Finger arthritis is a joint disease that is accompanied by wear and tear of the joints and a narrowing of the joint space. It usually first causes considerable problems and pain in the fingers due to a feeling of tension in the fingers and difficulties with everyday exertion of strength in the hands, such as opening a screw cap.
Stiffness of the hands in the morning also indicates the beginning of arthritis. Various forms of finger arthritis can be distinguished, affecting the end joints of the fingers, the middle joints of the fingers, the thumb saddle joint, or the carpal bones.
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Definition of finger arthritis
Polyarthritis is a painful arthritis (= degenerative, i.e., wear-related joint disease) that occurs simultaneously in several or many joints.
Typical for such a disease is that the cartilage layer, which should protect the joint, is used up.
Polyarthritis mainly affects the joints of the fingers, middle fingers, and thumb saddle joints, but knee and hip joints, as well as the metatarsophalangeal joints of the big toe, can also be affected.
There are different forms of arthritis of the finger joints. The name indicates the joint areas to which it refers.
For example, arthritis of the end joints of the fingers is called siphon arthritis, arthritis of the middle joints of the fingers is called bouchard arthritis, and arthritis of the thumb saddle joint is called rhizarthrosis.
The term “polyarthritis” implies that not only a single joint is affected by arthritis, but several.
The reasons for the occurrence of arthritis are usually individual (see below). As a result, pain initially develops, depending on the load, and later also at rest. The symptoms that occur vary depending on the affected joint.
In patients with siphoning arthritis, i.e., arthritis of the end joints of the fingers, bulges in the form of nodules on the finger joints can be felt at a very early stage. If Bouchard arthritis, i.e., arthritis of the middle finger joints, is present, the nodules often appear with joint swelling.
In the early stages of arthritis of the thumb saddle joint (rhizarthrosis), only load-dependent pain occurs, so that especially activities that require the thumb to be arthritis are associated with pain. In later stages, the pain also occurs at rest and may radiate into other areas.
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Causes of finger arthritis
The causes of the development are different. While arthritis of the finger joints can also be caused by poorly healed fractures close to the joint and poorly treated extensor tendon damage can also be recognized as a cause, the factor of heredity (genetic cause) plays a far more significant role.
Besides, an above-average number of women suffer from osteoarthritis during and after the menopause, so that hormonal components may also be the cause.
Finger arthritis can be shown in the X-ray image, for example, by a narrowing of the joint space.
The symptoms of arthritis differ depending on the affected joint. In the case of arthritis of the end joints of the fingers, a so-called siphoning arthritis, nodules on the end joints of the fingers can be palpated at an early stage. In the case of arthritis of the middle finger joints (Bouchard arthritis), these nodules also occur. At the same time, there are frequent complaints of swollen middle finger joints. In the case of arthritis of the thumb saddle joint, rhizarthrosis, pain initially occurs only under stress, later at rest. The tricky thing here is that the pain can radiate into the forearm, hand, or other areas.
If you have one or more of the following typical signs of finger arthritis, you should consult a doctor:
- Pain (including pain in the finger end joints)
- Restricted movement
- Force reduction in the affected finger joints.
In most cases, the doctor is unable to say precisely what the cause of the symptoms is. There are several factors that individually or together can lead to wear-related joint disease of the fingers.
Among the mechanical reasons for finger, arthritis is poorly healed bone fractures and not well-healed extensor tendon injuries.
A genetic component is discussed by rheumatologists and other specialists. It has been shown that arthritis occurs more frequently in the family environment of the person affected.
Women in the menopausal years suffer above average from finger arthritis, so that there is very probably a connection with the hormone balance. Exactly which hormones are responsible for this has not yet been determined. Above all, sex hormones must play an important role. Bleeding into the joint can damage the cartilage because the body’s macrophages in the blood eat away at the cartilage tissue and destroy it. If the cartilage is damaged, it roughens and becomes thinner. The cartilage can no longer perform its functions properly, such as absorbing shocks or distributing pressure evenly. The bone beneath the cartilage is exposed to extreme stress in some places.
The bone reacts to this new load by increasing its mass and forming small bone attachments at the edges. Unfortunately, these measures do not work as well as the cartilage itself. This results in abrasion and thus irritation of the joints. The synovial membrane produces more tissue fluid (synovia)—an effusion forms in the joint. The synovia contains more inflammatory cells than normal tissue fluid. The joint becomes warm, red, and swollen.
Crystals of uric acid (urate crystals) can be deposited in the joints in specific clinical pictures such as gout or pseudo-gout (chondrocalcinosis) and contribute to wear and tear of the joint cartilage.
A congenital malposition of the fingers leads to an unphysiological strain on the joints. This results in a higher pressure load than with a normal position of the joints. This can lead to changes due to wear and tear.
Some medications can cause wear and tear of the cartilage, which can lead to finger arthritis or other joints. Antibiotics such as the gyrase inhibitors (fluoroquinolones such as ciprofloxacin or levofloxacin) are among these drugs. Taking them can lead to clumping of magnesium particles in tissues with inadequate blood supply. As a result, damage to the connective tissue occurs that cannot be repaired. Premature degradation of the joint cartilage can occur.
As with many other diseases, overweight is a risk factor in finger arthritis and arthritis in general. A balanced diet and a reduction in body weight to a normal body mass index (BMI) are useful for the prevention of the disease.
Here you can find out all about the topic: pain in the finger end joints.
The initial interview
First of all, the attending physician conducts an initial consultation with the person concerned. The suspected diagnosis usually exists after the patient’s symptoms have been reported.
It is also of interest whether relatives of the affected person also suffer from arthritis or rheumatic diseases. If this is the case, there may be a possible indication of a family predisposition to the disease.
If you have to work with your hands a lot in your profession or have recently had a severe accident involving your hands, you should inform the treating physician. Accident-related damage can also contribute to osteoarthritis.
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Following the initial consultation, the doctor will carry out a physical examination. He looks at the joints of the hands individually. In most cases, nodules and swellings can be seen without having touched the finger joints. Then the doctor looks at each joint and checks its range of motion, ligament stability, pressure pain, swelling, skin changes, redness, overheating.
To confirm the suspicion, the attending physician orders an X-ray examination.
The following changes, which are typical for finger arthritis, can occur in the X-ray:
- Narrowing of the joint space
- Bull horn-like runners of the bones (osteophytes)
- Bone damage lying underneath the cartilage, which is filled up with other material (connective tissue, fluid, scars) (gravel cysts)
- Compression of the bone layer lying under the cartilage (subchondral sclerotherapy).
In addition to this imaging procedure, other diagnostic measures are available to doctors. The ultrasound examination (sonography) is non-invasive (does not penetrate the body), can be carried out quickly and easily, and can be repeated easily if necessary. Further imaging measures are magnetic resonance imaging (MRT), computer tomography (CT), scintigraphy, joint puncture with a simultaneous examination of the synovial fluid (synovia).
Furthermore, the blood of the affected person can be examined. Unlike rheumatic diseases, there are no typical laboratory parameters. However, it is possible to differentiate between active and expired arthritis (joint degeneration). In the active form, inflammation values in the blood may be elevated. These include the blood sedimentation rate, the white blood cells (leukocytes), and their subgroups such as lymphocytes, monocytes and granulocytes, and the C-reactive protein (CRP).
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Common concomitant diseases
Since the causes for the development of arthritis are less often to be found in the area of poorly healed previous illnesses (see above), but primarily in the genetic or hormonal area.
Frequently, a patient suffering from arthritis at the end of the finger joint also shows symptoms in the area of the metacarpophalangeal or thumb saddle joint. Besides, it cannot be ruled out that other parts of the body, such as the knee or hip joint or even the spinal column, are also affected by the disease. This must be checked and excluded in each case.
If several joints are affected by arthritis, it is called POLYarthritis (poly = many).
Treatment of finger arthritis
The treatment of finger arthritis aims to maintain freedom of movement. Any inflammation that occurs in the finger joint damages the cartilage and leads to its degradation.
In the symptom-free phases, the affected person can contribute to the mobility of the fingers using movement therapy and strengthening exercises. Exercises with a softball have proven to be effective. Pressing the ball together strengthens the fingers.
If functional disorders or severe pain occur, finger joint arthroses should be treated by a doctor. Before surgery, conservative measures are applied.
At first, drug therapy is started. Locally applicable ointments such as Voltaren Emulgel or tablets (such as Ibuprofen or Diclofenac) can be prescribed for severer pain. They belong to the class of non-steroidal antirheumatic drugs and have both analgesic and anti-inflammatory effects.
Besides, natural remedies such as Devil’s Claw can be taken. Studies have shown that it can alleviate mild symptoms on its own and in combination with synthetically produced drugs for more severe pain.
Other herbal remedies that can be taken for arthritis of the finger joints are Nettle leaves, willow bark, poplar leaves, goldenrod.
If drug treatment is not sufficient, laser therapy can help.
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The laser therapy
A laser is a light of a certain wavelength that is highly energetic and very effective. If the laser is directed to the affected finger joint, it has the following effects in the irradiated area:
Pain-reducing, anti-inflammatory, blood circulation-promoting, lymph drainage accelerating. The laser light influences the metabolic processes and triggers a repair and self-healing mechanism.
Injection into the joint
The doctor treating you injects a small amount of an active substance, which has an anti-inflammatory effect, into the joint.
In the course of an injection, the attending physician injects a small amount of an active ingredient into the affected joint. This active ingredient can be hyaluronic, cortisone, or, since 2009, orthokine.
Hyaluron is an endogenous component of the synovial fluid. Since hyaluron is often missing in osteoarthritis, the bone or cartilage parts rub directly against each other, which leads to an inflammatory reaction. Locally injected hyaluronan can help to minimize this friction and, thus, the inflammation.
Cortisone can be produced by the body itself. It serves as a stress hormone and inhibits inflammation. When injected into the joint, it also has an “anti-inflammatory” effect and relieves the swelling in the joint. Cortisone can help in many cases but does not necessarily lead to permanent pain relief or freedom from pain. There are patients in whom the typical symptoms of the disease reoccur after a certain period.
Orthokine is a drug that has anti-inflammatory properties. It is obtained from the patient’s blood sera. Orthokine has an excellent long-term effect. Even after several years, many patients are still free of symptoms.
If the treatment mentioned above methods do not bring improvement, surgical intervention can be performed. During the surgery, the lifter nodules are removed, and the swollen joint mucosa is removed.
The nerves responsible for the sensation of pain can also be severed. The remaining sensitivity is retained.
Patients who suffer from severe deformation of the fingers in addition to severe pain usually have the affected joint stiffened. Stiffening is achieved either by inserting two to three small wires (so-called Kirschner wires) or by inserting special screws. They are removed again after a certain period (6-18 months).
Exercises against finger arthritis
In the case of finger arthritis, specific exercises can contribute to pain relief by strengthening the muscles, promoting mobility, and increasing the supply of nutrients to the joint cartilage through increased blood circulation.
At the beginning of the exercise, a comfortable and upright sitting position should be adopted.
The first thing to practice is fist closure. To do this, the hand and forearm are placed on the table, and then the fingers are bent—first, the end joints, then the middle joints, and finally, the basic joints. Finally, the thumb is placed over the bent fingers so that the fist is completely closed. Then it is opened again, and the exercise is repeated about ten times.
As a further exercise, the finger closure and the extension of each finger can be practiced. To do this, the fingers are first stretched and spread. Then the thumb and index finger are brought together so that they touch each other. Then the fingers should be stretched again, and the finger- thumb closure should be repeated with all other fingers.
In addition to these simple exercises, the finger closure and the flexor muscles can be trained with a softball. To do this, the ball is taken in hand, squeezed together, and then released again.
This exercise can be repeated as often as desired on both sides. The movement, muscle strength, and coordination can also be improved with a tennis ball. To do this, hold the tennis ball with your fingertips and rotate it in a circle or surround the ball with both hands and move your hands in opposite directions as if it were a screw cap.
To improve muscular strength and to relieve pain, regular, preferably daily practice is recommended. It is also essential that the exercises are performed correctly and do not cause pain. If you are uncertain about how to exercise, a doctor or physiotherapist can be consulted.
General exercise tips and home remedies include swimming in the sea, light exercise for the affected joints, and movement of the joints after long periods of rest, such as after sleeping or long journeys. Also, one-sided loading of the affected joint should be avoided, as well as wringing movements of the fingers.
A daily stay of at least thirty minutes in daylight is therefore beneficial to health. Foods that should be avoided because of their high acidity are mainly coffee and alcohol. Still, asparagus, tomatoes, sweets, nuts, strawberries, margarine, butter, and egg yolk should also be consumed in small quantities if you suffer from osteoarthritis.
The success of a change in diet as the disease progresses is excellent and can even mean that drug therapy is not necessary or is used only very rarely.
Stop the finger arthritis
Finger arthritis, like arthritis of other joints, is a disease with a progressive disease process. Therefore, therapy should be started as early as possible and should be composed of several sub-areas which together achieve the best possible result.
In general, heavy strain should be avoided, and as often as possible, aids should be used in the household and everyday life. A stabilizing splint can also be worn during the day.
Besides, improvement can be achieved with medication, such as painkillers in the class of non-steroidal anti-inflammatory drugs or analgesics. The first mentioned group of painkillers is also anti-inflammatory, which is why they are of decisive importance, especially in cases of incipient joint inflammation. Cartilage-protecting substances such as glucosamine are also useful in this therapy concept.
Movement and muscle strength can be maintained by a physiotherapist and also by patient training. In addition to targeted exercises, ergotherapy, heat treatments, or electrotherapy are useful alternatives.
Joints can be surgically stiffened or replaced by artificial joints.
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