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Finger pain - pain in the fingers: causes and effective treatment

Finger pain - pain in the fingers: causes and effective treatment


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In general, finger pain refers to all those painful complaints that occur in the area of ​​the fingers or for which there are very different causes, such as a strain, contusion or diseases such as Dupuytren's disease. An inflammatory or degenerative disease such as rheumatoid arthritis or osteoarthritis is very common.

Painful fingers can be extremely uncomfortable for those affected and, moreover, are usually associated with restrictions on movement, which often increase after certain stresses such as bending, stretching or heavy carrying. As a result, finger complaints can make everyday life considerably more difficult and, in the case of severe rheumatic diseases, for example, can sometimes lead to inability to work. Accordingly, these should always be clarified by a doctor in order to initiate timely treatment if necessary and to be able to avoid health risks.

Definition

As part of the hand, the finger (scientifically: "digitus") belongs to the so-called "acra", which refers to the extreme ends of the organism (hands, feet, toes, nose, etc.). The bony support elements of the four fingers are formed by the bones of the fingers, with each finger normally having three bones: the "phalanx proximalis", "phalanx media" and "phalanx distalis", which translates to the near-body, middle and distant pelvis bones. The thumb, on the other hand, consists of only two bones (phalanx proximalis and distalis) and forms the strongest of the five fingers.

The individual phalanx bones are connected to each other by the finger joints, whereby a distinction is made here between the so-called "finger base joints" to the metacarpals and the "finger end joints" between the phalanges.

The thumb is an exception because it is connected to the carpal bone by the thumb saddle joint, which means that it can face the other fingers. In addition, the flexibility of the thumb makes it possible to grasp larger things by hand. The fingers form an elementary “tool” by making it possible to grip, hold or support. In addition, they also perform other important tasks such as touching or communicative or gestural functions such as pointing or sign language (thumbs up or down, extended middle finger, etc.).

Common cause of finger pain: joint wear

In most cases, degeneration or, colloquially, “wear and tear” is the cause of pain in the fingers. Often it is a so-called finger joint arthrosis (polyarthrosis), as a result of which the cartilage layer of the joint gradually wears out.

A distinction is made between two forms: First, primary osteoarthritis, which develops without a recognizable cause and is therefore usually regarded as typical, age-related wear. Since women in or after the menopause are particularly often affected by primary osteoarthritis of the finger, changes in the hormonal balance are often assumed to be the cause. Genetic factors also seem to play a role, because if close relatives are affected, the risk of contracting the disease increases.

Secondary arthrosis arises, for example, as a result of congenital deformities or malpositions acquired through accidents or injuries, poorly healed fractures, infections or metabolic disorders such as gout. Changes in the bone such as osteoporosis (bone loss) or osteonecrosis (death of bone tissue) can also cause secondary arthrosis, as can rheumatoid arthritis and constant overload or lack of movement.

Finger joint arthrosis most often occurs in the finger end joints (“Heberden arthrosis”) and less frequently in the middle finger joints (“Bouchard arthrosis”), whereas the finger base joints are not affected. Regardless of the type, the signs of wear do not develop overnight, but gradually - so that there are often no symptoms at the beginning and the disease remains undetected for a long time ("silent arthrosis").

In the further course, those affected typically suffer from stiff joints, associated with pain, swelling and the difficulty of clenching their hands into a fist or unscrewing a bottle. Later, the pain is no longer felt only when moving, but instead in every situation in life, the joints are sometimes very swollen, red and overheated ("activated arthrosis").

Typical for osteoarthritis of the finger end joints are joint cysts on the fingers (“mucoid cysts”), which are small protrusions of the joint capsule filled with thickened synovial fluid that gradually increase in size as the disease progresses.

Whether or in what form complaints occur over time, however, differs from case to case and also depends on where exactly the joint wear is present. Accordingly, the disease can be completely painless and largely without consequences, but can also take a serious course and lead to massive pain and misalignment of individual fingers, which can lead to severe impairments in everyday life.

Finger pain due to thumb saddle arthrosis

One possible reason for the complaint is osteoarthritis of the thumb saddle joint (rizarthrosis) - especially in women who are affected about ten times more often than men. This form of joint wear is particularly serious in most cases, since the thumb is indispensable when gripping and holding and thus an injury often brings about severe impairments in everyday life.

The so-called thumb saddle joint is the joint between the first metacarpal and the "large polygonal leg" (Os trapezium), which lies in the ball of the thumb and allows the thumb to rotate and juxtapose with the other fingers. If there is wear here, the affected person feels pain at the transition from the thumb to the wrist (thumb beam), which is often described as burning and is accompanied by swelling and significant restrictions on movement.

Since the thumb saddle joint is the most flexible joint of the thumb, it is in principle involved in all movements - which in turn leads to problems in various everyday activities (opening large glasses, turning a key in the lock, holding objects, etc.) .).

As the disease progresses, the ossification of the joint capsule often results in a noticeable misalignment (subluxation) of the thumb in the thumb saddle joint in addition to the thumb pain, and changes in the bone (osteophytes) can also be felt over time.

Cause arthritis / joint inflammation

A common reason for finger complaints is so-called arthritis, which is a chronic inflammation of the joints (from Greek "Arth-" for "joint" and "-itis" for "inflammation"). Such an inflammation of the joints can have many different causes, such as an infection with bacteria or other pathogens, and an inflammation can also be transported from another infected area (e.g. in the case of a herpes infection) in the body via the blood into the joint.

Metabolic diseases such as gout can be the cause of arthritis. Likewise, autoimmune diseases come into consideration, in which the immune system is "wrongly programmed", whereby the own joints and tissues are attacked and destroyed. These diseases include chronic inflammatory bowel diseases (Crohn's disease, ulcerative colitis), psoriasis and ankylosing spondylitis.

However, the most common form of joint inflammation is rheumatoid arthritis, which is also referred to as "inflammatory rheumatism" or simply "rheumatism". Women are affected about twice as often as men, and the disease can occur at any age - in women, however, it usually begins from the fifth and in men from the sixth decade, but in rare cases children are also affected (juvenile rheumatoid factor positive Polyarthritis).

It has not yet been clarified exactly what causes the “wrong control” of the body's defense system in rheumatism - it is assumed that genetic factors or infectious agents (viruses and bacteria) could play a role, and smoking is also attributed a central importance. Experts therefore often assume that rheumatoid arthritis is triggered by the interaction of several factors.

The disease proceeds in very different ways: they start very slowly on the small finger, wrist and toe joints on the left and right, but they can also appear very suddenly and initially affect only a few joints on one side. In most cases, however, the left and right fingers and wrists are affected first, but usually with the exception of the finger end joints. The inflammation leads to swelling of the joints, sometimes severe finger pain and redness, and morning stiffness of the joints, which sometimes lasts for hours, is also typical.

Many sufferers suffer from general feeling of illness such as fatigue, exhaustion, fever and increased night sweats.

In the further course, the progressive destruction of joints and tendons leads to characteristic malpositions ("90/90 deformity of the thumb", "buttonhole deformity" etc.). In many cases, this increases hand pain and the gripping force of the hands continues to decrease, which means that many everyday activities can no longer be carried out easily.

Rheumatoid arthritis can also affect organs such as the heart, lungs or eyes, which can cause chronic inflammation and dry eyes or a dry mouth (Sicca syndrome), as well as pulmonary fibrosis, pleurisy or pericarditis.

Although rheumatism has not yet been curable, the disease is considered to be treatable if diagnosed early. The course can be very different, in most cases chronic inflammation of the joint develops, which often leads to disability and disability. In addition, those affected have an increased risk of a number of other diseases that occur in parallel and can thus cause additional complaints in everyday life. Examples include calcification of the arteries and osteoporosis as well as fibromyalgia, a heart attack or stroke are possible in an emergency.

Painful fingers due to psoriatic arthritis

If the pain in the fingers occurs in connection with psoriasis of the skin or the nails, a so-called psoriatic arthritis (also called "psoriasis arthritis") can be the cause. This is a rarer inflammatory disease of the joints, which mainly affects the hands, feet and / or the spine and occurs in about 5 to 15% of all patients with psoriasis.

Characteristic are painful swellings on the fingers and toes as a result of inflammatory changes in the joints as well as changes in the fingernails or toenails such as dimples the size of a pin in the nail plate (“spotted nails”) or yellowish discolouration (“oil nails”). The causes of psoriatic arthritis have not yet been fully clarified, but a genetic predisposition is also suspected here in combination with a "trigger", whereby febrile infectious diseases (tonsillitis, measles etc.), hormonal changes (puberty, menopause), among other things, determined Medications and psychological factors such as stress are accepted.

Dupuytren's disease

Finger pain can indicate Dupuytren's disease (Dupuytren's contracture). It is a benign, scarring disease of the connective tissue (fibromatosis) of the palm and the long fingers. It is characteristic that the solid connective tissue plate of the hand (palmar aponeurosis) lying directly under the skin changes, whereby strands and nodules form in the palm and fingers, while the palmar aponeurosis shrinks at the same time.

If the hard knots press on the palmar nerves, pain occurs. The strand-like hardening means that the affected fingers can no longer be actively stretched, with the fourth and fifth fingers (ring finger and little finger) mostly being affected. Instead, they remained in a flexion position (flexion contracture), which can lead to the fact that the hand can no longer be placed flat on a surface.

In part, the curvature also causes finger pain, moreover, it is usually a great burden for those affected that the hands can no longer be stressed or used correctly. Dupuytren's disease primarily occurs in northern Europe, more among men from the age of 50 and affects an estimated 1.3 to 1.9 million people in Germany, according to the German Dupuytren Gesellschaft e.V.

The exact cause of the connective tissue disease has not yet been fully elucidated; an hereditary disposition is suspected in combination with a trigger of the disease, such as the poor healing of an injury that leads to the formation of excess tissue. In addition to the familial clustering, Dupuytren's disease also frequently occurs in connection with certain diseases such as diabetes mellitus, epilepsy, cirrhosis of the liver or increased blood lipid levels (hyperlipidemia).

Other causes of finger discomfort

Other possible reasons for painful fingers are, for example, a strain, sprain or a broken finger, which are usually accompanied by swelling and, in some cases, bruising under the affected fingernail (e.g. if the end of the finger breaks). Nerve damage due to diabetes is conceivable, because the disease destroys long and fine nerve fibers, which leads to sensory disturbances (running ants, tingling) and pain in the fingers and feet.

Considerable is a benign soft tissue tumor on the finger joint (ganglion), which is often colloquially referred to as the "leg". It is an elastic nodule filled with fluid that is often very sensitive to pressure and can sometimes cause massive pain when it presses on joints, nerves or blood vessels. Furthermore, an over leg often leads to restrictions in mobility and sensations such as tingling or numbness.

Treatment for painful fingers

There are a multitude of options for treatment, depending on the cause. For example, if there is osteoarthritis, a central step is to avoid additional stress on the joints and instead relieve the fingers as much as possible in everyday life, for example by reinforcing the grip on pins or using a special splint to immobilize them the thumb saddle joint arthrosis is used.

Different types of physical treatment, such as heat treatments, physiotherapy, electrotherapy or ultrasound, can be very helpful to relieve the symptoms. In the case of severe pain and / or restricted movement, medication (e.g. non-steroidal anti-rheumatics, in short: NSAIDs, pain relievers) is usually given first, either in the form of creams or gels applied directly to the affected finger or directly into the joint can be injected (cortisone, hyaluronic acid).

In the case of finger arthrosis, laser treatment is also an option. If the conservative measures are not successful, there is the possibility of an operation - however, this is usually only carried out if the symptoms have been going on for a long time and the joints are severely deformed.

Therapeutic measures for rheumatoid arthritis

In the case of rheumatoid arthritis, it is crucial that the disease is recognized and treated as early as possible - accordingly, those affected should always consult a doctor or rheumatologist immediately if they are suspected. The aim of the therapy is to inhibit the inflammatory processes as best as possible and to relieve the pain, but also to maintain the strength and functionality of the joint.

To achieve this, the treatment of rheumatoid arthritis is usually based on three pillars: First, treatment with medication (non-steroidal anti-inflammatory drugs such as ibuprofen or diclofenac, basic therapeutic agents, etc.) to slow down or stop the course.

Secondly, physiotherapy, occupational therapy and physical measures (e.g. cold or heat applications, electrotherapy) are used to maintain the mobility and function of the joints.

The third pillar is surgical intervention, which is usually only considered if the previous measures have not shown sufficient effects. In principle, there are various options here, e.g. arthroscopy (joint mirroring) or radiosynoviorthesis, in which inflammatory tissue can either be removed or obliterated using radioactive substances.

Therapy for Dupuytren's disease

If Dupuytren's disease is present, the therapy is also carried out according to the patient's existing complaints and limitations. Since the nodules usually grow very slowly in older people in particular and therefore hardly lead to impairments, in some cases no treatment is necessary at all.

After a certain degree of limited flexion of the fingers, a hand operation is usually performed in which the diseased connective tissue is removed so that the tendons can move freely again. This is the case, for example, when the fingers can no longer be laid flat on the table or can only be bent less than 30 degrees. After the operation, physiotherapy is a good support to quickly regain flexibility in the fingers or hand.

As an alternative to surgery, non-surgical methods can be used to treat Dupuytren's disease. An example here is the so-called needle fasciotomy, in which the doctor destroys the hardened Dupuytren strands with needle pricks to such an extent that they can be stretched and torn. At the beginning of the disease, radiation with X-rays or gamma rays is also suitable in some cases to inhibit the growth of the connective tissue and thereby prevent the disease from progressing.

Naturopathy for rheumatic pain

Since finger pain very often occurs in connection with rheumatic diseases, it is important to see a rheumatologist at the first sign, because only he can make a competent decision as to which treatment steps make sense in individual cases. Therapy for rheumatism patients includes anti-inflammatory drugs, but also a variety of non-drug measures such as physiotherapy, massages or thermal applications in the form of cold or heat.

In many cases, for example, radon heat therapy in the Gastein healing tunnel has proven itself here, which relieves pain naturally and without side effects, inhibits inflammation and also stabilizes the immune system. The "secret recipe" of this application consists of the combination of slight overheating, high air humidity and the absorption of the radioactive element radon, which has been used for over 100 years to cure rheumatism, but also skin and respiratory diseases.

Proper nutrition for aching fingers

In the treatment of rheumatic diseases, a healthy and sensibly balanced diet should play a central role, because particularly fatty foods can aggravate the inflammatory processes. This is due to the so-called inflammation mediators, which means biochemical substances that initiate or continue inflammatory reactions.

The starting substance for the formation of these inflammation mediators is "arachidonic acid", a polyunsaturated fatty acid, which is one of the essential omega-6 fatty acids and can only be produced in small quantities by the human body.

Accordingly, the largest portion is ingested through food, primarily meat and other arachidonic acid-rich foods such as egg yolk, lard, veal and pork liver. Accordingly, if too much omega-6 is ingested, the inflammation worsens - if, on the other hand, you eat a steady or predominantly vegetarian diet, complaints such as immobility in the morning, swollen joints and pain and sometimes even inflammation levels in the blood can be minimized.

In addition, the omega-3 fatty acids are of great importance because they are able to promote anti-inflammatory substances and can therefore also have a positive effect on the inflammatory processes in the joints. Particularly effective from the class of omega-3 fatty acids is “eicosapentaenoic acid”, which occurs primarily in high-fat fish such as herring, mackerel, tuna or salmon - which is therefore on the menu of rheumatism patients at least twice a week should.

“Alpha-linolenic acid” also belongs to the omega-3 fatty acids and can be very effective for pain in the fingers due to a rheumatic disease. This is primarily found in vegetable oils from soy, rapeseed, walnut or linseed and can therefore be taken in a variety of ways, for example in salads or as an ingredient in morning cereals.

Another option is a quark-linseed oil dish according to Dr. Budwig: For this, about two tablespoons of freshly ground flaxseed are placed in a small bowl together with fresh chopped fruit and poured with a cream of curd cheese and linseed oil. For the cream, 125 grams of low-fat curd cheese are mixed with one tablespoon of milk and honey and one or two tablespoons of linseed oil. You can add nuts, cinnamon or other spices, for example.

The sufficient intake of free radicals (antioxidants) is also important. Because these are able to render oxygen radicals harmless, which arise from the repeated inflammation in an increased form and promote the formation of inflammatory substances. These mainly include vitamins E and C, beta-carotene, the trace elements copper, zinc and selenium as well as various secondary plant substances such as polyphenols.

In order to absorb a sufficient amount of free radicals, care should be taken in the case of rheumatic complaints to eat several servings of vegetables and fruit throughout the day and also to prefer whole grains. Since the risk of premature bone loss (osteoporosis) is also increased for many people affected by medication such as cortisone, care should also be taken to ensure an adequate calcium supply - accordingly, milk or milk products should also be on the daily menu.

Exercise and stress relief

In addition to therapeutic applications and nutrition, exercise is also a key factor in rheumatic diseases in order to remain physically fit despite the disease. Above all, this includes physiotherapy exercises that stimulate the metabolism and thereby strengthen the stability of the bones.

Since stress is another factor that can cause inflammatory reactions, those affected should pay attention to regular breaks and relaxation, sleep well and, in addition, do not overload or overwhelm themselves in everyday work and private life. A wide variety of exercises for stress relief are available to support this, and yoga or autogenic training specially tailored to rheumatism patients can also be helpful in this context. (No)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch

Swell:

  • Michael Hammer: Rheumatoid Arthritis (chronic polyarthritis), Deutsche Rheuma-Liga Bundesverband e.V., (accessed on 04.09.2019), rheumal league
  • M. Schneider et al .: Interdisciplinary Guideline for Management of Early Rheumatoid Arthritis, German Society for Rheumatology e.V., (accessed on 04.09.2019), DGRH
  • Deutsche Gicht-Liga e.V .: Information about the disease (accessed: 04.09.2019), gichtliga
  • David R. Steinberg: Osteoarthritis of the Hand, MSD Manual, (accessed 04.09.2019), MSD
  • German Rheumatism League: Psoriatic Arthritis, (accessed 04.09.2019), Rheumatism League
  • C. Eaton et al .: Dupuytren's Disease and Related Hyperproliferative Disorders, Springer Verlag, 1st edition, 2012

ICD codes for this disease: M79.04, M79.24 ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


Video: Treating Basal Thumb Joint Arthritis - Mayo Clinic (September 2022).


Comments:

  1. Duardo

    I regret, that I can help nothing. I hope, you will find the correct decision.

  2. Paolo

    Agree, this remarkable message



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