How to treat deforming arthrosis of the joints of the hands
You probably had to see, especially in elderly women, calloused hands with deformed knobby fingers and protruding tubercles on them. About these people say - the worn out hands. These signs may be in those who have arthrosis of the joints of the fingers.
Osteoarthritis of the joints of the hands most often in the old age
Arthrosis of the fingers and wrist joint
Arthrosis of the fingers is much less common than a similar pathology in the knee, shoulder or hip joints .
The causes of arthrosis of the hands
To meet such a disease can be found among those who worked hard all their lives, often overcooled hands, exposed their hands to the constant dynamic loads of :
- of workers who are constantly dealing with vibration tools: a perforator, a jackhammer, a drill
- of women who have a lotwashed manually in cold water
- of agricultural workers engaged in rough, non-mechanized work of
- athletes: tennis players, baseball players, volleyball players
Another reason is genetic predispositiondix:
deformations in the joint at the same place unmotivated. Inside, a pathological process simply turns on, impoverishing the structure of the cartilaginous tissue of the joint and leading to its gradual destruction.
Injury can also lead to arthrosis, especially damage to the wrist joint.
Estrogen deficiency in menopausal women leads to bone resorption, which contributes including arthrosis
Many people mistakenly call arthritis arthritis, although arthritis is a much more serious disease.
How to distinguish arthrosis and arthritis
Both pathologies begin with the small joints of the hands or feet, and then the larger ones are also affected.
- Arthritis is a systemic inflammatory joint disease that changes the blood formula that affects some internal organs.
- Arthrosis is joint deformity, although it is due to internal dystrophic changes, but does not affect the whole body except for motor function disorders.
- Arthritis pain does not havesuch a link to the movement, and mostly comes at night and even a few subsides as soon as the movement of the
- arthrosis pain symptom always increases with the onset of motion and calms down at rest
- Osteoarthritis is more common in the elderly, and arthritis in young
Mixed form - arthrosis-arthritis is often observed, when joint deformity is accompanied by its inflammation .
In any case, if the joints of the hands began suddenly to change for no reason - this can serve as an indicator that serious pathological processes have begun in the bone system.
Types of arthrosis of the hands
Arthrosis of the wrist joint, mostly of traumatic origin, is more often diagnosed.
From the figure below you can understand how difficult the device of the brush, and what a large number of joints is in it.
In the hand a very large number of joints
Arthrosis of the brush can be nodular:
- Geberden nodes - on the joints of the distal( extreme) phalanx of the fingers
- Bouchard nodules - on the joints of the proximal( middle) phalanx
Separately isolate rizartroz - lesions of metacarpophalangeal and metacarpalwrist joints of the thumb .
Stages of the disease and symptoms
Geberden and Buschar nodules - symptoms of arthrosis of the fingers
- In the first stage there are no bright external manifestations of the pathology, but there are already symptoms of periodic pains arising from the movement of the hands or during physical work
- There may also be a smallswelling in distal phalanxes
- The pain begins to acquire a permanent character, but it is rather aching, acute symptoms are usually not typical for the pathology of the hands.
- Skin surfaces near the joints turn red and swell
- . Small Heberden nodules, often symmetrical on both hands, and Bushard.
- The formation of nodes is irreversible: they remain even after the disappearance of redness and swelling
- Movement in the hands is limited and accompanied by a crunch
- Symptoms of muscular atrophy appear
- Swelling and redness can also become a permanent sign of
- Deformation in the joints and bony growths lead to the inability to bend fingersor the brush itself, that is, to the actual complete immobility of the
- The knottyness of the joints is complemented by the curvature of all the elements of the brush
- th becomes exhausted and externally thinner
Treatment of arthrosis of the hands of
Before treatment it is especially important to differentiate the disease, that is, weed out the worst option - arthritis.
To lead to this suspicion can arthrosis of the wrist joint, which appeared, it would seem, for no reason: the patient can not remember about the fall on the brush, nor about any kind of load on it.
Diagnosis of the pathology of the hands
The doctor is likely to send a rheumatic test - an immunological blood test that can reveal a C-reactive protein, a rheumatoid factor and a marker called antistreptolysin. The presence of these elements in the blood confirm rheumatoid arthritis.
Preliminary radiographic diagnosis before treatment
X-ray diagnosis of the brush can reveal arthrosis by:
- joint deformity
- narrowing or closing the interarticular cleft
- overgrowth of osteitis
The disease rarely requires analgesic treatment.
The main condition of treatment is the elimination of the cause that provoked the disease :
- Constant physical activity
- Threats of microtraumas
- Metabolic disorders in cartilage
- Malnutrition, etc.
Scheme of complex treatment of
Arthrosis of the radial joint requires mandatory protection of the wrist with a special orthopedic wristband during the period of possible loads of
. In the first stages, metabolism in the joint can be improved with chondroprotectors - artificial substitutes needed for connective tissues of chondroitin sulfate and glucosamine
. But reassessment of the possibilities of these drugs - prescriptionthem in the last stages or an incorrect short-term reception, lead to unreasonable disappointment painbut with expensive drugs
At the last stage, already with a deficiency of synovial fluid, intraarticular injections with hyaluronic acid
are effective. Physiotherapy treatment improves blood circulation and joint nutrition:
- Laser therapy
- Mud treatment
- Thermal procedures( ozocerite and paraffin applications)
- Penetrating compresses( dimexide or bischofite, medical bile)
- Manual therapy
You can apply self-massage :
"Twisting" and pulling the fingers with the other hand
- Rubbing the palms of the hands
- Rubbing each finger of the diseased hand healthy from the base to the tip
- Pressing on the fingers when the
- is folded into a fist or diluted palm "Twisting" or drawing fingers with the other hand,e.
LFK for the hands
Gymnastics are necessary, even if the joints of the hands are almost not bent .
Do such simple exercises.
Isometric ( with pain and limited movements):
- The position of the hands is palm on the table, the fingers are placed
- With your fingertips we force against the surface of the table and try to collect the palm into the fist, but the fingers remain immovable
- Relax the brush and throughfor a few seconds, repeat the exercise
- Standing or sitting position, the arms hang freely
- Shake with relaxed tassels
Dynamic exercises :
- Drum fingertips
- "Walk" fellTsami on
- table Putting alternately on both hands thumb with the other fingers
- Bend and straighten, so far as the mobility of the joint
For the prevention of osteoarthritis of the hands and in the early stages of its useful exercises with expanders .
Video: Exercise for the hands
Recipes for the treatment of arthrosis of the hands of folk remedies
Arthrosis of the hands is one of the most dangerous manifestations of this disease. In the process of development of arthrosis, there is a strong decrease in the nutrition of the joints in the phalanges of the fingers, which leads to deformational changes in the structure of the hands. In the course of the disease, the fingers literally bulge in different directions, which leads to the fact that a person can no longer fully use them.
Arthrosis of the hand is most often observed in women and, as a rule, leads to serious irreversible consequences. The symptomatology of the disease is well expressed and develops rapidly, unless measures are taken to treat joint tissues. The main symptoms of joint damage to the fingers of arthrosis include severe pain, complete loss of mobility of the fingers, curvature of phalanges, swelling of tissues, pressure in the area of damaged joints. Arthrosis of the hands is a dangerous disease that requires complex medical treatment, but at the same time there are excellent folk methods that can become additional means in the treatment of this disease.
Treatment with folk remedies for internal use
It is believed that the destruction of the joints of the fingers with arthrosis occurs mainly from the lack of vitamins and minerals, in particular calcium and trace elements, necessary for its full assimilation. In order to make it easier to get rid of arthrosis, you need to "hit" the disease from the inside. One of the most effective folk remedies for arthrosis is calcined cottage cheese with a tincture based on honey and horseradish.
For the preparation of calcined cottage cheese it is necessary to take approximately 1 liter of milk and 3 tablespoons.calcium chloride. It is best to take 10% of calcium, which is sold in pharmacies. First calcium, which, as a rule, goes in tablets, must be thoroughly crushed in a mortar to the state of powder. Next, you need to boil the milk and add calcium powder to it. Boil the resulting solution for at least 10 minutes to allow calcium to dissolve well. Then the milk is filtered and left to complete souring. The resulting kefir must be filtered using a rag bag to get the whey and cottage cheese, which will contain a large amount of calcium.
To make tincture of horseradish and honey, it is best to take lime or flower honey, which was only recently obtained in the apiary. First, take about 4 liters of water, in which it is necessary to fall asleep 1 kg of horseradish. To get a quality decoction of horseradish it is necessary to grind well. Boil horseradish should be about 20 minutes after boiling water. After removing from the heat, the broth should be cooled to room temperature. In a cooled broth should be added to the decoction of 0.5 kg of honey. It should be noted that honey should be added to a warm broth, as in boiling water it completely loses its properties. When treating the arthrosis of the brush, you need to use 100 g of tincture 3-4 times a day, eating 1-2 l of calcined cottage cheese. To change this combined agent it is necessary during 1 month.
In addition, a good effect gives laurel tincture. To prepare this tincture, about 10 g of bay leaves are taken. The bay leaf should be crushed and poured 1 tbsp.boiling water. Next, you need to continue boiling the broth for 5-7 minutes. Ready broth should be allowed to infuse for 4-5 hours. The cooled decoction of bay leaves should be taken throughout the day in small sips. Treatment with broth should be continued for 3 days. Osteoarthritis of the hands, the treatment of which is carried out using this tool, proceeds much easier.
Treatment with folk remedies for external use
Treatment and prevention of arthrosis of the hand by folk methods can also be carried out by using formulations for external application that help to stabilize the joint condition and at the same time relieve severe pain syndrome. Osteoarthritis can be effectively treated with multicomponent lapping. To prepare one of the most effective brushes for the treatment of arthrosis brush you will need floral honey, iodine, glycerin and alcohol. All of the above ingredients are taken in equal parts and thoroughly mixed. In order for the lapping to acquire all its useful properties, it is necessary to let it brew for about 5-6 hours. To achieve the desired effect, you need to use this lap 4-6 times a day. Rub the compound carefully in the skin over the affected joints for 20 minutes. Remains of the composition must be washed off with warm water.
Arthrosis of the hands can also be treated with fresh cabbage juice. Best for these purposes, a cabbage of a new crop, which contains a large amount of juice, will do. To obtain juice, cabbage leaves can be passed through the juicer. The treatment is carried out only with fresh juice, therefore it needs to be stored for no more than 3 days. To get the best effect, it is advisable to make fresh juice whenever you plan to make lotions. Treatment is carried out by applying a thin gauze, soaked in cabbage juice. Use lotions of cabbage juice should be at least 2 times a day. Cabbage juice reduces the inflammatory process and contains a large number of vitamins that promote the nutrition of soft tissues and joints.
A good result in the treatment of arthrosis brushes folk remedies gives a grinding on the basis of propolis and the juice of the leaves of the fern. To prepare the lapping, it is necessary to take fresh fern leaves and squeeze juice from it using a juicer. For the preparation of grinding will be enough 3-st.l.fresh fern juice. Propolis needs to melt on the steam bath. Do not take too much propolis, since this substance quickly freezes at a low temperature. Fern juice and propolis should be mixed and rubbed into the skin of the hands before bedtime to reduce the pain syndrome.
Treatment of arthrosis of small joints of the hands
In the early stages of the disease degeneration of the cartilaginous tissue occurs almost asymptomatically, pain and swelling, as well as deformation occur already in 2-4 stages. Therefore, the treatment of arthrosis of small joints of hands immediately starts with a complex therapy, which includes not only the use of medications, but also physiotherapy, manual methods of exertion, gymnastics and massage.
How to treat arthrosis of small joints of the hands with exercises and physiotherapy?
Gymnastics for the treatment of this problem is extremely simple, and it is easy to perform at home yourself:
- Alternately, "drum" fingers on a smooth surface.
- Tear beads on the beads.
- Mash your fingers with soft foam rubber toys, bags filled with flour.
- Treat small grains, for example, buckwheat.
- Compress your hand into a fist and unclench it, spreading your fingers wide apart.
The following physiotherapy techniques also help:
- isometric kinesiotherapy;
- shock-wave action;
- laser therapy.
Restoring the nutrition of the joints and their mobility allows massage. It consists in first warming up the surface of the treated skin, strengthening local blood circulation, and then carefully stretching the joint. Such procedures can be performed independently, only you need to make sure that the massage does not cause pain attacks.
Treatment of arthrosis of small joints of hands with homeopathy
The described section of medicine offers such drugs for reducing the severity of the inflammatory process, pain syndrome, restoring the balance of the production of synovial fluid and cartilaginous tissue:
- Polygonum aviculare;
- Actea spicata;
- Rhus toxicodendron;
- Viola odorata.
Before purchasing one or more of the listed products, it is important to consult a professional homeopath so that the doctor will assess not only the degree of joint damage, but also the condition of the whole organism.
Medications in the treatment of arthrosis of small joints of the hands
When the pathological process is localized in, the same treatment scheme is applied as in other types of arthrosis:
- Painkillers - Diclofenac, Ibuprofen, Ketanov, Ketorolac.
- The use of chondroprotectors - Artra, Chondroxide, Hondrolon, Don.
- Execution of intraarticular steroid injections - Prednisolone, Hydrocortisone, Kenalog.
Conservative treatment works better and faster if combined with physiotherapy and manual intervention.
Arthrosis of the hands: stages, symptoms, effective treatmentRating: 5,00 ( 4 ) Loading. ..
Symptoms of carpal arthrosis depend on its stage. The onset of the disease is inconspicuous, and development is slow-progressing, because the unhealthy can for years not focus on discomfort in the hands and not even think about examination and treatment. And at this time, arthrosis can gain strength and sooner or later, it will give about for itself to know - often in an already neglected form.
Arthrosis of the hands: the first stage of
In the initial stage, arthrosis of the hand shows itself a crunch in the fingers when flexing and unbending. Pain in the joints, at first not strong, appears at times - with magnetic storms, after active work, etc. The pain is aching, blunt and bursting, acute pain attacks for this type of pathology are atypical.
Already at this stage, you can see a small swelling of the interphalangeal articulations of the fingers, which also arises from time to time.
Arthrosis of the hands: the second stage
The pain in this period becomes unchanged, its intensity increases. Most of all, she cares at night. There is a feeling of burning and pulsation in the joints of the fingers. Immediately there, where there was a swelling earlier, seals are formed - Geberden's nodules( outgrowths from bone tissue).In most cases, these nodules appear symmetrically on both hands.
At the second stage of arthrosis, you can see a small deformation of the fingers. Also unhealthy begins to disturb the limitation of mobility in the hands.
Arthrosis of the hands: the third stage
At the last stage of the disease, the cartilaginous surface of interphalangeal joints is virtually completely destroyed. Bony growths( Geberden's nodules) grow and join together, causing curvature of the fingers and marked restriction of mobility. Often ankylosis develops( fusion of the bony surfaces of the joints, leading to their complete immobility).
Pronounced aching pain in the fingers becomes an unchanged symptom. And in those joints where the cartilage is completely destroyed and developed ankylosis, there may not be pain, and there are no movements at all.
The best ways to treat arthrosis of the hands
What does the official medicine offer? Treatment of carpal arthrosis depends on its phase. At the first-second degrees, while the cartilage is not yet destroyed, the doctors intensively prescribe chondroprotectors to the clients - preparations that improve nutrition and restorative processes in the cartilaginous tissue.
These drugs are drunk in long courses. Immediately with chondroprotectors take non-steroidal anti-inflammatory drugs( ibuprofen, diclofenac and others).
If complications develop, when inflammation( arthritis or synovitis) can join the long-term degenerative process, corticosteroid hormones( hydrocortisone, cortisol, etc.) are administered.
Drug treatment is performed until the pain disappears and a significant reduction in other symptoms occurs.
Therapy for arthrosis of interphalangeal joints contains a manual effect: percussion massage( tapping on the affected area with fingertips), kneading, stretching of the fingers.
Excellent eliminates pain and simplifies the movement of physiotherapy: magnetotherapy, ozocerite and paraffin applications, laser therapy, as well as physical exercises( squeezing and unclenching fingers).
The existing traditional means of treatment of arthrosis of the hands of
Non-standard treatment will be much more effective if used at the early stages of the disease. The earlier you saw the symptoms, the faster you should be examined and, if necessary, begin therapy. Here are a few common recipes, which, according to reviews, have helped many unhealthy people.
Hot compress from oatmeal
At night cook a thick porridge from half a glass of flakes of oatmeal( without salt, sugar and other additives).After it has cooled a little, put into it 1 full tablespoon of honey and mix. Spread the porridge on unhealthy joints, wrap with a bandage and put on fabric mittens. After 7-8 hours rinse and smear hands with cream.
Reducing pain and other nasty symptoms with this treatment take about a week.
Mix in equal proportions honey, glycerin, honey alcohol and iodine. Give the composition to brew for a day, and use to rub the unhealthy joints. You can use up to 2 times a day, not often. Rastirka has a strong anti-inflammatory and warming effect, perfectly eliminates pain.
Diet for arthrosis of the hands
In joint diseases cartilage tissue is very important to provide good nutrition. This can be done by including in the diet reddish salmon, nuts and vegetable oils as sources of polyunsaturated fatty acids. B vitamins B and folic acid are useful for joints, these substances are abundant in germinated grains, coarse bread, beans, fermented milk products, cabbage, bananas, lentils. And alcohol and high-calorie dishes should be completely abandoned.
Take care of your hands and look after their health - then no arthrosis will take you by surprise.
Arthrosis of the joints of the hands symptoms |Hand massage for arthrosis
Symptoms of arthrosis of the joints of the hands
Geberden nodules with arthrosis
Arthrosis of the distal interphalangeal joints of the fingers of the hand( Geberden's nodules) is one of the most frequent localizations of primary arthrosis, usually affects women, especially in menopausal and postmenopausal periods. Geberden's nodules are considered the earliest manifestation of the primary genetically determined polyarthrosis of the hands, which is also associated with the overload of the distal interphalangeal joints by small and hard work.
In this case, the symptoms of arthrosis of the joints of the hands just in later terms will show themselves a little pain, usually with a change in the weather, there will be a slight soreness on palpation and noticeable elevations appear on both sides of the back surface of the distal interphalangeal joints. On the roentgenogram, there are narrowed joint arches, uneven joint surfaces, subchondral sclerosis and lateral osteophytes.
Bouchard nodules with arthrosis of the hand area
Osteoarthritis of proximal interphalangeal joints of fingers. Bushard's nodules are much less common than Heberden's nodules, but their clinical and radiological picture is almost the same. As a rule, Bushar's nodules appear in people who have Geberden nodules with arthrosis. This helps distinguish them from rheumatoid arthritis, in which proximal interphalangeal and metacarpophalangeal joints are often affected separately or together. In addition, the deformation of the joint at the nodules of Bouchard is caused not by thickening of soft tissues( as in arthritis), but by solid bone growths with arthrosis.
Risartrose of the hands
Arthrosis of the joints of the wrists - the wrist joint of the 1st finger( rizartroz of the thumb) occurs about the same frequency as the Heberden nodules. In this case, both lesions can be simultaneously. The cause of rizartroz of hands is microtraumatism. The clinical and radiologic picture is the same as in the case of arthrosis of the two preceding localizations.
Diagnosis of joint arthrosis
Diagnosis of any form of arthrosis is based on radiographic, clinical and laboratory data.
Diagnostic criteria for osteoarthritis of the American College of Rheumatology:
Pain or morning stiffness in the small joints of the hand + the presence of three or four of the following signs:
- The proliferation of hard tissues of more than one of the following ten joints: a) the second and third distal interphalangeal joints of both brushes;b) the second and third proximal interphalangeal joints of both hands;c) the first carpometacarpal joints of both hands.
- Overgrowth of hard tissues of more than one of ten distal interphalangeal joints.
- The presence of edema in no more than two metacarpophalangeal joints.
- Deformation of at least one of the ten joints listed above.
Arthrosis of the area of the hands:
1 - polyarthritis;2 - bushard's nodule;3 - Heberden's nodule;4 - rizatroz.
Anamnesis and a comprehensive examination of the patient help determine the form of arthrosis, the cause of its development, prescription and severity of the disease, concomitant diseases, etc.
When articulating the diagnosis of arthrosis, one can also focus on the diagnosis criteria( basic and additional) according to the data of other authors.
Differentiate arthrosis of the joints of the hands with frequent recurrences of synovitis with rheumatoid arthritis.
Diagnostic criteria of arthrosis of brushes( according to LI Benevolenskaya et al., 1993)
1. Joint pains arising at the end of the day and / or in the first half of the night
1. Narrowing of the joint gap
2. Painin the joints arising after mechanical stress and decreasing at rest
3. Bone growth due to bony growths( including Heberden and Bushard nodules)
Note: criteria 1-2 are basic;Criteria 3 - additional. For the diagnosis of arthrosis, the presence of the first two clinical and radiological criteria is mandatory.
Differential diagnostic signs of rheumatoid arthritis and arthrosis of hands( according to NN Borovikova, 1999)
None or unstable( synovitis reactive)
Appears in 80-85% of patients after 6-12 months.from the onset of
None at first, later - osteoporosis, bone erosion
Already at an early stage, articular narrowing, subchondral sclerosis, osteophytes
Hand massage for arthrosis
The massage of the region of the joint of the hand is carried out in the starting position of the patient sitting, while the forearm is on the table, the hand is bent. With a superficial and deep stroking, the masseur fixes his fingers with one hand, holding the forearm, puts the other hand across the rear of the hand and moves to the elbow.
In the wrist joint area of the hand, a grasping stroking is performed. Trimming the transverse and circular in the form of stroking spend I fingers of both hands on the palmar and back sides. When rubbing the palmar surface, you should maximally bend the brush for better penetration to the joint bag. Massage of the joint of the hand is completed by stroking, as well as physical exercises: flexion, extension, retraction, reduction and circular motions.
Hand massage - basic techniques
The basic techniques of hand massage in the brush area: stroking, rubbing, passive and active exercises. First, the back, then the palm surface of the hand is massaged. Stroking the rear of the hand produces the palm of the last four fingers. Massage movements correspond to the course of lymphatic vessels. Stroking is carried out in a circular motion. After the general stroking of the rear, the hands are massaged with the large or large and index fingers of the interosseous muscles, each separately.
Rubbing in massage is used rectilinearly, spirally and circularly;dashes in the longitudinal and transverse direction. When the fingers I and II are kneaded, the soft tissues are pulled from the bone and pressed aside to the metacarpophalangeal joint. On the palmar surface of the brush, which, when massaged, is translated to the supination position, ironing is performed in the form of ironing. After the general stroking and rubbing, they specifically affect the muscles of the elevation of the I and V fingers. Massaging movements are made in the direction of the tendon sheaths. Apply stroking, rubbing, kneading with weights, pushing the tissue from the bones. When rubbing the palmar surface, you should maximally bend the brush for better penetration to the joint bag.
Massage of the fingers of the fingers - basic movements
Massage movements on the fingers of the hand correspond to the course of the lymph vessels and are carried out simultaneously on the palmar and back surfaces, on the side surfaces - towards the base of the fingers. Massage consists in stroking, which is performed in the longitudinal direction by the thumb and forefinger first with the back( thumb), palm( index) and then with the side surfaces( thumb and forefinger).When grinding, which is done longitudinally, use spiraling movements;rubbing can be carried out and transversely. In this case, the hatching technique is applied.
When kneading I and II with your fingers, soft tissues are pulled from the bone. When massage between interphalangeal and metacarpophalangeal joints, stretching is applied: articular surfaces are drawn apart from each other;the purpose of taking is the effect on the capsule and ligaments of the joint. This technique is indicated for joint stiffness, cicatricial fusion. Indications for different types of massage are presented in the table.
For violations of tissue trophism, synovitis and acute pain syndrome, segmental massage is preferred: they affect the paravertebral regions of the corresponding spinal segments( joints of the fingers and the hand - C5-Th2).
Indications for various types of massage of the hands ( Geroyeva IB, 2000)
Local acute pain in joint with synovitis
with electrostatic field of the system "Khivamat"
Joint region: frequency 150-200 Hz, time 10 min. Proximal muscle groups: frequency 20-30 Hz, time 5 min
Local acute pain in joint without synovitis
Classic manual massage with therapeutic ointments( gel T, chondraxite, voltarenovaya, etc.)
Proximal muscle groups and joint area
Limb and correspondingspinal column with a pressure of 0.5-1 atm.
Whirlpool massage. It is possible to add sea salt, ozone, etc. to the water.
Local vortex massage
General effect: water temperature 38-40 ° C, time 20 min.
Fine finger joints, time 10 min
Combination with chronic lymphovenous insufficiency
Limb with pressure up to 60 mmHg.
Time - 30 min
Massage of the hand area with the electrostatic field of the "Khivamat"
system In addition to the segmental massage with the synovitis, bursitis, tendovaginitis clinic, the electrostatic field massage of the "Khivamat" system is successfully applied. A unique operating factor of the procedure is the sagittal reciprocating displacement of the entire thickness of the tissues to be exposed( deep tissue oscillation).
This occurs during current pulses only on the movements of the hands of the masseur with worn vinyl conductive gloves: the surface is attracted at the point of contact of the hand in the glove and descends after being withdrawn. Subjectively, the patient experiences vibration. This is the main difference of this method from other types of massage, when there is pressure on the tissues of the hands of a massage therapist or a vibrator nozzle. The effect is carried out both on the joint region and on the regional muscles.
Classic massage with soft technique of hands
In the absence of inflammatory changes and in the presence of violations of muscle tone, a classical massage with soft technique is used to improve blood circulation in the limb of the hand. The joint of the hands at this stage is not massaged. With a relaxing massage, the peculiarity of the technique is the use of stroking, kneading at a slow pace, surface grinding, continuous labile vibration with moving along a massaged muscle, and easy shaking. In cases of painful or myogenic contracture, the contracted muscles are subjected to a predominant effect, which, after the above described procedures, undergo manual stretching, which contributes to the correction of contracture.
Underwater massage of the hands
To reduce pain and relax the muscles, as well as improve the circulation conditions underwater massage. At this stage of treatment, a general vortex massage or jet massage with a water jet pressure of 0.5 atm is preferred.and a distance of 5-8 cm from the tip to the massaged surface. The procedure time is 10 minutes at a water temperature of 36.5-37.5 ° C.When performing an underwater jet massage, strokes and vibrations are used. Duration of the procedure is 5-7 minutes.
The duration of the massage with arthrosis of the joints of the hands is determined by the persistence of pathological changes and amounts to 12-15 procedures. Contraindications, generally accepted for massage. The presented basic program can be modified depending on the clinical condition of the patient. In addition, individual physical rehabilitation( LFK, massage, manual therapy, rational motor, etc.) are recommended as preventive measures.
Study of metacarpophalangeal joints in arthritis and arthrosis
The metacarpophalangeal joint is subjected to palpation to ensure that there is a thickening or stretching of the synovium, soreness, a rise in temperature in three places: in the region of the joint gap, over the head of the metacarpal bone and in the interval between the adjacent heads of metacarpal bones. Articular fissures are palpable better when the proximal phalanx is bent at 20-30 ° in the metacarpophalangeal joint;they are located at a distance of about 1 cm distal to the tip of the joint.
Study of the metacarpophalangeal joint
The examination of metacarpophalangeal joints allows one to determine that the phalangeal joint gap is located some distance from the head of the metacarpal bone with a bent proximal phalange, shown by an arrow in the figure.
When palpating the joint, the patient's hand should be relaxed and in the position of pronation with the palm turned down;Each doctor probes each joint separately, compressing it with the fingers located on the back side, and II - with the palmar;The doctor maintains the head of the patient's metacarpal bone with the remaining fingers. With a different method of palpation, the doctor palpates the joint on the back of I and II with the fingers of one hand, and the other - supports the patient's brush.
For these and other methods of examining the joint, called the metacarpal phalanx, it is necessary to palpate the joint slit, the metacarpal head and the longitudinal groove between adjacent joints to ensure there is a synovial thickening or enlargement with a bent and unbent joint. Subluxation of the proximal phalanx in relation to the metacarpal can occur in the direction of the palm;In this case, the bone boundaries of the phalanx become more prominent than usual.
The soreness of all metacarpophalangeal joints can be determined by lateral compression by the hand of a physician of all metacarche bones. The sensation of pain reflects the inflammation of one or more metacarpophalangeal joints.
Transverse compression of metacarpal bones.
The study of metacarpophalangeal joints allows one to determine their stability. The stability of metacarpophalangeal joints is assessed with a strong lateral displacement of the fully bent joints( lateral ligaments of the metacarpophalangeal joints tend to flex only when flexed, they relax and allow considerable lateral displacement when they are unbent).
Study of joint movement volume
When carrying out a study of the volume of movements, the following provisions should be adhered to:
- finger mobility is defined as a single unit, and then the mobility of each joint is considered separately;
- evaluation of the function of the fingers - squeeze your fingers into a fist and unclench;actively bend and unbend fingers. Normally clenched fist, obtained with full bending of all fingers, is estimated as 100%, and the expanded hand - as 0%;
- determining the volume of movements of individual joints, the doctor must determine whether all the finger joints of the hand take normal participation in the general movement;
- the volume of movements in the metacarpophalangeal joints consists of flexion-extension or reduction-retraction of proximal phalanges relative to the heads of metacarpal bones. The combination of these movements allows you to make circular motions. Lateral ligaments relaxed at extension and stretched when bent;therefore, when the metacarpophalangeal joint is bent, the fingers can strongly bend into a fist, without deviating to the side.
To measure the degree of flexion of any finger, the doctor holds the proximal phalanx when the patient moves with a distal phalanx or phalanx. The metacarpal phalangeal joints of the fingers are bent at 90-100 °, counting from the normal mean position during extension( 0 °).However, the metacarpophalangeal joint of the first finger is bent only by 50 °.In the metacarpophalangeal joint, hyperextension is possible by almost 30 °.
Metacarpophalangeal joint - treatment with
The patient's wrist is covered by the doctor's same hand( right-hand), the patient's hand is in the supination position;with the other hand, the doctor holds the first metacarpal bone so that its distal end is fixed with the finger of the doctor's hand from above and at the proximal end by the radial edge of the II finger from below. Then we achieve pre-stress( distraction thrust by jogging in the direction of the palm), after which a push in the same direction follows. The second stage of therapy consists in the fact that the doctor grasps the penetrated wrist of the patient with the opposite arm( right - left), with the other hand fixes the first metacarpal bone I on the top( dorsally) at the distal end and the radial edge of the finger in a similar manner from below( from the palm side)movement achieves pre-stress and then during traction - a push in the dorsal direction.
Treatment of carpometacarpal joint of 1 finger: a - with supine bristle I metacarpal palmarno( upward);b - in the position of pronation of the hand, pressure is applied to the first metacarpal dorsal( from above) with simultaneous traction( Levit K. et al., 1993).
Warning! The traction will increase significantly if you grab V with your finger the last phalanx of the patient's finger. The method of mobilization of metacarpal bones can be represented as follows:
1. Mobilization with dorsal and palmar "fan" techniques is performed with simultaneous action on all metacarpal bones.
2. Mobilization of each metacarpal bone can be performed in the back-palm( dorsovolar) direction.
3. Mobilization of each metacarpal bone is possible due to traction movement in the distal direction.
Joints of the wrist and phalanx and the head of the metacarpal bones
The head of the metacarpal bones is fixed between the I and II fingers of one hand and grips I phalanges I and II with the fingers of the other arm. Due to the fact that the displacement can be directed in the rear palmar and laterolateral directions, it is necessary that the fingers of both hands of the doctor are located transversely to the direction of the thrust. It is also expedient to manipulate the jaws with both fingers, bending them with it.
Manipulation on the metacarpophalangeal joint in the rear-palmar direction( a);scheme of motion( b).
These joints are capable of rear-palm displacement, distraction, slight lateral displacement and "break-in".To do this, the proximal phalanx is fixed by the doctor between the first and second fingers of his hand, which rests on the surface of the table. The doctor takes the distal phalanx between the first and second fingers of the other hand, after which the mobilization is carried out in one of these directions.
Warning! Both the rear-palmar and lateralateral displacement are carried out simultaneously with the distraction.
Mobilization of the interphalangeal joint in the back and palmar directions( a);scheme of movements( b).
After manipulation or mobilization, appropriate tests( for example, "joint play") should be conducted to ensure that these therapies are effective. In order to maintain the achieved effect, the patient is recommended to continue treatment aimed at improving mobility in the joints, restoring the full functional ability of the brush.
Arthrosis of the hands
Arthrosis of the hands is a widespread disease in our time. It is caused by a variety of causes, the main ones being trauma, infectious processes, endocrine disorders and, of course, age-related changes. The latter, coupled with prolonged occupational exertion, are caused by the fact that arthrosis of the joints of the hands of , in most cases, occurs in patients older than 40 years. Although now we are treating for arthrosis and young people. They have a disease more often associated with joint trauma and a genetic predisposition.
General signs of arthrosis of the joints of the hands
It is noted that the arthrosis of the hands of the is more often affected by men, which is explained by the greater physical exertion that they perform. In the process of progression, three degrees( stages) of the disease are distinguished. The first stage is characterized by slight aching pain in the joint, which occur with excessive load, but they themselves pass in a state of rest.
With the transition to the second stage, there is an increase in pain and an increase in their duration, the appearance of a rough crunch, the restriction of certain movements. Due to the periodically occurring inflammatory process, the joint may increase in volume. It is especially noticeable on the wrist joint and interphalangeal joints of the hand.
The third degree of arthrosis involves aggravation of deformities of the joints of the hands. Here we have both pronounced pain syndrome and limited movement. The patient often gives the hand a forced position in order not to feel pain again. At this stage, there is a high probability of trophic disorders in bone tissue - osteoporosis, as well as the appearance of bone growth along the edge of the joint surfaces. By this time the cartilaginous interlayer of the joint is almost completely destroyed. In addition to the above, with arthrosis of the hands significantly reduces the muscle tone of the upper limb due to lack of sufficient motor activity.
Features of arthrosis of the shoulder joint
In the initial stage of the disease, patients note the soreness of the shoulder, the rest of the movements are carried out in full and without discomfort. This meager symptomatology often makes it impossible to diagnose clinically, pathological changes can be detected only on radiographic examination.
The deforming arthrosis of the shoulder joint is progressing slowly, only the first stage can last several years. Most often, until the third stage does not reach and the disease does not lead to disability.
Features of arthrosis of the elbow joint
Arthrosis of the elbow joint is less common than arthrosis of the joints of the hands of other localization. Develops in athletes, musicians( violinists), people who work with pneumatic tools. The peculiarity of the course of this variant of the disease is expressed in a combination of a minimal clinical picture against the background of pronounced anatomical changes revealed during the examination. Patients can not complain about anything, but in fact the cartilage of their elbow joint is already undergoing destruction processes. Of all the movements, extensibility suffers most.
|"Arthrosis of the joints of the hands prevents a person from doing daily business, doing household chores, reducing work capacity." As a rule, my patients with this diagnosis are people whose work is associated with heavy physical exertion, sportsmen and elderly people who are progressing degenerative processes inincluding joints, arthrosis can develop in any joint, but changes in small joints( wrist, fingers) are less common than the pathology of large joints, and deformations are more noticeable in them.p, the damage to the brush changes the configuration of the fingers and their length. "|
Features of arthrosis of wrist joint
This pathology is observed in patients of our clinic quite often. Often arthrosis of the wrist joint develops as posttraumatic( after a dislocation or fracture of the bones of the wrist) in athletes, workers in construction specialties. The peculiarity of this arthrosis is that the pain in the joint is manifested only at the extreme positions of the brush, when the patient tries to bend and unbend the brush to the maximum, up to the stop. Mobility in radiocarpal arthrosis is always reduced. This localization is one of the "favorite" for the development of rheumatoid arthritis, so it is important to conduct differential diagnosis.
Features of arthrosis of the joints of the hand
Of the joints of the brush, interphalangeal joints are most susceptible to arthrosis. Bright representatives of this category of patients are people who, according to their duty, print a lot. The main load lies on the second, third and fourth fingers, that's why they are involved in the process before the others. These small joints become denser, increase and become like nodules. Hence their name - the nodules of Geberden and Bouchard.
Treatment of arthrosis of the hands
Do not rely on self-healing and traditional medicine, treatment of arthrosis of the hands should appoint a doctor. The goal of therapy is to remove pain, suppress the inflammatory process and, if possible, to stop degenerative changes in articular cartilage. Basically, the procedures for the treatment of arthrosis of the hands of are divided into not medicamentous, medicinal and surgical.
- Non-drug therapy. This group includes therapeutic gymnastics and physiotherapy procedures. LFK is appointed during remission. The most simple and comfortable gymnastics is performed for treatment of arthrosis of the hands of .Also useful is swimming. With arthrosis of the joints of the hands, thermal procedures( paraffin and ozoceretherapy), ultrasound, laser therapy are carried out. Massage should be done 2 times a year.
- Drug therapy. This includes symptomatic drugs that act immediately( analgesics, non-steroidal anti-inflammatory drugs, glucocorticosteroids) and structural-modifying( chondroprotective).The first subgroup is designed to reduce pain and suppress inflammation. The second subgroup has a different function: these drugs contribute to better cartilage nutrition and stop the destruction of cells.
- Surgical treatment. It is used when other methods do not bring the desired effect. Operative treatment includes arthroscopy, osteotomy and endoprosthetics.
Arthrosis of the hands is not a simple pathology for treatment, which requires the doctor competent use of medicines and medical procedures, and from the patient - clear implementation of the recommendations. The specialists of the medical center GarantKlinik possess sufficient knowledge and have the necessary experience for conducting such patients and achieving qualitative results in this therapy. It must be understood that it is impossible to completely get rid of this disease, but to minimize its manifestations and delay the appearance of severe symptoms for a long time, but it should be done by experienced specialists. Therefore, our clinic employs professors who have a rich experience in treating patients with this pathology.
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