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Our fingers are central to everything that we do.  Stiff fingers can make simple, everyday tasks almost impossible.  What is the cause of stiff fingers?  What are the first signs of arthritis in the fingers?  How do you relieve stiff fingers?  Let’s dig in.

What Is the Cause of Stiff Fingers?

There are multiple causes of stiff fingers which include:

  • Excessive daily wear and tear
  • Medications can cause hand and finger swelling and stiffness.  Common examples include hormones, calcium channel blockers for high blood pressure, steroids, anti-depressants, and NSAIDs.
  • Diets high in salt
  • Alcohol
  • Trauma with injury to bones, tendons, and muscles
  • Neck injury with irritation or compression of spinal nerves that provide important signals to fingers can lead to stiff fingers.
  • Medical conditions such as gout and diabetes (1).
  • Carpal Tunnel Syndrome:  Compression of the median nerve in the wrist can result in stiff fingers, weakness, and numbness.
  • Trigger Finger: A painful condition in which the tendon sheath becomes inflamed with stiff fingers and catching sensation.  Typically involves the ring finger or thumb however any finger can be involved (2).
  • Osteoarthritis: a joint disease that involves the breakdown of the joint cartilage that occurs gradually over time.   Fingers and thumb joints are the most commonly involved (3).

What Are the First Signs of Arthritis in Fingers?

Osteoarthritis is the most common joint disorder in the United States (4).   Risk factors include obesity, age, family history, repetitive use, female gender, and joint laxity.  Pain and stiff fingers are the most common symptoms. Pain can vary and often increases over time.  Reduced grip strength may occur (5).

How Do You Relieve Stiff Fingers?

Physical therapy is the initial treatment of choice for stiff finger and finger injuries.  The goal is to improve stability and range of motion with a reduction in pain.   In a large trial study, Weeks reported that 87% of stiff joints favorably responded to exercise and dynamic splinting (6).  Splinting is often helpful with stiff fingers as it provides needed support.  Other options include:

Pain Medications

Medications can help with pain associated with finger arthritis.   Topical NSAIDs and capsaicin are frequently used.  Oral medications include Tylenol, fish oil, curcumin, and NSAIDs.  NSAIDs have significant risks and side effects which include infertility in males, GI bleeding, increase risk of heart attack and aggravation of your arthritis.

Injections

When conservative care has failed, steroid injections are often recommended.  A high-level review of multiple studies demonstrated that steroid injections are no more effective than placebo (7).  Steroids are toxic to cartilage and should be avoided (8)

Surgery

If pain and dysfunction persist despite treatment, surgery is often recommended.  There are different surgical treatment options which include tendon transfers, tendon interposition, joint replacement, and fusion.  Risks include bleeding, infection, failure, poor wound healing, necrosis, pain and reduced range of motion.

Nonsurgical Alternatives?

A novel technique that uses a precise injection of platelets and or bone marrow concentrate is now available.  PRP is rich in growth factors that can increase blood flow and reduce inflammation.  Bone marrow concentrate contains many different cells that can repair local damage and inflammation in addition to signaling other remote cells to come and assist in the repair.  To learn more about precise PRP and bone marrow concentrate injections please click on the video below which reviews treatment of thumb arthritis.

 

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PRP and bone marrow ultrasound-guided injections into the fingers is a technically challenging procedure that your Primary Care Physician (PCP) or orthopedic surgeon can not perform.  To watch an advanced hand procedure at Centeno-Schultz Clinic please click on the video below.

 

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In Conclusion

Stiff fingers can arise from multiple causes.  Osteoarthritis in the fingers and hands is common and involves pain and finger stiffness.  Physical therapy is the first-line treatment.  Medications and steroid injections are often recommended if pain and finger stiffness persists.  Steroids are not effective and toxic to cartilage. Surgical options are multiple and include tendon transfers, joint replacement or fusion.  Complications include infection, poor wound healing, bone death and limited range of motion.  Precise injections of PRP and bone marrow concentrate are new options in the treatment of advanced finger arthritis that has not responded to conservative care.

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1. Rosenbloom AL. Limitation of finger joint mobility in diabetes mellitus. J Diabet Complications. 1989;3(2):77-87. DOI: 10.1016/0891-6632(89)90016-0.

2.Makkouk AH, Oetgen ME, Swigart CR, Dodds SD. Trigger finger: etiology, evaluation, and treatment. Curr Rev Musculoskelet Med. 2008;1(2):92-6. doi: 10.1007/s12178-007-9012-1.

3. Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1988;10:1-28.DOI: 10.1093/oxfordjournals.epirev.a036019

4. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69. doi: 10.1016/j.cger.2010.03.001

5. Kirchberger MC, Schnabl SM, Bruckner T, et al. Functionality of middle-aged women after resection-interposition arthroplasty of the trapeziometacarpal joint in comparison to a healthy control group. Arch Orthop Trauma Surg. 2014;134(5):735-9. DOI: 10.1007/s00402-014-1966-z.

6.Weeks PM, Wray RC, Kuxhaus M. The results of non-operative management of stiff joints in the hand. Plast Reconstr Surg. 1978;61(1):58-63.DOI: 10.1097/00006534-197801000-00010

7.Kroon FP, Rubio R, Schoones JW, Kloppenburg M. Intra-Articular Therapies in the Treatment of Hand Osteoarthritis: A Systematic Literature Review. Drugs Aging. 2016;33(2):119-33. doi: 10.1007/s40266-015-0330-5

8. Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthop J Sports Med. 2015;3(5):2325967115581163. doi: 10.1177/2325967115581163.