Pain in the fingers of A.Griguolo

Generality

Pain in the fingers is a widespread symptom, which may depend on both traumatic causes and non-traumatic causes.

Traumatic causes of pain in the fingers include: fractures of the phalanges, bruising of the fingers, skin wounds to the fingers, stings and insect bites to the damage of the fingers, and nail diseases; among the non-traumatic causes of pain in the fingers, on the other hand, stand out in particular: arthritis in the hands, rheumatoid arthritis, diabetes, tendon cysts with a seat on the fingers, multiple sclerosis, Dupuytren's disease, carpal tunnel syndrome and Raynaud's phenomenon.

Brief anatomical revision of the fingers

The fingers of the hands represent the terminal ends of the upper limbs .

In number of 5 for each hand, the fingers are anatomical elements that include: bones, joints, muscles, tendons, blood vessels, nerves and connective tissue.

Bones: they are the so-called phalanges;
Joints: are the metacarpophalangeal joints (between the first phalanx and the previous metacarpus) and the interphalangeal joints (between two contiguous phalanges).
They are essential for finger movements;
Muscles and tendons: together with the joints, they play a pivotal role in the movements of the fingers;
Connective tissue: it is basically the skin that covers the fingers;
Nerves: they are used for sensory and motor control of the fingers.
Blood vessels: they are used to transport blood to bones, joints, muscles, tendons and skin tissues of the hands.

What are Hand-Finger Pains?

The pains in the fingers are the sufferings with variable connotations, which, as can be easily understood from the clear reference to the site of the painful sensations in question, affect the final extremities of the upper limbs.

In most cases, pains in the fingers are mild and not particularly debilitating disorders, which appear in response to transient situations; less commonly, they are a serious and debilitating symptom that arises due to clinically relevant conditions.

Features

Depending on the cause, the pains in the fingers can be:

Throbbing, that is intense and pounding;
Similar to cramps;
An alternation between strong painful pangs and moments of apparent healing;
Equal to needle sticks or small electric shocks.

In addition to influencing the characteristics of pain in the fingers, causal factors also play a crucial role in another context: the location and number of suffering fingers. It is, in fact, strictly dependent on the factors triggering the involvement of a specific finger, a group of fingers or all fingers.

How common is suffering from pain in the fingers?

Pain in the fingers is a widespread symptom; it is indeed very rare to meet individuals who have never felt, at least once in their life, any painful suffering in their fingers.

Causes

Usually, pains in the fingers are the answer to trauma to the fingers or hands ; more rarely, they are the result of non-traumatic medical conditions affecting the nerves, muscles, joints and / or bones of the fingers or, more generally, of the human body.

Pain in the fingers: traumatic origin

Among the main traumatic causes of pain in the fingers, stand out:

The fractures of the phalanges .
They are usually the result of sports or work injuries.
Sports in which it is easy to develop pain in the fingers, due to a fracture of one or more phalanges, are rugby, volleyball, basketball and American football; as far as the work at risk is concerned, however, we highlight all those heavy work activities, in which the use of hands is fundamental (eg: construction workers, porters, warehouse workers, etc.).
Cutaneous wounds on one or more fingers .
They are generally the result of cuts due to the improper use of a knife, scissors or some tool for so-called "do-it-yourself jobs".
Bruises to one or more fingers .
To this voice belong all those injuries to the fingers of the hands resulting from a violent event, which however is not such as to cause a bone fracture or interrupt the continuity of the skin tissues (ie procure a wound).
Example of violent events involving contusion to one or more fingers are: crushing of one or more fingers in a drawer or door, violent impact of one or more fingers against an object and sports or work injuries minor grade to the hands.

Burns on one or more fingers .
Accidents whose severity of consequences varies depending on the degree and extent of the burn.
Burns on the fingers are very common in the home.
Nail diseases .
Some examples of nail diseases related to pain in the fingers are: onycholysis, onycho-cryptosis, onycho-dystrophy, onychophagia, paronychia, onychomycosis and ononic acid.
Bites and insect bites .
These traumatic events are responsible for inflammatory processes, sometimes combined with infectious processes, which, as usual, trigger a more or less intense pain sensation.

Pain in the fingers: non-traumatic origin

The non-traumatic conditions associated with pain in the fingers include:

Osteoarthritis or arthrosis . It is the inflammation of the joints, which draws from the progressive degeneration of the articular cartilage.
Arthrosis causes pain in the fingers when it affects the metacarpophalangeal joints and interphalangeal joints (see arthrosis in the hands).
Rheumatoid arthritis . It is the inflammation of the joint capsule of the mobile joints, due to a malfunction of the immune system (rheumatoid arthritis is an autoimmune disease).
Like osteoarthritis in the hands, rheumatoid arthritis is responsible for pain in the fingers when it affects the metacarpophalangeal and interphalangeal joints.

Some muscular dystrophies . Muscular dystrophies are genetic diseases, whose presence causes a weakening of the muscles, followed by a progressive disability.
The muscular dystrophies potentially responsible for pain in the fingers are: Duchenne muscular dystrophy, Becker muscular dystrophy and distal Welander myopathy.
Multiple sclerosis . It is a chronic and debilitating disease that occurs due to the progressive degradation of myelin belonging to the neurons of the central nervous system.
In a context of multiple sclerosis, therefore, pain in the fingers is the result of a nervous problem.
Carpal tunnel syndrome . It is the set of symptoms and signs that arises following compression of the median nerve at the wrist, exactly where the so-called transverse carpal ligament (carpal tunnel) is located.
At the level of the fingers, carpal tunnel syndrome causes pain in the thumb, forefinger, middle finger and part of the ring finger.
The formation of cutaneous warts on the fingers. The cutaneous warts are benign growths of the skin, with yellow-greyish and semi-spherical or oval shades, which typically form on the back of the hands, around the nails and on the soles of the feet.
Tendon cysts or synovial cysts located on the fingers. Extremely variable in size, tendon cysts are swellings filled with liquids, whose typical place of formation is close to the tendons (to be precise, on the tendon sheaths) or mobile joints (to be precise, on the joint capsules).
Tendon cysts located on the fingers cause pain in the fingers when they arise near a nerve end and cause it to be crushed.
De Quervain syndrome or stenosing tenosynovitis by De Quervain . It is a painful condition following irritation of the synovial sheath, which wraps the tendons of the abductor muscles along and extensor short of the thumb.
In De Quervain syndrome, the pain affects only the basal portion of the thumb.
Tumors located on the fingers. The association between tumors and pains in the fingers is very rare, because the formation of neoplasms starting from one of the bony or nerve structures constituting the extremities of the upper limbs is very rare.

Raynaud's phenomenon . It is the particular vascular phenomenon, whereby, due to an excessive spasm of the peripheral blood vessels, there is a reduction in the blood supply to: the fingers and toes, the tip of the nose, the ear lobes and the tongue.
The pains in the fingers caused by the Raynaud phenomenon can have a significant intensity, so much so that they are very annoying for those who are its victims.
Dupuytren's contracture or Dupuytren's disease . It is a disease of the hand, which causes the permanent flexion (or curvature) of one or more fingers towards the so-called palm of the hand.
Dupuytren's disease can affect one or both hands and can affect any finger, including thumb.
Diabetes mellitus . It is a widespread metabolic disease characterized by high levels of glucose in the blood ( hyperglycemia ).
In the presence of diabetes mellitus, pains in the fingers distinguish the more advanced pathological phases, when hyperglycemia has led to the deterioration of peripheral nerves ( diabetic neuropathy ).

Symptoms and Complications

Several other symptoms as well as some signs may accompany pain in the fingers.

Based on the same aching fingers, these symptoms and signs vary depending on the triggering condition; this means, for example, that pains in the fingers due to osteoarthritis are accompanied by symptoms other than those that can be observed when there are pains in the fingers due to a burn.

Entering more into the details of the subject, among the symptoms and signs that most commonly combine with the presence of pain in the fingers, there are:

Numbness and tingling.
Associated with pains in the fingers in: diabetes mellitus, Dupuytren's disease, Raynaud's phenomenon, carpal tunnel syndrome and multiple sclerosis.
Difficulty in gripping objects, writing, typing etc.
Associated with pains in the fingers in: Dupuytren's disease, arthrosis in the hands, rheumatoid arthritis, De Quervain syndrome and muscular dystrophies.
Sense of joint stiffness.
Associated with pains in the fingers in: osteoarthritis of the hands and rheumatoid arthritis.
Swelling.
Associated with pain in the fingers in: fractures, bruises and stings or insect bites.
Presence of a hematoma.
Associated with pains in the fingers in: fractures and bruises.
Bleeding.
Associated with pains in the fingers in: skin lesions and burns.
Presence of vesicles.
Associated with pain in the fingers in: burns.
Signs of infection.
Associated with pains in the fingers in: skin wounds and burns.
Pain during finger movements.
Associated with pains in the fingers in: arthrosis in the hands, tendon cysts, rheumatoid arthritis and De Quervain syndrome.
Muscle atrophy.
Associated with pains in the fingers in: muscular dystrophies, arthrosis in the hands and rheumatoid arthritis.
Presence of soft or hard-to-touch nodules.
Associated with pains in the fingers in: tendon cysts and tumors.
Presence of Heberden nodules.
Associated with pains in the fingers in: osteoarthritis of the hands and rheumatoid arthritis.

When should I go to the doctor?

Pain in the fingers is a symptom that should worry and induce the person concerned to consult a doctor when:

I have been working for several days;
Their intensity, rather than improving, continues to deteriorate;
They appeared for apparently inexplicable reasons;
They are associated with symptoms of a certain clinical relevance (eg: difficulty in gripping objects, severe loss of blood, presence of diabetes, etc.);
Despite the therapy, they continue to persist without hinting at a decrease in intensity.

Generally, bruises on the fingers, cuts in the fingers, first-degree burns of the fingers and other similar circumstances of the same clinical relevance produce pains in the transient fingers, which do not require consultation. medical or specific therapy.

Complications

Any complications that may affect an individual with pain in their fingers may depend on:

A serious cause (eg, tumors, third-degree burns, fourth-degree burns, etc.);
Failure to treat a triggering condition, the resolution of which requires specific therapy.

Diagnosis

When pains in the fingers of the hands cause concern and / or their origin is apparently unknown, a series of diagnostic investigations must be carried out, to go back to the triggering cause, understand the seriousness of the problem in progress and, finally, plan the most appropriate therapy .

The diagnosis of the causes of pain in the fingers always starts from a complete anamnesis, an in-depth objective examination and the patient's account of the symptoms; therefore, based on the information that emerges from these first 3 assessments, it can continue with:

Blood tests ;
Radiological examinations referring to the hand and suffering fingers (X-rays, nuclear magnetic resonance and / or CT scans);
Electromyography ;
A neurological examination .

Why is it important to find out the causes?

Knowing what causes pain in the fingers is very important, because it allows you to plan the therapy through which it is possible to obtain healing (or, at least, an improvement in the symptoms).

Therapy

In the presence of pain in the fingers, the treatment adopted varies according to the cause.

In practical terms, this means that pains in the fingers due to fractures of the phalanges require treatment different from pain in the fingers due to diabetes mellitus.

Examples of treatment against pain in the fingers

If the pains in the fingers are due to the fractures of the phalanges, the treatment includes: application of a plaster or a rigid splint on or on the affected fingers, rest of the affected hand, analgesics to mitigate pain and physiotherapy once the callus has occurred .
If pains in the fingers depend on diabetic neuropathy, the patient will benefit from all those treatments indicated in case of diabetes mellitus (proper diet, exercise, reduction in body weight, etc.).
If the pains in the fingers come from bruises, the therapy is very simple and consists in the application of ice, in order to alleviate the painful sensation.

If the pains in the fingers are related to an onychomycosis, the treatment involves the administration of an antifungal for topical use or systemic use and particular attention to nail hygiene.
If the pains in the fingers depend on arthritis in the hands, the treatment can vary from conservative to surgical, depending on the severity of the degeneration of the articular cartilage. Conservative treatments include the application of ice, the use of NSAIDs, physiotherapy and injections of corticosteroids; instead, surgical treatments include arthrodesis, arthroplasty and osteotomy.

Prognosis

As a rule, the pains in the fingers of the hands deriving from causes of modest clinical relevance (eg: bruising of the fingers) heal in a short time, without aftermath; on the contrary, pains in the fingers of the hands, the result of a serious health problem or a condition that is difficult to treat (eg: rheumatoid arthritis or arthrosis in the hands) have a more uncertain course, which involves long therapies and / or unpleasant consequences.

In essence, therefore, the prognosis in the presence of pain in the fingers is strictly dependent on the triggering factor.