation of small joints, restriction of their mobility join.
Morning stiffness is defined as the impossibility of active and passive movements in the joint, due to inflammation of the synovial membrane, a decrease in the elasticity of cartilage, which leads to the need for starting movements to restore motor activity. The duration of morning stiffness determines the severity of the process.
Geberden's nodules are a pathognomonic symptom for DOA of the interphalangeal joints of the hands. They are represented by marginal osteophytes that deform the articulation, ranging in size from a rice grain to a small pea. Nodules are formed on the back and side of the distal interphalangeal joints - those that are localized closest to the nail plate.
Usually, Geberd's nodules are located symmetrically and affect the same joints on both hands. Distal interphalangeal joints of all fingers, from the thumb to the little finger, can be involved in the pathological process.
The formation of Geberdden nodules is accompanied by a vivid clinical picture:
- characteristic pulsating pain syndrome
- swelling and redness in the area of the affected joint.
However, asymptomatic progression is observed in a third of patients. In half of the cases, the debut of the disease is accompanied by a period of exacerbation, during which intense throbbing pains occur in the nodules.
The skin above the nodules becomes thinner and bursts with the outflow of clear fluid, which leads to a reduction in pain. In some cases, a breakthrough does not occur, as a result of this pain lasts for several weeks or months, after which the symptoms subside or completely disappear, the nodules become more dense and painless. Heberdain's nodules inevitably lead to deformation of the joints and their stiffness.
Bouchard nodules are another pathognomonic symptom for arthrosis of the fingers. They differ from Heberdain nodules in their localization and process. Bouchard nodules are formed in the region of the middle interphalangeal joints (second from the nail plate) and affect their lateral surfaces. This leads to the formation of a specific fusiform shape of the fingers involved in the pathological process.
According to the clinical course, Bouchard's nodules differ from Heberden's nodules by less pronounced symptomatology. Progression occurs gradually with a weak pain syndrome, but the process also leads to deformity and stiffness of the articulation.
With polyosteoarthrosis, the joints of the thumb may be involved. Osteoarthritis of the thumb is called risarthrosis.
Rhizarthrosis is characteristic of people who, in the course of their professional activities, subject their thumb to intense and prolonged exertion.
Diagnosis is based on the clinical picture, the patient's complaints, the results of laboratory and instrumental studies.
There are three diagnostic criteria to diagnose osteoarthritis of the hands:
- pain, stiffness or stiffness in the hands during the past month,
- dense thickening of two or more joints (II and III distal interphalangeal, II and III proximal interphalangeal, wrist-metacarpal joints of both hands),
- the number of edematous metacarpophalangeal joints is less than three.
Perhaps the appointment of X-ray, computed and magnetic resonance imaging (the last two diagnostic methods are used extremely rarely).
X-ray of the hand visualizes the condition of the bone structures, the joint space, the presence of osteophytes. X-ray image allows you to indirectly assess the condition of the cartilage.
Treatment of osteoarthritis of the hands
The treatment is carried out on an outpatient basis, in a complex, conservative manner.
Physiotherapeutic methods, physiotherapy, pharmacological means, diet therapy are applied. Traditional methods of treatment are rarely used because of their inefficiency.
Phonophoresis, iontophoresis, balneotherapy, sulfide, radon baths, light therapy, electromyostimulation, ultrasound therapy, diathermy, cryotherapy, exercise therapy (therapeutic exercises), massage
Diet aimed at weight loss, normalization of endocrine and metabolic disorders
NSAIDs - nonsteroidal anti-inflammatory drugs - are used to reduce pain, swelling. Paracetamol, diclofenac, ibuprofen, nimesulide, ketorolac, meloxicam, celecoxib, etc. are prescribed.
Chondroprotectors - used in the early stages (chondroitin sulfate, glucosamine). The action of drugs aimed at restoring damaged cartilage
The introduction of glucocorticoids (hormonal drugs): reduces the severity of intra-articular inflammation and reduces pain. It is known that glucocorticoids negatively affect cartilage, therefore, the method is used in extreme cases when NSAIDs show their effect insufficiently.
Introduction of hyaluronic acid: facilitates the process
There is no specific prevention of osteoarthritis of the hands.
- to dose physical loads, avoiding prolonged static and mechanical overload of joints,
- try to avoid injury
- timely diagnose and correct congenital anomalies of the musculoskeletal system,
- normalize overweight.
We offer for viewing a video on the topic of the article.
Education: Rostov State Medical University, specialty "General Medicine".
Found a mistake in the text? Select it and press Ctrl + Enter.
According to studies, women who drink a few glasses of beer or wine a week have an increased risk of developing breast cancer.
During sneezing, our body completely stops working. Even the heart stops.
If you smile only twice a day, you can lower blood pressure and reduce the risk of heart attacks and strokes.
The human stomach copes well with foreign objects and without medical intervention. It is known that gastric juice can even dissolve coins.
Everyone has not only unique fingerprints, but also a tongue.
In order to say even the shortest and simplest words, we will use 72 muscles.
Our kidneys are able to clean three liters of blood in one minute.
American scientists conducted experiments on mice and came to the conclusion that watermelon juice prevents the development of atherosclerosis. One group of mice drank plain water, and the second - watermelon juice. As a result, the vessels of the second group were free from cholesterol plaques.
Allergy drugs in the United States alone spend more than $ 500 million a year. Do you still believe that a way to finally defeat an allergy will be found?
Falling from a donkey, you are more likely to break your neck than falling from a horse. Just do not try to refute this statement.
There are very curious medical syndromes, for example, obsessive ingestion of objects. In the stomach of one patient suffering from this mania, 2500 foreign objects were found.
Cough medicine "Terpinkod" is one of the top sellers, not at all because of its medicinal properties.
With regular visits to the tanning bed, the chance of getting skin cancer increases by 60%.
74-year-old Australian resident James Harrison has become a blood donor about 1000 times. He has a rare blood group whose antibodies help newborns with severe anemia survive. Thus, the Australian saved about two million children.
During operation, our brain spends an amount of energy equal to a 10-watt light bulb. So the image of a light bulb above the head at the time of the emergence of an interesting thought is not so far from the truth.
According to statistics, about 80% of women in Russia suffer from bacterial vaginosis. As a rule, this unpleasant disease is accompanied by a white or grayish mouth.
Causes of the onset and development of the disease
The main cause of the onset of the disease is older age. The fact is that in the body irreversible regressive processes begin to occur with age: the cartilage tissue becomes thinner, its elasticity sharply decreases, and the instability to strong loads increases. So age changes provoke high chances to get osteoarthritis.
Hormonal changes also play an important role in the appearance of problems in the joints of the hands. Women experiencing a period of menopause are in a high-risk zone, and the disease of osteoarthritis for them is a particular phenomenon. It is worth noting that in such a period the female body suffers from a lack of calcium. Therefore, doctors advise to pay special attention to nutrition and taking vitamins, which will help maintain the level of this element, which is necessary for the proper functioning of the joints.
Preventive factor will be the stability of metabolic processes and proper production of collagen. For patients with osteoarthritis is characterized by a violation of such processes. Also an important factor will be the presence of concomitant diseases.
Particularly dangerous is the factor of genetic predisposition. Modern medicine, for obvious reasons, is not able to influence this circumstance. However, research in this direction does not stop, and I would like to hope that soon the hereditary factor will be taken under control or, in general, leveled.
The cause of osteoarthritis of the hands may also be a person’s professional activity. Especially, it is associated with those types of work, where there is a monotonous movement of the fingers.
Joints may suffer from microtraumas as a result of working at a weaving machine or typing on a keyboard. This leads to the weakening and damage of cartilage tissue, which, in turn, provokes the development of arthrosis.
Symptoms of osteoarthritis of the hands
Surprisingly, only every fifth person decides to turn to specialists in the event of complaints about the condition of the joints of the hands. In people over fifty years old, changes in cartilage tissues can be detected by x-ray.
When arthrosis in the joints of the fingers form a kind of seal. Especially from this phalanges suffer, which is closely adjacent to the nail plate.
By their nature, such thickenings represent a disproportionate growth of bone tissue. They are located on the side and back of the finger surface. Their structure is dense, and the nodules themselves do not cause any pain.
The main feature of seals on the fingers is their permanent character.
If they appear at least once, it will be impossible to get rid of them. The lesion occurs symmetrically, both hands suffer from the disease. The primary affected area is the index and middle fingers.
At the same time there is a slight curvature. Sometimes the occurrence of nodules is accompanied by a slight tingling. True, people almost do not pay attention to this symptom of osteoarthritis. On thumbs such changes do not occur.
The symptoms of osteoarthritis begin to listen when pronounced stiffness is observed movements. Motility with an increase in the considered seals deteriorates so much that it becomes impossible to control the fingers. It is difficult to make even minor movements.
Patients celebrate appearance of characteristic crunch and pain when moving thumb up It spreads along the edge of the wrist at the point of convergence of the trapezoid with the 1st metacarpal bone. Mobility restriction is also associated with impaired motor functions. Deformation of the joint at a late stage gives the brush a characteristic square shape.
Articular disorders occur due to changes in bone tissue. In osteoarthritis of the hand, the performance of elementary movements is very difficult. Compression and precision movements are the hardest. Roughly speaking, it becomes impossible to even write with a pen.
The degree of osteoarthritis of the hands
At the first (initial) stage of the disease articular cartilage gradually loses its elasticity.
There is a characteristic aching pain, attacks of which are found periodically, often at night. Muscles are tense, the area of development of the disease becomes a little swelling. At this stage, the movement of the fingers is not difficult.
Achievement second degree osteoarthritis of the hand is characterized by the appearance of the first cartilage deformities.
Chronic inflammation of the articular sac begins. Painful sensations appear more often, especially after significant loads on the fingers. The so-called stiffness appears. In the affected area, the temperature rises and redness of the skin occurs. There is a gradual atrophy of the muscles of the inflamed fingers and hand, the joint increases in size.
On third degree develop severe osteoarthritis. An almost complete restriction of the mobility of the affected fingers and hand appears.
The cartilage is completely destroyed. Pain increases and is accompanied by a strong burning sensation. Curvature and change the length of the fingers. Deformation of the bones becomes pronounced. With further development of the disease and no treatment, ankylosis is possible, in which the joint will be completely immobilized.
We help folk remedies
In case of osteoarthrosis at the initial stage, it is allowed to use various ointments based on wax or propolis. Well help to lull the pain and relax the damaged area of compresses from the decoction of horseradish. If possible, it is recommended to take baths with the addition of coniferous extract, essential oils and healing salts.
Especially popular is the bandage of honey and salt.
It is enough to mix salt and honey in equal proportions, apply the mixture on linen fabric and apply it to diseased brushes. It is advisable to leave such a compress until the morning, after having warmed up your arm properly.
Brushes can also be dipped or moistened with infusion of birch leaves, sabelnik or fern.
A very effective ointment can be made at home:
- Dried wormwood is required to crush into powder and pour olive oil.
- Then using the water bath to heat the resulting mixture for thirty minutes.
- After a couple of days of infusion, the ointment should be drained and calmly used.
Positive feedback earned fresh onion dressings. It needs to be crushed to a mushy state and mixed with kefir and chalk. It is useful to drink diuretic teas and tinctures, as well as a decoction of nettle.
Osteoarthritis of the hands is a very serious disease. When the first symptoms described above, should immediately go to the doctor to undergo a qualitative diagnosis, proceed to timely treatment and preventive procedures.
In the early stages, the disease can be adequately treated, which makes it possible to restore the condition of the damaged joints with almost no losses. In no case should not let the disease take its course, as in this case, to avoid surgery will not succeed.
The causes of the disease
Osteoarthritis of the hands
As a rule, to identify the cause of this disease is not so simple. Moreover, there is a so-called secondary osteoatrosis. To understand this question, consider the most well-known prerequisites:
- Cartilage tissue, like any other, is subject to age-related changes. After fifty, the cartilage wears out, the tissue becomes less elastic, and accordingly, it is more susceptible to various loads. Old age is one of the causes of osteoarthritis.
- The hormonal background of the body significantly affects the condition of cartilage. It is during the imbalance of hormones that calcium and various vitamins are “washed out” of the body, and the elasticity of the joints suffers.
It can be considered that this is an occupational disease, since it is often subject to people who have been producing the same movement for many years in a row. This is simply due to the joints "get used" to one movement, and "forget" about others.
Healthy and damaged arm joints
All sorts of violations of the metabolic system, another one of the causes of the disease. In this case, collagen production is disturbed, which directly affects articular changes.
Secondary osteoarthritis of the hands, may occur due to:
- transferred operation,
- various injuries
- endocrine system pathologies,
- disorders of the circulatory system, in particular, the blood supply to the hands.
Symptoms of the disease
The first manifestation of osteoarthritis, are external thickenings in the area of small joints. Similar nodules can be seen on the back of the fingers. The first time, they do not cause discomfort, do not cause pain.
The pain appears for some time. This period is quite long and can last several years. It should be noted that nodular formations appear symmetrically. The disease affects the interphalangeal joints. The base of the thumb is also subject to pathological changes.
After the onset of pain, the disease can enter the acute phase, swelling and redness of the skin are possible. There are problems with flexion movements of the fingers.
Osteoarthritis can cause severe pain and swelling of the fingers.
Traditional treatments for osteoarthritis of the hands
This disease of the hands is known for a long time. It is not surprising that our wise people have invented their own ways of dealing with illness. Folk remedies can be both external and internal.
First of all, you need to understand that the main cause of the disease is the lack of vitamins and minerals in the body. A very effective remedy for restoring balance is calcined cottage cheese with the addition of vitamin tinctures:
- "Special" cottage cheese is prepared quite simply. When boiling three liters of milk, three tablespoons of calcium chloride is added. This drug is sold in any pharmacy and comes in tablet form or ampoules. Tablets pre-crushed.
- To obtain tincture with horseradish, it is boiled on low heat for half an hour. After cooling the broth, honey is added to it, in the amount of 0.5 liters. The use of tincture with daily intake should be at least a month. At one time about 100 grams of tincture is drunk together with three spoons of cottage cheese. Reception is repeated 3-4 times a day.
- A large number of nutrients contained in laurel tincture. To make it, crushed 10 grams of leaves, boiled in a glass of water for six minutes. After infusion for 4–5 hours, it is recommended to drink the tincture all day, dividing the serving by 3-4 times.
Tincture of Bay Leaf
It is very useful to combine the internal means with the use of ointments and lapping. They are made from natural ingredients:
- The juice of the cabbage leaf with the addition of flower honey and glycerin is recommended to be rubbed into the hands until complete absorption. Very useful lotion from pure cabbage juice or compresses from a whole leaf of white cabbage, smeared with honey.
- Honey lapping is made on the basis of flower honey with the addition of iodine and glycerin. The product is rubbed along the entire perimeter of the brush for 20 minutes, then rinsed with warm water.
- Fern juice mixed with propolis is also used as a lapping.
Propolis and fern juice help with osteoarthritis of the hands
Gymnastics for the prevention and treatment of disease
A very effective way to treat and prevent disease, is a special gymnastics for brushes. The Dr. Bubnovsky Center has developed a kinesitherapy complex, which includes exercises performed on unique simulators. This complex allows to correct the deforming effect at the initial stage of the disease.
If for some reason you cannot use this service, you can do gymnastics on your own at home. This will help you not only to stop the disease, but also to help the restoration of cartilage tissue. Perform these exercises daily, and the result will not take long:
- clenching and unclenching fists with visible effort,
- squeezing the expander
- put your fingers together and try to reach the base of the hand,
- reach for the base of your little finger with your thumb
- putting your elbow on a flat surface, “drumming” on it with your fingers, make it with the closed palm, then repeat one by one,
- hands stretched forward, put your palms to yourself, squeeze and unclench your fist, alternately moving your thumb to the inner and outer side,
- rotate the brushes in different directions,
- keep your palms away at arm's length, bend and unbend your joints alternately: upper, middle, wrist,
- swipe the pads against each other, alternately
- press your palm to a flat surface, tear off your fingers, closed together, repeat one by one.
Each of these exercises, spend 5-6 times. Before gymnastics, warm your hands with hot water.
Massage for osteoarthritis of the hands
Experts say that self-massage can reduce pain, restore the blood circulation of the hands, even in advanced cases. At the initial stage, it is possible to correct insignificant deformations of the joints.
Please note that self-massage is contraindicated in the presence of inflammatory processes.
General rules for self-massage:
- Brush massage should be carried out in a completely relaxed state, it is best to do it after doing gymnastics,
- before carrying out the main procedure, hands must be rubbed against each other,
- during self-massage, try not to use the muscles of other parts of the body,
- during the entire session, you should monitor your breathing.
Diet during treatment
Proper nutrition throughout the course of treatment of the disease, as well as for preventive purposes is the key to successfully getting rid of the problem. It is important to pay attention to products containing mucopolysaccharides and collagen. It is these substances that are the building material for cartilage tissue. Consider some of them:
- various root vegetables
- low-fat dairy products,
- cereals and beans,
- jellies, jelly, jellies,
- cereal bran bread, cereals,
- fatty fish
Unwanted products for asteoarthritis of the hands:
- egg yolks,
- fruits of solanaceous plants.
In conclusion, I say, treat the disease correctly, ask for help from specialists. Choose the best path for your healing. If you liked the article, recommend reading it to your friends in social networks. Subscribe to our blog updates. Good luck to you!
What is osteoarthritis of the hands
This disease affects the joints. Symptoms of the disease are most common in people over 45 years of age. Far less often, osteoarthritis occurs in young people. The sexual nature of this pathology is noticeable: women are more often affected than men. Particularly at risk are those people whose relatives had osteoarthritis.
The disease is characterized by a slow course. At first, the deforming process practically does not manifest itself, the patient does not feel the symptoms of cartilage tissue damage. Gradually, pain occurs at the site of the disease, nodular forms of thickening occur. The survey shows a marked change in bone tissue thickness.
There are several types of seals:
- Bouchard nodules are characterized by degenerative changes in the interphalangeal joints. Seals can be seen on the back of the wrist. Feeling does not cause discomfort, pain. Sometimes the patient may feel a slight pain. Lack of treatment subsequently leads to a significant limitation of movements, immobilization of small joints.
- Geberden nodules are more common. Distal interphalangeal joints are usually affected. Typical seal seals are index and middle finger. Rarely seals affect the little finger, ring finger. In the described variant of the pathology, the joints of both hands are affected. Appeared formations do not hurt, although sometimes patients may notice discomfort.
Finger progression due to disease progression. The patient can not make small movements. As the degenerative process develops, he experiences difficulties performing physical work. Finally, due to neglect of pathology, complete immobilization of fingers and wrist is noted.
Sometimes the inflammatory process can develop rapidly, which quickly leads to immobilization.
Why does this disease develop?
Arthrosis of the hands develops for the following reasons.
- Elderly age. Numerous studies suggest that it is age-related changes that lead to the fact that the tissues of the joint become thinner and less elastic. Ongoing physical exertion is impossible for bone and cartilage. That is why the risk of developing arthritis increases in the elderly.
- Hormonal dysfunction. Menopausal women are most susceptible to them. This period is characterized by a lack of calcium, which is why the body suffers.
- Osteoarthritis of the wrist joint develops due to a specific professional activity. Working at looms, typesetters are most at risk. Microtraumas arising from prolonged monotonous work adversely affect the state of the musculoskeletal system.
- Violation of metabolic processes. In some patients, the production of collagen may be impaired. This negatively changes the composition of cartilage, restricts active movement.
- Congenital defects of the structure of the joints contribute to the development of pathology.
- Diabetes mellitus is another cause of degenerative changes in the fingers, wrist.
All these causes lead to the development of pathological changes in the musculoskeletal system.
Stages of the pathological process
Manifestations of this disease depend on the stage of development. The onset of the disease is imperceptible, so a person cannot indicate exactly when it occurred. Moreover, he may not pay attention to pathological processes for years, as arthrosis of the wrist of the hand does not manifest itself for a long time.
The characteristic symptoms of this disease, depending on the severity of the disease are:
- Arthrosis of the 1 st degree is characterized by a slight crunch in the fingers. The crunch appears during flexion-extensor movements. Sometimes there is pain. At first it is not strong, it appears only periodically, then it increases, it appears more often. Unpleasant feelings are intensified before a thunderstorm, weather deterioration, with geomagnetic disturbances, after intensive physical work. The pains are dull, arching. The initial stage of osteoarthritis is usually not characterized by a sharp pain.
- Arthrosis of grade 2 is characterized by the appearance of constant intense pain. She worries a person most at night.Because of this, the patient becomes nervous, he is overcome by chronic fatigue. A nodule is noticeable in the joints; it sometimes swells up and becomes painful. The painful process is accompanied by some deformation of the fingers. The mobility of the fingers is significantly limited.
- Osteoarthritis grade 3 is characterized by the fact that changes in the cartilage tissue of the joints are pronounced. Found almost complete destruction of tissues. Bone growths increase, merge, which causes a sharp limitation of mobility, curvature of the fingers. Due to ankylosis, that is, accretion of bone surfaces, there is complete immobility of the fingers and wrist. A constant symptom of a neglected disease is pain. Ankylosis almost does not cause pain, finger movements are impossible.
What is rheumatoid lesion of the joints of the fingers
The rheumatic process in the joints of the fingers can begin at any age, but more often than 30 years old people suffer from it. It belongs to the most severe articular lesions.
At the beginning of this disease edema of the metacarpophalangeal joint occurs (usually the middle, index finger swells). It is combined with swelling of the carpal joint. The inflammatory process is characterized by the fact that proceeds symmetrically. Differs in resistance, strong pain.
The pain can often worsen in the morning, which deprives the patient of proper sleep. The intensity of such sensations remains fairly high until about noon, then decreases slightly. In the evening, the pain may not be at all. From the morning hours, pain attacks are renewed.
There is inflammation of those joints that are located at the base of the fingers. This process is manifested by pain when pressing on the pads of the fingers. Sometimes patients describe morning stiffness in their hands, wrist as a sensation of thick gloves.
As the disease progresses, severe deformity of the joints and fingers develops. They warp, it's hard not to notice. The mobility of the fingers and wrist is noticeably reduced, they are difficult to bend, unbend. It is difficult for the patient to do petty work. There is an atrophy of the muscles of the hands, thinning, blanching of the skin in these areas.
The disease is characterized by undulating course with periods of exacerbation and remission. Patients can suffer for a long time, often their entire life. The treatment of this disease occurs according to an individually prescribed scheme for each patient. Any self-treatment is categorically inappropriate, since it can significantly worsen the condition of a person.
How is the disease treated?
The treatment of this pathology can be conservative or operative. Surgical treatment is indicated only in advanced cases.. Its use is also advisable when drug therapy has not brought results.
The goals of treatment are:
- a decrease in the intensity of inflammation (and it is necessary that the left and right joints should be treated),
- pain relief,
- slowing of the chronic degenerative process, inflammation,
- improving the quality of life of the patient, preventing its disability.
The following groups of drugs are used:
- Nonsteroidal anti-inflammatory drugs. Most often, experts prescribe Diclofenac, Ibuprofen to their patients. Indomethacin cannot be used for the treatment of osteoarthritis, as it affects the joint even more.
- Selective anti-inflammatory drugs - Celecoxib, Rofecoxib. The risk of gastrointestinal pathologies in case of their admission is significantly lower than when using NSAIDs.
- Paracetamol refers to non-steroidal anti-inflammatory drugs as the least toxic drug. Perfectly relieves pain, but only the doctor chooses the dosage.
- Colchicine is often used to treat erosive osteoarthritis.
- Ointment for the treatment of osteoarthritis is prescribed during the initial stages. Used Voltaren, Diklak, Nimesulide.
- Chondroprotectors - preparations for the restoration of articular cartilage. They are used for a long time, and the effect of such treatment is not immediately apparent.
- Hyaluronic acid is injected. The patient is given intra-articular injections.
Non-drug therapy of this disease includes the following therapeutic measures:
- Physiotherapy. Applied phonophoresis, electrophoresis, shock wave therapy.
- Exercise therapy with specially assigned exercises.
- Massage of the joints.
- The diet is aimed at reducing weight in obese people. It is important for patients to limit the amount of harmful products - flour, sweet. For healthy joints, it is important to abandon fried foods, it has a negative effect on the joints.
- Hirudotherapy relieves inflammation, pain, swelling. Leeches are not given to pregnant women with thrombocytopenia, hemophilia, an allergic reaction to hirudin, or hemoglobin deficiency.
- Treatment with bee venom is carried out within two weeks. During this time, you can significantly improve the metabolic processes in the joints, restore their mobility, and reduce the intensity of pain.
For joints and gymnastics is useful. It must be systematic, always performed only under the supervision of an experienced rehabilitation instructor. Any exercise can not be performed by force when you feel pain.
The method of their implementation should be as gentle as possible. Joint contractures are an indication for relaxation exercises.
Symptoms and degrees
The disease develops gradually, therefore it is enough to prevent serious consequences if you start treatment in time. The disease is characterized by 3 stages of development, each has its own characteristics:
- I stage.At the initial stage, symptoms may be absent. The patient is disturbed by slight pain, which is aggravated in the evening or after physical exertion. This stage is also characterized by the appearance of seals on the phalanges of the fingers. Bouchard and Heberden nodules may appear. The first type of seals occurs on the back of the hand, they cause a slight soreness, but without treatment they lead to limited mobility. Geberden nodules occur at the distal interphalangeal joints, so they can be seen on the middle and index finger. They rarely cause discomfort.
- Stage II The pain does not subside even at rest, but it is aching, not sharp. Formation of bone growths (osteophytes), which indicate degenerative processes. Mobility in the joint is limited, the fingers become less flexible, flexion and extension are difficult, a crunch appears. If you do not take therapeutic measures, the joints will grow and the muscles will atrophy. The skin over the affected articular joints reddens.
- Stage III.Pain syndrome pronounced, the pain has to stop with painkillers. Due to progressive degenerative-dystrophic processes, mobility in the joint is impaired, usually it is completely absent. The number of osteophytes increases, and the cartilage tissue almost disappears. The joint and the muscular-ligamentous apparatus cease to perform their functions. Fingers twisted, bent.
If you do not deal with the treatment of deforming arthrosis of the hands in the early stages, then it will be impossible to regain normal performance due to the distortion of the limbs.
Useful video about osteoarthritis of the hands
List of sources:
- Kalyagin A.N., Kazantseva N.Yu. Osteoarthrosis: modern approaches to therapy // Siberian Medical Journal, 2005. - V. 51. № 2.- p. 93-97.
- Mironov, S. P. Osteoarthrosis: the current state of the problem (analytical review) / S. P. Mironov, N. P. Omelyanenko, A. K. Orletsky // Vestn. traumatology and orthopedics, 2001. - № 2. - p. 96-99.