Finger pain can be caused by trauma, overload, circulatory problems, inflammation of the nerves, or other inflammatory diseases such as arthritis.
Finger pain can be pulsating, dull or stabbing, as well as cold, burning, stiffness or tingling in the fingers.
If the sensation of pain is comparable to pinpricks, it is based on a nerve disease; in this case, paresthesia may be present.
Paresthesia is a perceptual disorder, often caused by the temporary or permanent damage to the nerves that carry the sensitive signals from the fingers to the spinal cord.
A finger consists of nerves, bones, blood vessels, muscles and skin. The finger joints are the joints of the bones and contain cartilage, ligaments, tendons, bursae (fluid-filled sacs that favor sliding movement) and synovial membranes (inner layer of the joint capsule), which provide joint lubrication.
Each of these finger structures can become inflamed or irritated as a result of illness, disorders, overuse, injury or infection.
The most common cause of finger pain is injury, for example when the finger is bent backwards (slipping); but if the fingers hurt, there may also be repetitive strain or serious illnesses behind it, such as diabetes and inflammation of the nerves of the cervical spine or spinal cord.
If the symptoms are nervous, tingling, burning and a feeling of cold can also occur on the fingers.
These include cervicobrachialgia (the origin lies in the spine), ulnar groove syndrome (elbow) and carpal tunnel syndrome (wrist).
Symptoms radiate from the neck and arm and can also occur at night.
Pain in the finger joints can be caused by osteoarthritis or arthritis, which causes inflammation.
A doctor must be consulted immediately if pain, swelling, redness, overheating and fever become noticeable.
The fingers are easily injured during everyday activities, during sports (e.g. climbing) and making music (playing the guitar); Finger injuries are among the most common cases in the accident ward.
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Causes of finger pain
The causes of finger pain can be divided into two categories.
1. The cause may be temporary inflammation that does not result in permanent injury to the finger, such as trauma to the hand.
The fingers can be injured in various ways. If the hand collides with a hard surface in an accident, a fracture of the fingers or a cartilage lesion may occur.
A bruise usually occurs at the level of the middle finger or index finger middle joint, for example when punching a fist or trapping in a car door.
The pain that arises as a result of a finger fracture is one of the worst pains of all, along with nerve pain.
The result is swelling, pain, stiffness of the fingers and possibly a bruise (black finger).
The symptoms disappear within a short period of time.
Finger pain in children is usually caused by a blow.
2. Other causes can cause permanent finger damage.
Osteoarthritis or rheumatoid arthritis causes an increasing breakdown of finger cartilage.
In some cases, osteoarthritis can lead to the formation of bone outgrowths and visible deformations of the last finger limb.
Tendon and connective tissue complaints
Tendinitis de Quervain
In Quervain’s narrowing (tendovaginitis de Quervain), the tendon on the thumb saddle becomes inflamed and numerous microlesions form.
The word “tendinitis” refers to a swelling of the tendon.
The thickening of the tendons can cause pain and numbness on the thumb side of the wrist.
This phenomenon is particularly noticeable when the hand closes into a fist, grasps objects and holds something (e.g. plates or cups).
Signs and symptoms of finger pain
The main symptom of Quervain’s disease is pain in the wrist at the foot of the thumb, which can radiate to the forearm.
The pain may develop slowly or come on suddenly.
The pain worsens when using the hand and thumb, especially when gripping or turning the wrist vigorously.
Characteristic is a clearly visible swelling on the thumb side of the wrist, here can also form a fluid-filled cyst.
If the thumb is moved, a crunch may be heard.
Pain and swelling can affect the movement of the thumb and wrist.
There may be tingling sensation on the back of the thumb and index finger. This feeling is triggered by the tendon sheath, which exerts pressure on the surrounding nerves.
The diagnosis is made clinically, during which the so-called Finkelstein test is performed: the thumb is placed in the palm of the hand, the other fingers enclose it into a fist; then the hand is bent down on the wrist and towards the little finger. Attention, the test is also positive for rhizarthrosis, this is the arthrosis in the thumb saddle joint.
The aim of treatment for Quervain’s disease is to reduce pain and swelling.
Conservative treatment for finger pain
A wrist brace is helpful for restricting the movements of the thumb and wrist.
Anti-inflammatory drugs (nonsteroidal anti-inflammatory drugs, NSAIDs for short) can be taken against swelling and pain.
Movements that produce pain and increase inflammation should be avoided.
In this way, the symptoms can subside on their own.
Cortisone infiltrations into the tendon sheath support swelling and pain relief.
Surgical treatment of finger pain
Surgery may be considered if symptoms are particularly severe or do not improve despite treatment. During a surgical procedure, the tendon compartment is opened and space is created to avoid friction of the tendons. Rehabilitation and return to everyday activities takes place after about two weeks.
Prognosis
Recovery times depend on protection and treatment measures; without surgery, healing can occur after two to four weeks of treatment, in severe cases it can take three to four months.
Dupuytren’s disease
Dupuytren’s contracture (or Dupuytren’s disease) is a thickening and shrinkage of palmaraponeurosis (tendon plate of the hollow hand) under the skin of the palm and fingers.
Plamaraponeurosis is a connective tissue ligament that connects the tendon of the long hollow hand muscle in the wrist to the place of origin of the fingers.
The condition is painless, but the formation of excess fibrous tissue in the palm of the hand can lead to permanent curvature of the fingers.
Men are more likely to develop Dupuytren’s disease than women.
Causes
The causes of Dupuytren’s disease are unknown.
It is not triggered by injuries or overload, but there are factors that favor its occurrence.
As a rule, it is a hereditary disorder that occurs in adults or in advanced age.
Risk factors include various conditions, such as diabetes and epilepsy, as well as alcohol consumption.
Signs and symptoms of finger pain
As a rule, the symptoms of Dupuytren’s disease develop very slowly.
Knots: One or more soft and small knobs (knots) form in the palm of the hand. Over time, their softness is lost.
Fiber strands: The knots can thicken and contract, with hardened fiber strands forming under the skin.
Curved fingers: One or more fingers curve towards the palm of the hand and can no longer be stretched.
Ring fingers and little fingers are most often hit, but virtually all fingers can be affected. As the curvature progresses, it becomes increasingly difficult to stretch the finger. The everyday handles are becoming increasingly difficult, it is particularly problematic to grab large objects and put your hand in your pocket.
Treatment for finger pain
Possible therapeutic measures include: collagenase injection, needle asciotomy or surgery. The injection of collagenase is a form of treatment in which a drug is injected into the region of the thickened fiber strands to soften them; then the finger is manually manipulated and stretched.
Needle asciotomy is a procedure in which a needle is inserted through the skin and the contracted strands of tissue are severed. Collagenase injection and needle asciotomy can be performed on an outpatient basis.
In severe cases, the hand surgeon will incide the skin and remove the affected portions of palmaraponeurosis (resection).
The position of the finger cannot always be restored one hundred percent.
If the amount of skin is insufficient due to shrinkage, the surgeon may perform a skin transplant to fill in the open areas on the fingers.
After the procedure, the doctor may recommend immobilizing the hand for some in a bandage.
To restore muscle strength and mobility of the fingers, physiotherapy exercises must be performed at home or at the physiotherapist.
Ultrasound treatment may be useful to improve the elasticity of tissue structures and absorb postoperative bruising.
Office work can be resumed after about 10 days, those who engage in physically strenuous activities should wait at least a month.
If there are no complications, complete healing occurs between two and six months, depending on the severity and progression of Dupuytren’s contracture.
Thorn in the finger
During gardening and carpentry work or in other situations, a thorn or splinter can get into the finger.
The pain is continuous and very annoying, but the foreign body can be easily removed.
Mix a paste with water and bicarbonate, spread on the skin and protect with a plaster.
After a few hours, the splinter comes to the surface and can be removed with ease.
Joint complaints
Arthrosis
Osteoarthritis is a degenerative disease that causes inflammation of the fingers and wrists.
Cartilage is a smooth and supple tissue that covers the joint-forming bone ends.
In this type of arthritis, the cartilage is gradually rubbed off.
Joint injuries (sprain or fracture) can cause cartilage damage. Even if the injury does not directly damage the cartilage, the sliding movement and movement dynamics of the joint bones may be impaired.
The joints may lose their natural axis position when the injury has healed.
If the contact point of the bones within a joint is displaced and spatially restricted as a result of an injury, increased wear of the cartilage will occur, which is the first sign of osteoarthritis.
Heberden knots are bone outgrowths that form on the outside of the finger joints.
Bouchard knots are excess bone formations similar to the Heberden nodes, but they are located on the middle joints of the fingers.
Osteoarthritis affects both hands, but usually it is more pronounced on one side.
Diagnosis of osteoarthritis of the finger joints
Usually, to diagnose finger osteoarthritis, the medical history is examined to find out whether the patient has suffered injuries in the past that could have caused these ailments.
As part of the physical examination, the doctor will assess the range of motion of the affected finger joints and determine which movements cause pain.
The appearance of typical nodules (Bouchard or Heberden nodes) helps diagnose finger and hand arthrosis.
Usually, the doctor prescribes an X-ray examination to better assess the joint damage, especially to see if and how much cartilage tissue is still present or if the bones rub directly against each other during movement.Symptoms of arthrosis of the finger joints
- Ache
- Stiffness
- Swelling
- Development of Heberden and Bouchard knots
- limited mobility
- Weakness in handshakes
Typically, osteoarthritis pain occurs at the beginning of an activity, but then subsides with prolonged practice.
After completing the activity and at rest, pain and stiffness return.
In advanced osteoarthritis, the pain can also be felt at rest.
Therapy for osteoarthritis of the finger joints
As a rule, it is the pain that moves the patient to treatment. Early therapy can help to get osteoarthritis of the finger joints under control.
The first therapeutic measures include:
- nonsteroidal anti-inflammatory drugs or aspirin (Ben-u-ron);
- reduced activity;
- avoidance of activities and occupations involving repetitive finger movements;
- cortisone infiltrations into the inflamed joint;
- physiotherapy to improve range of motion and strengthening exercises;
- Occupational therapy;
- Immobilization;
- ointments against inflammation and swelling;
- Heat therapy.
A swollen finger can be caused by a hand injury, joint wear, circulatory problems or rheumatic diseases.
Below are some inflammatory diseases that cause swollen fingers.
Rheumatoid arthritis
Rheumatoid arthritis is a chronic inflammation of the joints that occurs when the immune system mistakenly attacks the inner shell of the joint capsule (synovial membrane).
As a result, joint lesions, pain, swelling, inflammation, loss of function and inability to move may occur.
The inflammatory rheumatism usually hits the wrists and finger joints, sometimes causing severe deformations; the use of the hands is then only possible with difficulty or not at all.
The symptoms are worst in the morning in the first hour after waking up.
Juvenile arthritis
The term “juvenile arthritis” is used when the arthritis occurs before the age of 16.
There are several types of juvenile arthritis that can cause pain and swelling of the wrists and fingers.
Gout
Gout is a form of arthritis that occurs when an excessive amount of uric acid is deposited in the joints. Uric acid is a waste product of the body that circulates in the blood.
Those who suffer from gout have needle-shaped deposits of uric acid crystals in various tissue structures of the body, including in the joints.
For many patients, the first symptom of gout is severe pain and swelling of the big toe, which can occur after trauma, illness, or injury.
The subsequent seizures may show up on the wrist and finger joints.
Over the years, uric acid nodules can form under the skin of the hand.
Reactive arthritis
Reactive arthritis is a chronic form of arthritis that often develops as a result of an infection of the sex, bladder or digestive system.
Typical for reactive arthritis are: inflammation and swelling of the joints, eyes and structures within the gastrointestinal area or the genital organ and urinary tract region, such as the intestine, kidneys or bladder.
A small percentage of gout patients develop a rash or hard lumps on the soles of the feet or palms.Psoriatic arthritis
Psoriatic arthritis is a form of arthritis that may be accompanied by psoriasis of the skin.
The skin disease most often precedes arthritis; the joint disease develops earlier than the skin lichen only in a few cases.
Psoriatic arthritis can cause the inflammation of the entire finger so that it takes on a sausage-like appearance. About 80% of people suffering from psoriatic arthritis notice changes in the nails, including roughness, thickening and/or detachment of the nail from the nail bed.
The skin lichen of psoriatic arthritis can also affect the hands.
Lupus
Lupus is a chronic autoimmune disease, which means that the immune system develops antibodies that attack healthy tissue structures, including the joints.
The wrist and small joints of the hand are most commonly affected.
Lupus can also cause inflammation of numerous organs, including the skin, heart, lungs and kidneys.
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