Some chronic diseases, such as rheumatoid arthritis (RA), Ehlers-Danlos Syndrome (EDS), and mixed connective tissue disease (MCTD) contribute to damage of the joints in the hand. Along with damage, the fingers can become unstable, leading to additional pain, disability, and dislocation. There are ways to minimize or treat instability in the fingers.
1. Reduce Inflammation
When you have a chronic disease that affects your hand joints, it is critical that you find methods of reducing inflammation. The foundation of reducing your inflammation is finding chronic disease medications that are effective for long-term use. Many people with chronic disease affecting their joints will try several types of medications, such as disease-modifying anti-rheumatics and biologics, throughout their life. Although you may not find the medication that will keep symptoms at bay indefinitely, it is important to push forward with treatment.
Anti-inflammatory pain medications are also an important component of treatment for both pain control and inflammation reduction. Depending on the extent of your pain and progression of your disease, long-term steroid use may be necessary to minimize inflammation. Much of the reason instability in the fingers occurs is due to long-term inflammation, which weakens the tissues that are necessary to support the joint. Repeated swelling of the joint can cause these supporting structures to become damaged or rupture, which makes the joint increasingly unstable.
2. Learn Temporary Fixes
If you have experienced a partial dislocation in one finger or you feel instability in a finger, it is important to have methods readily available to provide support. When a finger seems unstable, you may notice it goes numb with certain movements or it has a larger range of motion than is normal. The quickest fix is to use buddy splinting. Use medical tape to splint your unstable finger to the neighboring finger.
When splinting your ring finger, it is better to splint this finger with your pinky than your middle finger. When the pinky finger is left isolated, it is more prone to injuries. Since your thumb is difficult to buddy splint, it can be splinted by taping it to the side of your hand. When you are wrapping tape around your fingers, do this loosely enough that if you experience subsequent swelling, your finger can swell without enough constriction to cause loss of circulation but tightly enough to provide support to the affected finger.
3. Consider Surgical Options
Unfortunately, there is no nonsurgical option to fix a finger once it has become damaged to the point of instability. Eventually you will face the decision of whether to have one or more fingers surgically repaired. The options available depend on the extent of damage to a specific finger. For example, if your unstable finger also has deformities, you may want to have a pin placed along the length of the finger. Once the pin heals, the finger will become stabilized, but any deformities will also be straightened. Another option is to only have the specific affected finger joint fused. When instability occurs, it often occurs where the fingers meet the palm of the hand (the metacarpophalangeal joint).
Fusing the affected joint will make it difficult to experience future episodes of partial or complete dislocations of the finger, but with any fusion method there will be loss of movement in the finger. Fusion of the joint can also reduce pain from the underlying disease process, since the joint space has been removed. If you do not have many fingers that need to be repaired, the loss of movement in the affected fingers may not significantly affect your dexterity. If the problem is in your thumb, the resulting loss of motion can be more difficult to overcome.
For many people, the loss of motion after surgery is trivial when compared to the significant limitations due to the disease. Surgery can bring peace of mind when you do not have to be overly concerned that activities of daily living will cause a partial or complete finger dislocation. Engaging in physical therapy after surgery will help you compensate for any changes in dexterity.
Finger instability is not only painful, but it also limits simple activities. There are ways you can reduce further damage to supporting structures and provide support to your fingers. Ultimately, you will have to decide if surgery will give you long-term relief from an ongoing concern. Contact an orthopedic surgeon through a website like http://www.towncenterorthopaedics.com for further information.