Contrary to popular belief, the pain of osteoarthritis of the fingers eventually disappear over time. The point about this painful disease, osteoarthritis of the fingers ...
Frequent source of pain and deformity of the fingers, osteoarthritis is diagnosed usually without radio or blood test. Treatment is based largely on painkillers such as paracetamol.
Women 50 years particularly affected
Osteoarthritis of the fingers is common. It can affect the joints of the phalanges of the fingers (interphalangeal joints), or the joints between the fingers and hand (metacarpophalangeal joints). Women over 50 are most often affected. In this population, more than one in five women shows signs of hand osteoarthritis in radiography.
Paradoxical pain
But this figure is misleading because the women who have signs of osteoarthritis on radiographs of hands, only a three to one in five will suffer one day. The pain is progressive, and most often affects the joints between the second and third phalanges of the fingers. Osteoarthritis also causes deformities of the fingers.Quite often, we see two round projections push hard, sometimes painful to pressure, separated by a small valley at the back of the finger joints.
Later, fingers are often deformed in flexion (fingers can not be opened completely) and tend to leave the side of the little finger: the former spoke of the strain "on the run" of the fingers. Curiously, the most deformed joints are often quite painless. Indeed, the initial pain disappear with time (usually within a few years).
he diagnosis is usually easy
Rare exceptions, the diagnosis of osteoarthritis of the fingers is purely clinical: the physician need only ask a few questions and then watch and feel your joints. Blood tests and radio stations are usually totally useless, both for initial diagnosis and for monitoring. An exception (infrequent): in cases where surgery is being considered to treat the deformation of an inch, radiographs are useful in determining when to intervene.
Monitoring is primarily to assess the pain and difficulty of use of the hand (eg using the questionnaire and hand osteoarthritis "Dreiser, we present another article). Such monitoring is often reassuring for osteoarthritis of the fingers is usually far to cause the same difficulties as rheumatism such as inflammatory / rheumatoid 257/polyarthrite
Treat pain
There is no effective prevention of osteoarthritis, no treatment that alters the evolution. And so there is no useful drug in osteoarthritis of the fingers with deformation but without pain.
If pain due to osteoarthritis, the first drugs to try are the painkillers with the least side effects. Paracetamol is the drug of first line (at a dose of 3 grams per day), with anti-inflammatory local, gel or cream (provided you choose those whose efficacy is proven and who have the least 'potential side effects).Ibuprofen (800 to 1200 mg daily) is an alternative to paracetamol. These treatments are usually sufficient. In the rare cases where pain persists, it is logical to use anti-pain level 2, that is to say, distant derivatives of morphine. For example, a combination of paracetamol and codeine.
The anti-inflammatory drugs (or NSAIDs) are indicated only in rare cases of significant episodes of pain, resistant to other treatments. For two reasons: firstly, osteoarthritis is an inflammatory disease, and other treatments are generally effective enough. And secondly, the value of these drugs is limited by their common side effects and even more dangerous than the consumer is a woman, he advances in age, and take many medications.
Very unusually, severe pain from the base of the thumb can be treated by injection of a cortisone derivative action late in the joint (several weeks of effectiveness). Finally, there are two drugs called antiarthrosiques-acting.Chondroitin sulfate (Chondrosulf °) has no indication in osteoarthritis of the fingers. As for the diacerein or diacerein (Art 50 ° Zondar °), it is an anti-inflammatory effect of low power. Its effectiveness is highly controversial. At best, it would be a (weak) analgesic effectiveness after 30 to 45 days of treatment. But its cons-indications and undesirable effects (including gastric and intestinal) are not uncommon. It actually causes diarrhea in nearly 30% of patients treated. His place is extremely marginal. At the point it is not marketed in most developed countries other than France.
Limit the deformation of the thumb
In osteoarthritis of the thumb base, it is important to allow the joint to reduce pain. In some cases, pain and especially the progressive deformation of the joint may be limited by wearing a "brace". This is a resin casting of the wrist and thumb, and you can put on and remove yourself. This brace is often worn at night. It is in cases of severe osteoarthritis deformans of the base of the thumb suggests that sometimes surgery, which may be intended either to limit deformation and maintain mobility, or conversely of the bone between solder them (thus reducing the mobility) to fight against the pain and keep the strength of grip (for example, manual workers very uncomfortable in the business).
A more or less favorable over time
In general, pain due to osteoarthritis improve spontaneously after a few years and eventually disappear. Rest of disability due to deformation, and sometimes decreased muscle strength, after the forced inactivity due to pain. And the psychological difficulty of accepting the deformation of the fingers, often deemed unsightly (whereas in past centuries, this deformation of the fingers was sometimes viewed positively as a sign of long life and wisdom).
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