Swelling of wrist and hand
Article of Dr. Evdokimenko © for the book "Pain and numbness in the hands", published in 2004. Edited in 2011. All rights reserved.
Symptoms of arthrosis of the wrist joint
Arthrosis of the radiostiastic joint is not very common. In general, it is post-traumatic, that is, it develops as a complication after a dislocation or fracture of the wrist bones (it should be clarified that arthrosis usually does not occur immediately, but several weeks or months after the injury).
For arthrosis, the wrist joint is characterized by such symptoms as crunching in the joint with motion and pain that ariseOnly with certain movements or at extreme positions of flexion-extension of the joint - i.e. when trying to bend-unbend the joint to the maximum, "to the stop." At rest, without pain, pain occurs only if a person has reloaded a sick joint several hours earlier.
Mobility of the wrist joint with arthrosis is always reduced by 30-50%. But the appearance of the wrist joint affected by arthrosis remains practically unchanged - from the side it looks almost healthy or the joint is deformed very little. Strong deformations of the wrist joint with arthrosis occur only when the disease was provoked by a fracture of the bones of the wrist with their displacement.
Attention! It must be remembered that the wrist joint is one of the "favorite places" of inflammation in rheumatoid arthritis. And it's important not to be confused arthrosis of the wrist with this serious illness. Fortunately, distinguishing arthrosis from arthritis is usually quite simple. In arthritis, unlike arthrosis, pain is more often manifested in rest, at night or in the morning.
When moving pain, on the contrary, often decrease(although the extreme attempts of flexion-extension of the joint with arthritis, as well as with arthrosis, are also almost always painful). After noon, especially towards evening, arthritic pains almost always completely subside - until late at night.
Appearance of wrist joints affectedrheumatoid arthritis, as a rule, significantly changes: either pronounced edema and "swelling" of the wrist joint, or a "dip zone" in the region of this joint with the atrophy of its muscles is observed.
It is also characteristic that in cases of arthritisonly wrist joints are extremely rare - any arthritis often leads to inflammation of several joints; and on the contrary, arthrosis of the wrist joint is an isolated post-traumatic pathology affecting usually one single damaged wrist joint. Another distinctive feature: the general condition of the arthrosis of the wrist joint usually does not change, and with arthritis, there may be fever, weakness, chills, aches in the body, etc.
Mechanism of development of arthrosis of the wrist joint
As already mentioned above, arthrosis of the wristThe joint is most often posttraumatic and develops usually after fractures and dislocations of the bones of the wrist. But, in addition, there are also "professional" arthrosis of the wrist joint, associated with his professional overload or micro-trauma. Such overloads and micro-traumas often occur in athletes and workers in construction specialties, actively loading hands.
Another arthrosis of the wrist joint is oftendevelops in people who by virtue of their profession are forced to work a lot with a jackhammer, a drill with a perforator, etc. After all, in such cases, one more damaging factor, vibration, is added to the overloads and microtrauma.
As a result of the above-mentioned unfavorableAs the doctors say, the joint starts to "degrade": small bones of the wrist joint are deformed, and the articular cartilage loses some of its moisture, becomes dry and less smooth, rough. In addition to this, it becomes thinner and loses its ability to absorb the load on the joint bones. And to top it off, the joint can reduce the amount of healthy joint fluid that performs a "lubricating" function when moving the joints.
All this leads to the appearance of those unpleasant symptoms, mentioned above: to a decrease in the mobility of the wrist joint, the appearance in it of a crunch and painful sensations during movement.
Diagnosis of arthrosis of the wrist joint
First, it is necessary to conduct X-raya study of the wrist, to determine the degree of arthrosis changes in the patient's wrist joint. And also in order not to miss a possible inflammatory process (ie arthritis).
And, secondly, again, with the goal of "not to miss"arthritis, it is necessary to conduct blood tests: clinical (from the finger) and analysis for rheumatic tests (from the vein). Characteristically, with arthrosis, blood tests from the finger and from the vein remain within normal limits, and with arthritis, almost always there are some deviations (an increase in such indicators as ESR, C-reactive protein, seromucoid, uric acid, globulin levels, etc.) ).
Treatment of arthrosis of the wrist joint
Correct treatment of arthrosis of the wrist joint almost always gives a good result. But this happens only if we can eliminate the damaging effect that led to the disease - if we prevent further overload of the joint, we will exclude the possibility of repeated microtraumas, immobilize the wrist joint with a fixing bandage or special orthopedic wristband etc. In such a situation, the treatment of arthrosis of the wrist joint will almost certainly succeed.
If our patient continues to overload his handor continues to work on traumatic work without taking care of the joint with any orthopedic devices (for example, wristbands), the effect of treatment will be reduced to zero or be minimal and short-term.
Now let's talk about those medical procedures that bring with arthrosis of the wrist joint the maximum benefit.
First, as with any type of arthrosis, weyou need to take care of saturation of the damaged cartilage of the joint with special nutrients - chondroprotectors. The course of treatment of arthrosis with chondroprotectors is described in detail here >>>
Secondly, we must try to restore"Articular game." those. return the mobility of articulations in the wrist joint. For this, manual therapy (mobilization method) is well suited. Usually 3-4 sessions of manual therapy are sufficient to maximize the mobility of the patient's wrist joint.
The third task before us in the treatmentarthrosis of the wrist joint, - improvement of blood circulation in it and acceleration in the joint of metabolism. To solve this problem, we have a wide range of treatment options. So, we can successfully use:
- compresses with bischofite or medical bile;
- healing mud;
- paraffin therapy;
- massage or self-massage with ointments based on anti-inflammatory substances (voltaren gel, fastum, dolgite cream, etc.);
- laser therapy;
And, finally, in the treatment of the most severe casesarthrosis, we can use the method of saturation of the patient's joint with special "lubricating" substances - derivatives of hyaluronic acid (preparations ostenil, fermatron, go-on, hyastat, etc.). With 3-5 injections of hyaluronic acid in the aching joint, performed after manual reposition of the joint (and sometimes without it), it is possible to dramatically improve the condition in 70-80% of patients (see details in Chapter 26 for hyalonic acid preparations).
And if to carry out treatment in a complex way, for allfour positions (the use of chondroprotectors, manual therapy, improvement of blood circulation in the joint and intra-articular injections of hyaluronic acid preparations), the result of therapy will be even higher.