Managing Scleroderma: What to Do for Affected Fingers - Internal Medicine

More Info

---

Scleroderma, also known as systemic sclerosis, is a chronic autoimmune disease characterized by the hardening and tightening of the skin and connective tissues. When it affects the fingers, it can lead to significant discomfort and functional impairment. Managing scleroderma, particularly in the fingers, requires a multifaceted approach that includes medical treatment, physical therapy, and lifestyle modifications.


Medical Management
1. Medications: The treatment for scleroderma often involves medications to manage symptoms and slow disease progression. Commonly prescribed medications include:
- Immunosuppressants: Drugs like methotrexate or mycophenolate mofetil can help reduce the immune system's overactivity.

- Vasodilators: Medications such as calcium channel blockers (e.g., nifedipine) can help improve blood flow to the fingers, reducing symptoms like Raynaud's phenomenon, which is common in scleroderma patients.

- Topical treatments: Creams or ointments containing moisturizers or corticosteroids can help alleviate skin tightness and dryness.

2. Pain Management: Pain can be a significant issue for individuals with scleroderma. Over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) may be helpful. In more severe cases, prescription pain medications may be necessary.


Physical Therapy and Rehabilitation
1. Occupational Therapy: Working with an occupational therapist can help you learn techniques to manage daily activities despite the limitations caused by scleroderma. They can provide adaptive tools and strategies to make tasks easier.

2. Hand Exercises: Regular hand exercises can help maintain flexibility and strength in the fingers. Stretching and range-of-motion exercises are particularly beneficial. Your therapist can guide you on the appropriate exercises to perform.

3. Thermal Therapy: Applying heat to the hands can help relax the muscles and improve circulation. Warm water soaks or paraffin wax treatments can be soothing and beneficial.


Lifestyle Modifications
1. Skin Care: Keeping the skin moisturized is crucial. Use thick creams or ointments to prevent dryness and cracking. Regularly apply moisturizers, especially after washing your hands.

2. Avoiding Cold: Since many scleroderma patients experience Raynaud's phenomenon, it's essential to keep your hands warm. Wear gloves in cold weather and consider using hand warmers.

3. Diet and Nutrition: A balanced diet rich in antioxidants can support overall health. Some patients find that certain foods exacerbate their symptoms, so keeping a food diary may help identify triggers.

4. Stress Management: Stress can exacerbate symptoms of scleroderma. Techniques such as yoga, meditation, or deep-breathing exercises can help manage stress levels.


Monitoring and Follow-Up
Regular follow-up with a healthcare provider is essential for managing scleroderma effectively. This includes monitoring for potential complications, such as lung involvement or gastrointestinal issues, which can occur in more advanced cases of the disease.


Conclusion
In summary, managing scleroderma in the fingers involves a combination of medical treatment, physical therapy, and lifestyle adjustments. While the condition can be challenging, proactive management can help maintain hand function and improve quality of life. If you suspect you have scleroderma or are experiencing symptoms, it is crucial to consult with a healthcare provider who specializes in autoimmune diseases for a comprehensive evaluation and tailored treatment plan.