Osteoarthritis was defined by the WHO as a joint degenerative process that is the consequence of mechanical and biological disorders that destabilize the balance between the synthesis and degradation of articular cartilage, producing reactive changes in the adjacent periarticular bone structures and chronic inflammation of the joints. synovial membranes.
Osteoarthritis affects all structures of the joint, without systemic effects, and is clinically characterized by the presence of pain and limitation of joint function, crepitus (clicking) and possible effusion.
Symptomatic hand osteoarthritis or hand stiffness is estimated to affect 5% of the general adult population. About 50% of adults over 65 have radiological signs of osteoarthritis, predominantly affecting the female sex, with a 2: 1 ratio or even higher.
Types of arthrosis in the hands.
The stiffness in the hands (osteoarthritis) characteristically affects the fingers, and depending on the affected area it will be the type of osteoarthritis.
· Most common osteoarthritis: when the distal interphalangeal joints or tips of the fingers are affected.
· Nodal osteoarthritis: affection of the proximal interphalangeal joints (initial part of the fingers), giving rise to the appearance of painful nodules, Heberden's in the first case and Bouchard's in the second, more frequently affecting the index, little and medium.
· Rhizarthrosis: affects the trapeziometacarpal joint (palm of the hand). It is usually bilateral, but more severe in one of the 2 hands and may or may not be associated with osteoarthritis of the interphalangeal joints.
· Erosive osteoarthritis: affects the distal interphalangeal joints, less frequently the proximal ones and rarely the metacarpophalangeal joints, usually bilateral and symmetric, it presents with inflammatory episodes and joint deformity. It is usually the cause of significant functional limitation.
Cartilage, synovial membrane and subchondral bone are implicated in the cause of hand stiffness. They present 3 fundamental manifestations: synovitis caused by joint mechanical overload (high frequency and intensity mechanical loads), progressive destruction and cracking of the cartilage and alterations in the subchondral bone such as mineralization defects, bone tissue growth. Different risk factors have been described that may be involved in the onset and progression of osteoarthritis:
· Sex: it is more prevalent in the female sex, with a relative risk of 2: 6.
· Hormonal factors: The estrogen deficit in women is related to its development.
· Muscular weakness.
· Bone mineral density.
· Previous joint anomalies such as: trauma and fractures, malformations or dysplasia, alignment defects, joint instability and laxity, meniscopathies and neuropathic arthropathies.
· Joint overload (physical and work activity): various work activities are related to osteoarthritis.
Symptoms of stiff hands
The symptoms of stiffness hands are characterized by:
Pain: main symptom, it begins with joint function and diminishes with rest. Pain is variable depending on the person's pain threshold.
Joint stiffness: localized, morning and disappears after mobilization in a few minutes (no more than 30 min).
Joint deformity: they are more evident in the hands, feet and knees. It is the reason for consultation in case of absence of pain.
Crackles: they are frequent and easy, produced by the friction of deteriorated cartilage.
Limitation of mobility: if they evolve, they condition a significant disability.
Subcutaneous cysts: predominantly in distal interphalanges.
There is drug treatment and alternative treatment for stiff hands. In this case, reference will be made to alternative therapies:
· Change in lifestyle: although it is not a therapy, it is important to make certain changes or follow certain behaviors such as quitting smoking, since it has been shown that this habit is correlated with greater pain, functional limitation and progression.
· Hydrotherapy: It can be useful when the area to be treated is not accessible to other forms of systemic or superficial heat.
· Orthopedic aids: There are splints to keep the painful joint at rest, such as at the base of the thumb (wrist brace).
· Thermotherapy: Heat and cold applied in different ways (diathermy, ultrasound, infrared, paraffin baths, heating pads, etc.) can be useful to relieve pain caused by osteoarthritis.
· Electrotherapy: Transcutaneous nerve electrostimulation or TENS, is a type of portable electrostimulators that can be used at home and that allow patients to control acute pain situations very effectively.
· Acupuncture, meditation, yoga, reflexology or Reiki: they have shown an adjuvant effect in the pain of osteoarthritis, but applied together with some other alternative.
· Phytotherapy or the use of medicinal herbs: both ingested and applied to the joint with osteoarthritis that hurts, is based on the possible analgesic potential of certain natural plants such as willow or ginger.
· Magnetotherapy: treatment using magnetic fields. When magnetic fields are produced by electric current it is called magnetotherapy itself and if they are obtained by magnets, natural or artificial, it is called magnetotherapy. It has a series of actions such as: muscle relaxation that helps to improve joint mobility, analgesic effect, cartilage regeneration
· Compression gloves.
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