What is finger osteoarthritis?

Synonyms

Arthrosis of the finger joints, polyarthrosis of the finger joints, arthrosis of the ankle, mid-finger joint arthrosis, polyarthrosis, polyarthrosis, finger joint arthrosis

Medical: Herbedenarthrosis, Bouchardarthrosis

English: polyarthrosis

introduction

Finger arthrosis is a joint disease that is associated with wear and tear of the joints and a narrowing of the joint space and usually first through a feeling of tension in the fingers and problems with everyday exertion of the hands, such as opening a screw cap, leading to considerable problems and pain in the fingers leads.

A stiffness of the hands in the morning also indicates a beginning arthrosis down. Different forms of finger osteoarthritis can be distinguished Finger joints, Median joints, Saddle thumb joint or the Carpal bones affect.

definition

Under one Polyarthrosis one understands painful osteoarthritis (= degenerative, i.e. wear-related joint disease) that occurs simultaneously in several or many joints.
It is typical of such a disease that the cartilage layer, which is actually supposed to protect the joint, is consumed or used up.
Polyarthrosis is particularly common End of the finger, median joint, or. Thumb saddle joints, but also Knee and hip joints, as well as the Metatarsophalangeal joints can be affected by such a condition.
In the context of osteoarthritis of the finger joints, a distinction is made between different forms. The name indicates which joint areas it relates to.
This is how arthrosis of the end joints of the fingers is called Heberden osteoarthritis, osteoarthritis of the median joints as Bouchard– and arthrosis of the thumb saddle joint as Rhizarthrosis.
The term "polyarthrosis" implies that arthrosis affects not just a single joint, but several.

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My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Further information about myself can be found at Lumedis - Dr. Nicolas Gumpert

Gender distribution

Due to the hormonal component, women are far more likely to develop osteoarthritis than men. Statistically, the gender distribution is at a ratio of 10 : 1.

Illustration of finger osteoarthritis

I - finger joint line - green
II - mid-finger joint line - blue
III - saddle thumb joint line - purple

1. Distal phalanx - Phalanx distalis
2. Phalanx - Phalanx media
3. Phalanx - Ph. Proximalis
4. Metacarpal bones - Metacarpals
5. Trapezoidal leg - Trapezium
6. Trapezoid leg - Trapezoid bone
7. Scaphoid bone of the hand -
   Scaphoid bone
8. Articular surface with articular cartilage -
   Articular facies
9. Joint capsule - Articular capsule

a - Healthy joint
b - arthritis (inflammation of the joints)
c - osteoarthritis

A - Back of the right hand
B - osteoarthritis of the finger joint
= Heberden osteoarthritis (green line)
Mid-finger joint arthrosis
= Bouchard osteoarthritis (blue line)
C - Thumb saddle joint arthrosis
= Rhizarthrosis (purple line)

You can find an overview of all Dr-Gumpert images at: medical illustrations

What is finger osteoarthritis?

As already mentioned, osteoarthritis is a joint disease caused by wear and tear, in the course of which the cartilage layer of the joint is consumed and no longer rebuilt.
The reasons for the occurrence of osteoarthritis are mostly of an individual nature (see below). As a result, initially stress-dependent pain, later also pain at rest, occurs. The symptoms that occur vary depending on the joint affected.

In patients with Heberden osteoarthritis, ie arthrosis of the end joints of the fingers, protrusions in the form of nodules on the finger joints can be felt at a very early stage. If there is Bouchard osteoarthritis, i.e. osteoarthritis of the middle joints of the fingers, the nodules often appear with joint swelling.

In the context of an osteoarthritis of the thumb saddle joint (rhizarthrosis), only load-dependent pain usually occurs in the initial stage, so that activities that require a grip on the thumb are particularly painful. In later stages, the pain also occurs in the resting state and can under certain circumstances radiate into other areas.

Read more on the topic: Thumb saddle joint osteoarthritis

causes

The causes for the development are different. While arthrosis of the finger joints can also be caused by poorly healed fractures near the joint and poorly healed extensor tendon damage can also be recognized as the cause, the inheritance factor (genetic cause) plays a far greater role.

In addition, women in and after the menopause suffer from osteoarthritis more than average, so that hormonal components can also be the cause.

Learn more about the Causes of finger osteoarthritis

The risk of osteoarthritis also increases as a result of multiple overstretching of already damaged ligaments on the finger. Please also read our article on this: Overstretched finger

Symptoms

The symptoms of osteoarthritis differ depending on the affected joint. In the case of arthrosis of the end joints of the fingers, known as Heberden's arthrosis, you can feel nodules on the end joints of the fingers even in the early stages. With osteoarthritis of the middle joints of the fingers (Bouchard's arthrosis), these nodules also occur. At the same time, there are frequent complaints about swollen middle finger joints. In the case of arthrosis of the thumb saddle joint, the rhizarthrosis, pain initially only occurs under stress and later on 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 symptoms of finger osteoarthritis, you should consult a doctor:

• Pain (including pain in the finger joints)
• stiffening
• Nodules
• swelling
• Restriction of movement
• Reduced strength in the affected finger joints.

Find out more about the topic: Pain in the ring finger

The doctor cannot usually say which cause exactly leads to the symptoms. There are several factors which, individually or together, can lead to joint disease of the fingers due to wear and tear.

• The mechanical reasons for finger osteoarthritis include poorly healed bone fractures and poorly healed extensor tendon injuries.
• A genetic component is discussed by rheumatologists and other specialists. It could be shown that osteoarthritis occurs more frequently in the family environment of the person affected.
• Menopausal women suffer from finger osteoarthritis more than average, so that there is very likely a connection with the hormonal balance. It has not yet been possible to determine which hormones are responsible for this. Above all, sex hormones must play an important role.
• Bleeding into the joint can damage the cartilage, as the body's own phagocytes in the blood corrode the cartilage tissue and damage it. If the cartilage is injured, it becomes rough and thinner. The cartilage can no longer perform its functions properly, such as dampening impacts or evenly distributing pressure. The bone under the cartilage is exposed to extreme loads in some places. The bone reacts to this new load by increasing its mass and forming small bone structures at the edges. Unfortunately, these measures do not work as well as the cartilage itself. There is 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.
• Uric acid crystals (urate crystals) can accumulate in the joints in certain diseases such as gout or pseudogout (chondrocalcinosis) and contribute to the wear and tear of the articular cartilage.
• A congenital misalignment of the fingers leads to an unphysiological stress on the joints. There is an increased pressure load than with a normal position of the joints. This can lead to changes due to wear.
• There are also drugs that can cause the cartilage to wear out and thus lead to finger osteoarthritis or other joints. Antibiotics such as gyrase inhibitors (fluoroquinolones such as ciprofloxacin or levofloxacin) are among these drugs. Ingestion can cause magnesium particles to clump together in tissues with poor circulation. This results in damage to the connective tissue that can no longer be repaired. It can lead to premature breakdown of the articular cartilage.
• As with many other diseases, overweight is a risk factor in finger osteoarthritis and osteoarthritis in general. A balanced diet and a reduction in body weight to a normal body mass index (BMI) of 18-25 kg / m2 is useful for the prophylaxis of the disease.

Find out all about the topic here: Pain in the interphalangeal joints.

diagnosis

The first meeting

First, the attending physician conducts an initial discussion with the person concerned. The suspected diagnosis usually already exists after Report of complaints of the patient.
It is also of interest whether Relatives of the person concerned also from osteoarthritis or rheumatic diseases Suffer. If so, there may be a possible indication of a family predisposition give the disease.
If you are in your job work a lot with your hands need or recently one bad accident affecting the hands, you should inform the doctor treating you. Accidental damage can also contribute to osteoarthritis.

Physical examination

After the initial consultation, the doctor will conduct one physical examination by. He looks at them Joints of the hands individually. You can mostly Nodules and Swelling recognize without having touched the finger joints. Then the doctor devotes himself every single joint and checks its range of motion, ligament stability, tenderness, swelling, skin changes, redness, overheating.

Imaging procedures

To the To secure suspicionthe attending physician assigns a X-ray examination on.
The following changes, which are typical of finger osteoarthritis, may appear on the X-ray:

• Narrowing of the joint space
• bull horn-like Extensions of the bones (Osteophytes)
• lying under the cartilage Bone damagethat are filled with other material (connective tissue, fluid, scars) (Rubble cysts)
• compression the layer of bone under the cartilage (subchondral sclerotherapy).

In addition to this imaging procedure, doctors have other diagnostic measures at their disposal. The ultrasound examination (sonography) is non-invasive (does not penetrate the body), can be carried out quickly and easily and, if necessary, easily repeated. Other imaging measures include magnetic resonance imaging (MRI), computed tomography (CT), scintigraphy, and joint puncture simultaneous examination of the joint fluid (synovia).

Furthermore, it can blood of the person concerned are examined. There are in contrast to rheumatic diseases no typical laboratory parameters. However, one can distinguish whether it is a active or past osteoarthritis (Joint wear). In the active form you can Inflammation values be increased in the blood. These include the Sedimentation rate, the white blood cells (Leukocytes) and their subgroups like lymphocytes, monocytes and granulocytes and that C-reactive protein (CRP).

Frequent comorbidities

Since the causes for the development of osteoarthritis less often in the area of ​​poorly healed previous illnesses (see above), but primarily in the genetic or hormonal area.

Often times, a patient who has a Arthrosis of the finger joint the sick is also symptoms in the range of Middle finger and / or des Thumb saddle joint on. In addition, it cannot be ruled out that other parts of the body, such as Knee- and or hip joint or also the Spine are affected. This has to be checked and excluded in each individual case.

If multiple osteoarthritis Joints are affected, one speaks of a so-called POLYarthrosis (poly = a lot).

Note

The concomitant diseases of osteoarthritis do not include the various forms of rheumatoid (chronic) arthritis, as these diseases are so-called systemic diseases of the entire connective tissue and therefore not only (like osteoarthritis) only affect the joint and the surrounding tissue.
It can be difficult to draw a line between these two forms. The symptoms are very similar, especially in the early stages. As already mentioned above, the formation of the so-called Heberden nodules is an indication of the clinical picture of osteoarthritis, which can already appear in the early stages.
These nodules are very atypical for rheumatoid (chronic) arthritis of the terminal joints. However, if these nodules do not appear, the two diseases can often only be differentiated in more advanced stages by using laboratory values ​​and X-rays.
Typical of rheumatoid (chronic) arthritis is a thickening in the tendon sheath area of ​​the wrist, often also at the base joints.

treatment

General information on treatment

The aim of treating finger osteoarthritis is to maintain freedom of movement. Any inflammation that occurs in the finger joint damages the cartilage and leads to its breakdown.
In the symptom-free phases, the person affected can contribute to the mobility of the fingers with the help of movement therapy and strengthening exercises. Exercises with a softball have proven effective. Squeezing the ball strengthens the fingers.
If functional disorders or severe pain occur, finger joint arthrosis should be treated by a doctor. Before any surgical intervention is made, conservative measures are used.

First of all, drug therapy is started. Topically applicable ointments such as Voltaren Emulgel or tablets (such as ibuprofen or diclofenac) for severe pain can be prescribed. They belong to the class of Non-steroidal anti-inflammatory drugs and have both pain-relieving and anti-inflammatory effects.
In addition, natural remedies such as devil's claw can be taken. Studies have shown that it can alleviate the problem in the case of mild discomfort alone and in the case of severe pain in combination with synthetically produced drugs.
Other herbal remedies that can be taken in case of osteoarthritis of the finger joints are: nettle leaves, willow bark, poplar leaves, goldenrod.
If drug treatment is not enough, laser therapy can help.

Further information is available under our topic: Treatment of finger osteoarthritis

The laser therapy

A laser is a light of a certain wavelength that high energy and is very effective. If the laser is directed to the affected finger joint, it has the following effects in the irradiated area:
Pain-relieving, anti-inflammatory, stimulating blood circulation, accelerating lymph drainage. The laser light influences the metabolic processes and triggers a repair and self-healing mechanism.

Injection into the joint

As part of an injection, the treating doctor injects a small amount of an active ingredient into the affected joint. This active ingredient can hyaluronan, Cortisone or since 2009 too Orthokine be.
hyaluronan is an endogenous component of Synovial fluid. Since hyaluronic acid is often missing in osteoarthritis, the bone or cartilage parts rub against each other, which leads to an inflammatory reaction. Locally injected hyaluronic acid can help to minimize this friction and thus inflammation.
Cortisone the body can form itself. It acts as a stress hormone and inhibits inflammation. When injected into the joint, it 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. There are patients in whom the typical symptoms of the disease reappear after a certain period of time.
Orthokine is a drug that has anti-inflammatory properties. It will be out body's own Blood sera obtained from the patient. Orthokine has a good long-term effect. Even after several years, many patients are still symptom-free.

The operation

If the above-mentioned treatment methods do not improve, surgical intervention can be used. During the operation, the Heberden nodules are removed and the swollen joint lining away.
The annoythat are responsible for the sensation of pain are severed. The rest of the sensitivity is retained.
In patients who, in addition to severe pain, suffer from severe deformation of the fingers, the affected joint is usually stiffened. The stiffening is done either by inserting two to three small wires (so-called. Kirschner wires), or by inserting special screws. They will after a certain time (6-18 months) removed again.

Exercises against finger osteoarthritis

In the Finger osteoarthritis Targeted exercises can contribute to pain relief by strengthening the muscles, promoting mobility and increasing the supply of nutrients to the articular cartilage through increased blood flow.
At the beginning of the exercise, you should sit comfortably and upright.
First of all, the Close fist be practiced. To do this, the hand and forearm are placed on the table, then the fingers are bent. First the end joints, then the middle joints and finally the base joints. Finally, the thumb is placed over the bent fingers so that the fist is completely closed. Then open it again and repeat the exercise about ten times.
As a further exercise, the finger closure and the extension of each individual finger can be practiced. To do this, the fingers are first stretched and spread apart. Then the thumb and index finger are brought together so that they touch. Then the fingers should be stretched again and the finger-thumb closure repeated with all other fingers.
In addition to these simple exercises, finger closure and flexor muscles can also be trained with a softball. To do this, the ball is picked up, squeezed and then released again.
This exercise can be repeated any number of times on both sides. With a tennis ball, movement, muscle strength and coordination can also be improved. To do this, hold the tennis ball with your fingertips and rotate it in a circle or encircle the ball with both hands and move your hands in opposite directions as if it were a screw cap.

To improve muscle strength and relieve pain, regular, preferably daily, practice is useful. In addition, it is important that the exercises are performed correctly and that they do not cause pain. If you are unsure about exercising, you can consult a doctor or a physiotherapist.

Home remedies for finger osteoarthritis

There are plenty of simple home remedies that can help alleviate osteoarthritis symptoms and progression.
A rough subdivision is made according to:

1. Home remedies for external use
2. Home remedies that must be taken orally like medication and
3. Tips for movements in everyday life

The first group of home remedies includes tinctures and ointments to be applied to the affected joints. A chilled mixture of cottage cheese and olive oil that is used to wrap the joints will help relieve pain.
Enelbin kaolin clay also has this effect and should be applied two to three times a week. It also helps reduce swelling in the affected joint. Applying propolis to the painful area can also help.
This is a product made by bees that has antimitcrobial, antiviral and antifungal effects and also promotes wound healing and minimizes allergic reactions.
The squeezed juice from orange peel can be applied to the affected joints like an oil.
Wraps with white cabbage are primarily anti-inflammatory in acute joint reactions. Both cold therapy with a cooling pad and the warming and circulation-promoting effect of mustard flour poultices can alleviate the symptoms. In general, it varies greatly from person to person which home remedies help. The best way to find out is to try out various applications in acute situations, in the event of pain or impending inflammation, and to pay attention to your body reaction.
Finally, leech therapy can stimulate blood circulation and reduce pain, because the saliva of these leeches contains pain relievers. However, this therapy option should be discussed with a doctor first.
Baths with warm salt water or a sulfur mud bath can also be helpful.

To relieve the symptoms from the inside, taking chestnuts soaked in gin can help relieve pain, two to three cups of rose hip tea a day or capsules with rose hip powder, celery bulbs brewed with water, extract or tea of ​​devil's claw or a vitamin E tablet daily can help.

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. In addition, one-sided loading of the affected joint and wringing out movements of the fingers should be avoided.

Diet for finger osteoarthritis

A special one Osteoarthritis diet does not exist, but a balanced and calorie-conscious diet makes sense in any case, so too bone and cartilage be adequately supplied with nutrients, especially minerals, vitamins and antioxidants.
The diet should be based on:

• Grain
• vegetables and fruit and
• lean meat and fish based.

An intake of fish and marine animals two to three times a week covers that Omega three fatty acids Requires and promotes the development of healthy cartilage and connective tissue and also has an anti-inflammatory effect.
Of meat, however, should not be over a week 500g because it contains inflammatory substances such as arachidonic acid. For the maintenance of healthy bones Vitamin D and Calcium essential.
Calcium is found primarily in milk and dairy products such as yogurt, quark or cheese and should be consumed regularly. Vitamin D, on the other hand, is only found in small amounts in food and is formed into an active form by the body with the help of sunlight.

Therefore, a daily stay of at least thirty minutes in daylight is beneficial for health. Food that should be avoided mainly because of their increased acidity are coffee and alcohol, but asparagus, tomatoes, sweets, nuts, strawberries, margarine, butter and egg yolks should only be consumed in small amounts in the case of osteoarthritis.
The success of a change in diet in the progressive course of osteoarthritis are great and can even mean that drug therapy is not necessary or is only used very rarely.

Stop the finger osteoarthritis

Finger osteoarthritis, like osteoarthritis of other joints, is also a disease advancing disease processTherapy should therefore be started as early as possible and consist of several sub-areas that together achieve the best possible result.
In general, high stress should be avoided and aids in household and everyday life should be used as often as possible. A stabilizing splint can also be worn during the day.
In addition, an improvement can be achieved medically by painkillers of the class of Non-steroidal anti-inflammatory drugs or the Analgesics. The first-mentioned group of painkillers is also anti-inflammatory, which is why they are of decisive importance, especially when joint inflammation begins. Also cartilage protecting substances like Glucosamine are useful in this therapy concept.

Movement and muscle strength can be maintained through a physiotherapist and also through patient training. Here are besides targeted exercises as well Occupational therapy, Heat treatments or Electrotherapy sensible alternatives.
Joints can be surgically stiffened or replaced by artificial joints.

Figure finger joint

Herbeden osteoarthritis affects the end joints of the fingers (see red circles).

In Bouchard osteoarthritis, the middle joints of the fingers are affected (see blue circles).