Finger joint pain is a common pain. It is mostly seen in middle-aged and elderly people, both men and women, more women than men. In severe cases, the finger joints are deformed (swollen). What causes it? Many doctors say it is “rheumatism” or “rheumatoid”, but in fact, the cause of finger joint pain is that the person in pain has injured his or her knuckles. Why do you say so? Please see the explanation later. Zhou Meng Han, Department of Orthopedics, The Fifth Affiliated Hospital of Xinjiang Medical University, wants to know the cause of finger pain, first of all, we need to know the structure of the fingers. In a finger, except for the thumb, there are three bones for support. Between the three bones are two joints. One is near the palm of the hand (the proximal joint of the finger) and the other is near the end of the finger (the distal joint of the finger). The joint bones are surrounded by a joint capsule. There are two tendons on the palmar side of each finger that are capable of flexion. Each finger has one tendon on the dorsal side (some have two tendons) and is capable of straightening. The tendons on the palmar side of the fingers are called superficial flexor tendons and deep flexor tendons, depending on their proximity to the skin and bone, respectively. The superficial flexor tendon is located at the middle phalanx and is responsible for flexing the middle phalanx. The deep flexor tendon is located at the distal (end) phalanx and is responsible for flexing the distal phalanx. The superficial and deep flexor tendons grow differently at the phalanges, which determines the location of the finger pain. The superficial flexor tendon divides into two forks (Y-shaped) near the middle phalanx and grows on each side of the proximal middle phalanx, merging with the wall of the joint capsule (which is the basis of finger joint pain). The deep finger flexor tendon attaches to the proximal end of the palmar side of the distal phalanx. Thus, we can know that the distal phalanx bending force originates from the palmar side. The bending forces of the middle phalanx come from the sides of the middle phalanx. This is the structural basis for why finger joint pain is on either side or one side of the finger joint. Knowing the structure of the finger, it is possible to understand why the finger joints are painful. Pain on both sides of the finger near the joint When the finger is bent, the most force is applied to the shallow flexor tendons attached to both sides of the proximal phalanx. Therefore, any flexion of the finger to grasp, grip or lift may result in injury to the tendons on both sides or on one side of the proximal end of the middle finger. The injured tissue is edematous and can spread to the lax joint capsule wall, resulting in persistent and significant swelling or pain to touch. The swelling also limits joint flexion, and pain appears or is significantly worse during finger flexion. For example, the pain may be caused by scrubbing, wiping with a rag, lifting heavy objects, or being hit by a basketball. Pain on the dorsal side of the finger joints (proximal and distal joints) The extensor tendon of the finger is not as strong as the flexor tendon, so if there is an adhesion of the flexor tendon, the extensor tendon will become more burdened when extending the finger and an overuse injury will occur. Dorsal swelling of the finger joint with flexor pain (swelling of the joint restricting movement) and pain to touch. For example, forceful holding of pliers, scrubbing, lifting heavy objects, being hit by basketball and other objects. Why do the fingers hurt more in cold temperatures? The fingers are the end of the body and the blood vessels are very thin. At room temperature, the fingers move freely. In low temperature, the blood vessels are constricted, the fingers are relatively ischemic, at this time, the activity will appear ischemic pain, numbness (nerve ischemia). If you have to exert force at this time, it will increase the burden of the finger damage. This is the reason why the fingers are prone to pain in low temperature. If the finger joints are already damaged, if they are exposed to low temperature (cold water work), repair will stop, ischemia will occur, and pain will occur. This is the reason why it is usually more painful when the finger is in pain when exposed to cool water. Once we know the cause of finger joint pain, we know how to treat it. Rest and warmth are the only effective treatments for finger joint pain. By keeping your fingers rested and out of the cold for a period of time, finger joint pain can disappear. In this time is about two to three weeks. There are two types of finger joint deformities. One is associated with pain. The basis of this deformity is swelling. It is possible to recover by keeping warm and resting, but it takes longer, usually more than a year. The other type is no pain, only swelling and deformation. This is a repeated injury to the joint capsule that forms a thickened scar. Because there is no pain to limit finger movement, re-injury needs to be prevented. Over several years, the scar softens and thins and can be nearly restored to its original state. Treatment of pain on the dorsal aspect of the finger joint is self-healing by keeping the finger in a relaxed, pain-free position for two to three months. Because the injury is caused by adhesions of the flexor tendon sheath, relaxing the finger without forceful flexion is the key to treatment. Wrong treatment methods include sealing, plastering, heat application, baking with a baking lamp, hot water soaking, etc. Closure can only relieve the pain for a while, not cure the injury. If you continue to move after the closure, it will be more serious injury. Paste, hot compress, baking lamp baking, hot water soaking and other practices can aggravate the injury congestion, aggravate the injury. Why do you say so? The blood supply to the finger relies on arteries, and dilated arteries can increase the blood supply. The return of blood to the finger depends on veins and lymphatics, and the return of venous blood and lymphatics depends on the movement of the finger. Injured fingers have reduced activity due to pain, poor return, and increased blood supply due to heating, and the water in the blood has no way to go but to seep into the perivascular tissue, aggravating edema.