Swollen and Painful Finger Joints: Causes and Treatments

Swollen and painful finger joints that cannot bend?

Hello Doctor: Three days ago, I felt stiffness (a clicking sensation) in the joints of my left index finger (the distal and middle joints), which was different from the normal movement of my other finger joints.
I used to occasionally stretch and manipulate each finger joint, but I haven't done that for at least three months.
I thought it was just stiffness or a lack of exercise, possibly due to poor bone quality, so I tried to stretch it more, but there was no improvement.
Two days ago, upon waking up, I noticed slight swelling in the left index finger (the segment between the middle joint and the distal joint), along with a bit of increased pain (the pain is coming from the middle joint).
I thought I would wait and see for two days (today) during my day off to visit a doctor (I made an appointment with a traditional Chinese medicine practitioner).
However, yesterday, upon waking up, I noticed that the left index finger (the segment between the middle joint and the distal joint) was more red and swollen (about 0.3 cm larger than the right index finger), and the pain had increased; it hurts even without touching it, and I can hardly bend it (bending it causes more pain).
The skin looks normal on the outside.
This morning, I hurried to a nearby clinic for a consultation.
The nurse referred me to family medicine/orthopedics/rehabilitation (combined).
The doctor examined me and noted significant swelling, drew blood (the results will be available in three days), and prescribed medication (the medication details indicated functions such as: anti-inflammatory, pain relief, treatment for skin rashes, muscle relaxation, and relief for gastrointestinal discomfort).
I am currently taking the medication as prescribed and waiting for the report.
My usual work involves using a computer and filming with a single-lens camera.
The only possible cause I can think of for the pain in my left index finger joint is that I usually carry my lunch in a plastic bag, using both hands to carry items.
Sometimes when I rush for the bus, I walk quickly and, fearing that the juices from the lunch might spill, I wrap the plastic bag handle around my wrist and index finger (I will not do this again in the future).
Coincidentally, I also carried lunch two days before I felt the stiffness in my joint.
So I suspect I might have injured the finger joint.
Recently, there have been no incidents of bending or hitting the finger joint.
I would like to ask: 1.
Is the blood test to check for "rheumatoid arthritis" or something else? (The clinic doctor did not explain, I referred to Google for information.) 2.
For symptoms like this, is it common to first take anti-inflammatory medication, have blood drawn, and then "wait three days" for the report? 3.
For symptoms like this, is it typical to confirm that the blood results are normal before considering an X-ray to check for bone abnormalities? 4.
For these symptoms, would you recommend ice or heat therapy? Thank you for your assistance!

Da J, 20~29 year old female. Ask Date: 2020/04/11

Dr. Shi Guozheng reply Orthopedics

1.
If rheumatoid arthritis is suspected, it is appropriate to check for rheumatoid factor (RF) in the blood.

2.
This approach is correct.

3.
If necessary, X-rays can be taken.

4.
If there is redness, swelling, heat, and pain, ice packs can be applied, but heat should not be used.

Reply Date: 2020/04/11

More Info

Understanding swollen and painful finger joints can be quite complex, as there are numerous potential causes and treatment options. Based on your description, it seems that you are experiencing swelling and pain in your left index finger joint, particularly in the middle joint area. This condition can arise from various factors, including overuse, injury, or underlying medical conditions such as arthritis.

Possible Causes
1. Overuse or Strain: Given your description of using your fingers frequently for activities like carrying heavy items (like lunch bags) and working on a computer, it is possible that you have strained the tendons or ligaments in your finger. Repetitive motions can lead to inflammation and pain, particularly if the joints are not given adequate rest.

2. Injury: You mentioned that you have not experienced any direct trauma to the finger, but sometimes, minor injuries can go unnoticed. The way you were carrying the lunch bag could have inadvertently put stress on your finger joints, leading to inflammation.

3. Arthritis: The symptoms you describe, including swelling, stiffness, and pain, could indicate a form of arthritis, such as osteoarthritis or rheumatoid arthritis. Rheumatoid arthritis, in particular, often presents with symmetrical joint involvement and can cause significant swelling and pain.

4. Tendonitis: Inflammation of the tendons in the finger can also lead to pain and swelling. This condition is often caused by repetitive use and can be exacerbated by activities that require gripping or pinching.

Diagnostic Approach
1. Blood Tests: The blood tests your doctor ordered are likely aimed at ruling out inflammatory conditions such as rheumatoid arthritis or other autoimmune disorders. Common tests include rheumatoid factor (RF), anti-citrullinated protein antibodies (anti-CCP), and markers of inflammation like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).

2. Imaging: If your blood tests indicate inflammation or if your symptoms persist, your doctor may recommend imaging studies such as X-rays or MRI to assess the condition of the bones and soft tissues in your finger. This can help identify any structural abnormalities or damage.

3. Initial Treatment: It is common practice to start with anti-inflammatory medications to manage pain and swelling. These medications can help reduce inflammation and provide relief. Your doctor may also recommend rest and possibly splinting the finger to prevent further strain.

4. Cold vs. Heat Therapy: For acute swelling and pain, ice therapy is generally recommended to reduce inflammation. Applying ice for 15-20 minutes several times a day can help. Heat therapy may be beneficial for stiffness but is usually not recommended in the acute phase of inflammation.

Next Steps
- Follow-Up: After your blood tests return, your doctor will be able to provide a clearer diagnosis and tailor your treatment plan accordingly. If the tests indicate an inflammatory condition, further treatment options may include disease-modifying antirheumatic drugs (DMARDs) or corticosteroids.

- Activity Modification: It may be wise to modify your activities to avoid exacerbating the condition. Consider using ergonomic tools and techniques to reduce strain on your fingers.

- Physical Therapy: If your symptoms persist, a referral to a physical therapist may be beneficial. They can provide exercises to improve flexibility and strength in your fingers, which can help alleviate symptoms over time.

In conclusion, while your symptoms could be indicative of several conditions, the appropriate course of action involves thorough evaluation and tailored treatment based on your specific diagnosis. It’s essential to communicate openly with your healthcare provider about your symptoms and any changes you notice.

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