Pain in the fingersoccurs when bones, joints, soft tissues, blood vessels, nerves are affected. It can be dull, acute, weak, intense, constant, intermittent, short-term. Often there is a connection with physical activity, weather conditions, and other factors. Concomitant external disturbances are possible: deformations, changes in color and temperature, 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
A finger injury is characterized by moderate pain. Then the intensity of pain gradually decreases. Edema, hyperemia, cyanosis, hemorrhages are possible. The function of the finger is slightly impaired. Hematomas on the palmar surface of the fingers are manifested by moderate pain, skin detachment with the formation of a cavity filled with dark blood. With subungual hematomas, pain is intense, jerking, pulsating, aggravated by lowering the brush. Partial or complete detachment of the nail plate is possible.
A broken finger is accompanied by severe 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, crepitus, 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, spring resistance is determined.
With frostbite in the first hours, the pain is slight, tingling. Then the pain syndrome intensifies, acquires a burning character. The finger swells, becomes cyanotic. With deep frostbite, there is no sensitivity in the distal parts, the fingers are cold, pale, pain bothers at the border between healthy and affected tissues.
Panaritium is characterized by rapidly increasing pain, swelling, hyperemia, cyanosis, abscess formation. Pains jerking, throbbing, depriving the night of sleep. Especially strongly painful sensations are expressed with subungual panaritium and deep forms of the disease (bone, articular, tendon). With superficial forms of panaritium (skin, periungual, subcutaneous, subungual), the general condition suffers slightly, with deep symptoms of intoxication, fever.
Chinga develops in people involved in cutting and processing the carcasses of marine game animals, occurs with minor injuries: abrasions, wounds, cracks. It manifests itself as dull, weak pain in the wound area, which after 1-2 days is replaced by pain in the joint of the finger (usually the proximal one). The pain grows, becomes aching, throbbing, complemented by swelling, pallor, cyanosis of the finger.
Pain in the joints of the fingers in rheumatoid arthritis is symmetrical. 1 degree of activity is manifested by minor arthralgia, quickly disappearing stiffness. At grade 2, pain is disturbed at rest and during movement, combined with prolonged stiffness, limitation of movement, redness. Grade 3 is characterized by intense constant pain, persistent stiffness, swelling, hyperemia. Movement is severely limited.
Gouty arthritis of the fingers is more common in women. One or more joints may be affected. Pain is usually acute, sharp, combined with edema, hyperemia, impaired function, and an increase in general temperature. Erased symptoms are less often observed - minor pain and slight redness with a satisfactory general condition.
Psoriatic arthritis occurs suddenly or gradually. In the first case, the pain is moderate, growing, in the second - sharp, intense. At the height of the disease, the typical picture includes soreness, aggravated at night and at rest, weakening during the day, with movements, swelling of the fingers, purplish-bluish coloration of the skin. The distal interphalangeal joints are most often affected. Over time, multiple deformations appear.
In post-traumatic arthritis, one joint is affected. For infectious-allergic forms of the disease, developing against the background of bacterial and viral infections, multiple lesions are typical. With professional peripheral arthritis, the most loaded joints of the fingers are involved in the process. Pain in all of the listed forms of pathology intensifies at night, weakens during the day, and is supplemented by morning stiffness, local swelling, and difficulty in movement. With a long course, deformations are noted.
With arthrosis of the hands, the pain is initially indefinite, periodic, short-term. There is morning stiffness. Subsequently, painful sensations intensify, become prolonged, sometimes burning, are noted with any movements, limit daily activity, and perform delicate operations. Heberden and Bouchard nodes are formed. Lateral deformations are formed.
Diseases of ligaments and tendons
Patients suffering from stenosing ligamentitis are concerned about pain along the palmar 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, 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 motor activity, some patients are disturbed even at rest. Typical irradiation to the distal phalanx or to the forearm from the side of the first finger.
Raynaud's syndrome is caused by vasospasm, accompanied by paroxysmal numbness, cold fingers. The pain occurs in the second phase of the attack, has a breaking character, is combined with a burning sensation, fullness. The pain syndrome is short-term, replaced by a feeling of heat, redness of the distal parts of the hands. Pathology occurs in a variety of diseases of various origins, including:
- rheumatoid arthritis;
- systemic lupus erythematosus;
- Sharp's syndrome;
- antisynthetase syndrome;
- thromboangiitis obliterans of the upper extremities;
- endocrine, metabolic, occupational pathologies.
In the absence of other diseases that provoke this condition, they talk about 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, hematological diseases. It is manifested by paroxysmal attacks of baking, burning pain, edema, hyperemia of the fingers. It is possible to spread pain from one limb to another or to occur simultaneously in the region of both limbs. 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.
Pain in the fingers occurs when nerves are damaged, spreads in the zone of innervation, has a shooting or burning character, is complemented by sensory disturbances, autonomic-trophic disorders. Possible neurological causes:
- Neuropathy of the median nerve.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 level of the wrist. Localization of pain - as in the previous case. Typical nocturnal attacks, a decrease in pain when lowering the arms, shaking the brushes.
- Neuropathy of the radial nerve.With a lesion at the level of the forearm and wrist, pain is noted along the back surface of the first finger and hand, sometimes spreading to the second and third fingers. Irradiation in the forearm, numbness of the back of the hand are characteristic.
- Neuropathy of the ulnar nerve.Pain is localized mainly in the area of the elbow joint, but can radiate to the hand, IV-V fingers. The pain syndrome often intensifies in the morning.
Benign tumors that affect the bones of the fingers include chondromas and osteoid osteomas. Chondromas are manifested by non-intense pain sensations with indistinct localization, osteoid osteomas - by sharp pains in the affected area. Malignant neoplasia of the fingers is rare.
Pain in the fingers and hand is observed in patients with writing spasm, which develops with occupational neurosis, some other mental and neurological disorders. Pain occurs when writing, working on a computer or typewriter. They are breaking, pulling, complemented by trembling, sudden weakness of the hand, local convulsions. In addition, soreness in the fingers can be detected in the following pathologies:
- Leukemia: Waldenström's macroglobulinemia.
- Tumors of the adrenal glands: aldosteroma.
- Complications of diabetes: diabetic neuropathy.
- Vascular diseases: distal digital embolism due to occlusion of the subclavian artery.
- hereditary diseases: Fabry disease.
- Childhood diseases: neuro-arthritic diathesis.
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:
- Survey. The doctor finds out when and under what circumstances the pain syndrome and other symptoms first appeared, determines the characteristics of the dynamics of the development of the disease, factors provoking an improvement or deterioration in the patient's condition. Studying life history, family history.
- Physical examination. The specialist evaluates the appearance of the fingers, reveals deformities, inflammation, cracks, dry skin, temperature and color disturbances, swelling, and other manifestations of pathology. Examines sensitivity, range of motion, pulsation in the peripheral arteries.
- Radiography.It is performed in two projections with the 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 panaritium forms.
- Electrophysiological studies.They are performed for pain of neurological origin to clarify the level of nerve damage, assess the condition of the muscles, and nerve conduction.
- Lab tests. Produced to determine inflammation, assess the general condition of the body, detect specific markers in collagenoses.
According to the indications, patients are referred for a consultation with an endocrinologist, neurologist, vascular surgeon, and other specialists. Assign CT, MRI, other instrumental techniques. Carry out a biopsy of hard and soft structures for cytological or histological examination.
In case of traumatic injuries, cold, elevated position of the limb is recommended. The hand is fixed with a splint or improvised materials (for example, planks). The brush is raised up or a scarf is used. With an intense pain syndrome, an analgesic is given, in the absence of external damage, chloroethyl is applied.
Help for 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. Acute twitching pains, pronounced signs of inflammation, general hyperthermia are the reason for an urgent consultation with a specialist.
In case of dislocations and fractures, local anesthesia is performed, reduction is carried out, and a plaster cast is applied. Conservative treatment of traumatic and non-traumatic pathologies of the fingers involves the following activities:
- Protective mode. 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 plaster cast.
- Medical therapy. Non-steroidal anti-inflammatory drugs, antibiotics, drugs to improve blood circulation, neurotropic drugs are used. According to the indications, blockades with corticosteroids are performed.
- Non-drug methods. Exercise therapy, massage, physiotherapy, manual therapy, kinesio taping are prescribed.
Operations are performed when conservative methods are ineffective, to reduce the time and improve long-term results of treatment. Taking into account the characteristics of the lesion, the following is carried out:
- Injuries: fixation of fractures and dislocations with knitting needles, necrectomy and amputation of fingers in case of frostbite.
- Infectious diseases: opening, drainage of panaritium, in case of severe lesions in some cases - amputation or disarticulation.
- Diseases of 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.
- Neoplasms: removal of neoplasia, bone resection.
- Neurological diseases: nerve decompression.
After surgery, antibiotic therapy is prescribed. Patients undergo a comprehensive rehabilitation aimed at maximizing the restoration of hand functions.