Where exactly does arthrosis develop?
Three zones in the hand are most often affected. The first is the joint at the base of the thumb, which experiences enormous stress in any grip; its arthrosis is called rhizarthrosis. The second is the distal interphalangeal joints, closest to the nail, where Heberden's nodes form. The third is the proximal interphalangeal joints with Bouchard's nodes. The nodules are bone growths, and not salt deposits, as is commonly believed. They form slowly, sometimes with periods of redness and pain, and then become painless, but the deformity remains.
- Rhizarthrosis - joint at the base of the big toe
- Heberden's nodes - terminal joints of the fingers
- Bouchard's nodes - middle joints of the fingers
- Arthrosis of the wrist joint after injury
- Erosive form with more pronounced inflammation
Causes and risk factors
Age and heredity play a major role: the nodular form is often found in mother and daughter. The risk is noticeably higher in women, especially after menopause, when hormonal levels change. Long-term manual labor with repeated gripping and vibration, the work of a seamstress, hairdresser, builder, musician, as well as fractures and dislocations of the fingers contribute to the development. Excess weight affects not only through load, but also through metabolic factors. Arthrosis stands out separately after inflammatory diseases of the joints, when the cartilage is already damaged.
- Age over 50
- Female gender and menopause
- Hereditary predisposition
- Manual labor with repetitive gripping
- Vibration load
- Suffered fractures and dislocations
- Excess body weight
- Consequences of arthritis
Symptoms
At first, pain appears only during exertion: after washing, working with tools, sewing. Then morning stiffness is added, which goes away in a few minutes. With rhizarthrosis, the base of the thumb hurts when grasping with a pinch, turning a key, opening lids, and gradually this zone protrudes, forming a characteristic tubercle. With the nodular form, the end joints thicken, the fingers deviate to the sides, and the hand looks deformed. From time to time, the joint may become red and swollen, which is scary and resembles arthritis, but goes away on its own.
- Pain in fingers after exercise
- Brief morning stiffness
- Dense nodules on the knuckles
- Pain at the base of the thumb when gripping
- Decreased hand strength
- Crunching sound when moving
- Curvature of fingers over time
Diagnostics
Usually, an examination and x-ray of the hands are sufficient: the image shows a narrowing of the joint space, bone growths, and compaction of the bone under the cartilage. It is important to distinguish arthrosis from rheumatoid arthritis, in which other joints are affected - metacarpophalangeal and wrist, stiffness lasts more than an hour, and inflammation levels in the blood are increased. Therefore, if in doubt, a general blood test, C-reactive protein, and rheumatoid factor are prescribed. Uric acid is tested if gout is suspected. Ultrasound helps evaluate inflammation and condition of the tendons.
- Examination and tests for rhizarthrosis
- X-ray of hands
- Complete blood count and C-reactive protein
- Rheumatoid factor
- Uric acid
- Ultrasound of the joint and tendons
Treatment
The basis of help for rhizarthrosis is an orthosis that fixes the thumb: it relieves the joint and significantly reduces pain, especially during work and at night. Useful household appliances with thick handles, can openers, and avoiding pinch grips in favor of gripping with the entire palm. Exercises maintain mobility and strength of the hand muscles. To relieve pain, local anti-inflammatory drugs and short courses of oral medications, thermal procedures and physiotherapy are used. In case of persistent pain, injections into the joint are possible, and in case of severe destruction, surgery on the thumb joint is possible.
- Thumb orthosis for rhizarthrosis
- Devices with thickened handles
- Exercises for hand mobility and strength
- Local anti-inflammatory drugs
- Short courses of oral painkillers
- Physiotherapy and thermal treatments
- Injections into the joint according to indications
- Surgical treatment for severe arthrosis