Hand Joint Arthritis Symptoms and Treatment

By Houston Hand Surgery Specialist & Orthopaedic Surgeon, Dr. Dean Smith

The knuckle joints in the fingers act as hinges between the long bones in the hand and the smaller bones in the fingers. These joints are called metacarpophalangeal joints or MP joints of the hand. The MP joints are important to the hand for gripping and holding things. Pain and deformity in the knuckle joints of the fingers are common in rheumatoid arthritis but can also occur with trauma, gout, psoriasis, or other diseases. Diseases such as those mentioned can injure the MP joints by ruining the structures and muscles that move the joint, or by destroying the surface of the joint causing pain and deformity in the knuckle.

Signs and Symptoms of Hand Joint Arthritis

Difficulty in using the hand for daily activities (holding or gripping a cup, tool, or eating utensils, turning a key, for example) is the most common complaint of patients with hand joint arthritis. These problems in using the hand may be due to deformity, pain, or both. Many patients notice their fingers slowly drifting (leaning) to the little finger side of their hand. Daily activities may become more difficult with time.

Figure 1:Loss of position of tendons on top of MP joint result in loss of ability to straighten fingers and the drift of fingers toward little finger-side of the hand.

Causes of Hand Joint Arthritis

There can be many reasons for these symptoms to occur. The ligaments that hold the joint in place can be loosened by the disease, causing the joint to slip out of place and eventually dislocate. The tendons at the top of the joint may slip out of place and lose their ability to straighten the fingers.

Treatment for Hand Joint Arthritis

Treating the symptoms can sometimes be done without surgery. Medication, splinting, changes in daily activity, and injections of anti-inflammatory medicine may be recommended by Dr. Smith in the early stages of hand joint arthritis. If these forms of non-surgical treatment do not work, surgery may be needed.

Some advanced cases of hand joint arthritis may need surgery. Two types of surgery are commonly performed.

Synovectomy (Soft-Tissue Replacement) – Generally performed in less severe cases.  If the tendons have slipped out of place, they are put back into place over the knuckle joint. If the small muscles of the fingers are causing the fingers to lean toward the small fingers, the muscles are operated on to stop the fingers from being pulled toward the little finger.

Joint Replacement – Generally performed on more severe cases. The diseased metacarpophalangeal joint is replaced with an artificial joint. Complications with this type of surgery may happen. Infection is possible or the artificial joint may eventually break or wear down. There is a possibility that a second replacement of the joint or fusion of the joint may be recommended in later years.

The goals of treatment are pain relief and restored motion to the fingers. Dr. Smith can advise you on the best treatment for your situation.

Figure 2: With joint replacement an artificial joint is placed between the bone ends and tendons are repositioned. This procedure allows the fingers to straighten and the drift is corrected.

Rehabilitation

Following joint replacement surgery, close supervision by Dr. Smith is as important as the surgery. The hand is usually initially immobilized following surgery. A therapy program, consisting of exercises and special splints, usually starts the first week after surgery. In some cases the splinting portion of the program is continued for a longer period of time.

Dr. Smith provides a comprehensive multidisciplinary approach for the evaluation, treatment and care of hand joint arthritis.

Call Dr. Smith at 713-524-0580 to schedule an appointment concerning Hand Joint Arthritis.

Finger Dislocation | Middle Georgia Orthopaedics, Warner Robins, GA

A direct blow to the hand, fingers, or thumb may cause a dislocation. Falls and contact sports, such as baseball and football, are commonly linked to finger dislocations.

Other factors may contribute to a finger dislocation such as:

• previous injuries that have damaged the bone or soft tissues (ligaments)
• using improper equipment during daily activities and exercise
• diseases that affect the joints, such as rheumatoid arthritis

What are the symptoms?
You will have some pain and swelling in the area of the dislocated joint. Movement will be limited and extremely uncomfortable. The finger may look crooked and feel numb or tingly. The skin may also become discolored from bruising.

What can I do after it happens?
Immediately after the injury occurs, do not try to move the finger back into place. Further movement may damage the surrounding tissues, nerves, and blood vessels. Apply an ice pack to the area and elevate the hand to control swelling. Over-the-counter anti-inflammatory medications will also help reduce swelling and give pain relief. See a doctor as soon as possible.

How is it diagnosed?
Your doctor will examine your finger and discuss the history of the injury with you. X-rays will be needed to identify the dislocation and rule out broken bones.

How is it treated?
Typically, your doctor can reposition the bones using a hands-on technique. You may be given medications to numb the area and relax the muscles during the procedure. The finger may then be “buddy taped” to the finger next to it or a splint may be applied. These measures will support the finger and limit movement during the healing process.

Surgery at times is required to relocate the joint. In addition, surrounding soft tissues such as ligaments, tendons and nerves may need to be repaird and/or reconstructed. Postoperatively, it is common to be referred to a hand therapist to assist with a rehabilitation program to maximize function of the injured finger.

While your finger heals, treatment is focused on reducing swelling and pain. Continue to elevate the area and use ice packs for the first few days every three to four hours (10 to 15 minutes at a time). Your doctor may recommend over-the-counter or prescription drugs to control inflammation and discomfort. You may begin exercises to regain flexibility and strength in the finger when cleared by your doctor.

What is the outlook?
Finger dislocations usually mend with good results in approximately three to six weeks. Healing at times can be prolonged with these injuries with some swelling and stiffness persisting for up to six months. Your recovery will depend on your age, overall health, and how well you follow the instructions of your doctor and therapist.

Are there any complications?
Most finger dislocations heal well, but they could be complicated by injuries to the bone, tendons, and ligaments in the hand. Damage to blood vessels and nerves may also occur.

How to Treat a Sprained or Dislocated Finger

Finger sprains and dislocations are common injuries to the hand. When a sprain occurs, a ligament that supports a joint is stretched too far and the tough fibers of the ligament tissue become either partially or completely torn.

Ronald Martinez / Getty Images

In some cases, the damage to the supporting ligaments is significant enough that the joint comes apart, causing an injury called a dislocation. Common causes of finger sprains and dislocations include sports injuries, work-related injuries, and automobile accidents.

Finger Sprains

Finger sprains are fairly common, especially as a result of sports injuries and falls onto your hand. Often, these cause the finger to bend unusually, causing the ligament injury and subsequent pain.

Finger sprains can occur at any of the “knuckle” joints of the digit but are most common at the PIP (proximal interphalangeal) joint in the middle of the finger.

Common symptoms are:

• Pain with finger movement
• Swelling around the knuckle
• Tenderness of the finger

Finger ligament injuries can vary in severity. Have your injury evaluated by your doctor to ensure you get any necessary treatment to help your finger heal properly.

If your doctor recommends an X-ray, rest assured that it’s standard procedure to ensure that there is no bone fracture, as fractures around the joint may require more invasive treatment.

Other tests, such as magnetic resonance imaging (MRI) or computerized tomography (CT) scan, are seldom necessary to make a diagnosis of this type of problem.

Treating Finger Sprains

Finger sprains are often splinted or buddy-taped (taped to an adjacent finger) for a short period of time. So long as there is no fracture or dislocation, most finger sprains should be allowed to move within about a week.

Splinting the sprained finger during sports can help protect the injury, but unnecessarily splinting the finger will cause the digit to become stiff. You should discuss with your doctor when to begin finger movements.

In addition to taping or splinting the injured finger, other treatments for a sprain include:

• Ice the injured finger
• Elevate if there is swelling
• Take an anti-inflammatory medication
• Gently move the finger to prevent stiffening

Thumb sprains and certain finger sprains in children may require a longer period of immobilization or evaluation by a specialist, especially if there is a concern that a ligament was torn.

One injury, in particular, the so-called gamekeeper’s thumb, requires immobilization and occasionally surgery. This particular injury is important because chronically injured ligaments at this joint affect our ability to pinch.

It is not unusual for finger sprains to cause swelling and stiffness that can persist for months following the injury. It’s important if you have these persistent symptoms that you let your doctor know so that they can ensure there is not a more severe injury (such as a finger fracture).

Finger Dislocations

A finger dislocation is a more severe injury to the digit, as it involves not only the ligament, but also the surrounding joint capsule, cartilage, and other tissues. When a joint is dislocated, the normal alignment of the finger is altered, and the joint must be put back into place.

Sometimes, relocating a finger dislocation can be simple and other times it can be very difficult. Often, the individual being treated can relocate their own finger just by simply pulling it back into position.

Other times, the dislocation may require anesthesia or even a surgical procedure to realign the digit. In these challenging situations, there may be tendons or other tissues preventing the joint from going back into position.

After the dislocation has been reduced (put back into position), the joint should be splinted and an X-ray obtained. The X-ray is performed to ensure the joint is perfectly aligned, and that there was no fracture that occurred at the time of the injury.

Once is has been reduced and splinted, care for a dislocated finger is similar to that of a sprained finger. You should ice and elevate the injured finger after the injury. Follow your doctor’s recommendations for when to begin finger motion.

When the joint is dislocated, the ligaments and the joint capsule surrounding the injured joint are torn. Sometimes, these ligaments do not heal adequately and surgery is occasionally needed to repair the injured structures. That said, most finger dislocations can be treated with a simple splint.

A Word From Verywell

In most cases, both a finger sprain and dislocation are easily treatable. Usually, you’ll be able to use your hand as normal within a week. It is also normal for a sprain to cause pain and discomfort for a longer period of time. If it’s really bothering you, ask your doctor if there is a way to reduce the discomfort.

Although dislocation is a more serious injury, expect treatment similar to that of a sprain. In both cases, don’t worry if a doctor recommends an X-ray—that’s normal procedure for ensuring that your digit is healing properly and back to normal.

Thumb Dislocation

A thumb dislocation occurs when the tissues, or ligaments, that hold the joint together are torn. The bones then move, or are dislocated, out of their normal position. This causes pain, swelling, and bruising. Sometimes there is also a small fracture. You may need surgery to keep the joint in place while it heals. This may be the case if your injury is severe and the joint is not stable.

Once the joint is back in place again, it will take about 6 to 8 weeks or more for the ligaments to heal. During this time, your thumb should be protected from re-injury. This may be done with a cast or splint.

Finger splints prevent motion at the joint. They should generally not be left in place longer than 3 weeks to avoid stiffness and loss of joint function.

Hand exercises may be prescribed at your follow-up visit. These can help speed healing and maintain function. In most cases you will regain full function of your thumb. But it may take 12 to 18 months before all mild pain and swelling goes away and full function returns.

Home care

• Keep your arm elevated to reduce pain and swelling. When sitting or lying down, raise your arm above the level of your heart. You can do this by placing your arm on a pillow that rests on your chest. Or you can place your arm on a pillow at your side. This is most important during the first 48 hours after injury.

• Apply an ice pack over the injured area for no more than 20 minutes. Do this every 3 to 6 hours for the first 24 to 48 hours. To make an ice pack, put ice cubes in a sealed, zip-lock plastic bag, then wrap in a thin, clean towel or cloth. Don’t put ice or an ice pack directly on your skin. As the ice melts, be careful that the tape, gauze, cast, or splint doesn’t get wet. After that, keep using ice packs as needed to ease pain and swelling.

• Keep the splint or cast dry at all times. Bathe with your splint or cast out of the water, protected with 2 large plastic bags. Place 1 bag around the other. Tape each bag with tape at the top end or use rubber bands. Water can still leak in even when your hand is covered. So it’s best to keep any tape, splint, or cast away from water. If a fiberglass cast or splint gets wet, you can dry it with a hair-dryer on a cool setting. A vacuum cleaner with a hose attachment can also be used to pull air through the cast for speed drying.

• You may use over-the-counter pain medicine to control pain, unless another pain medicine was prescribed. Talk with your healthcare provider before taking these medicines if you have chronic liver or kidney disease, or if you have ever had a stomach ulcer or gastrointestinal bleeding.

• Don’t play sports or do any physical exercise until your healthcare provider says that you can.

Follow-up care

Follow up with your healthcare provider in the next 2 to 3 weeks, or as advised. It is important that you see the referral doctor. He or she can determine how long to leave any splint or cast in place and when to begin hand exercises.

If X-rays were taken, you will be told of any new findings that may affect your care.

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

• The injured thumb has increased pain or swelling

• The injured thumb is red, warm, or has drainage

• The injured thumb becomes cold, blue, numb, or tingly

• The plaster cast or splint becomes wet or soft

• The cast or splint has a bad smell

• The splint or cast is too tight or too loose

Dislocation – Symptoms and causes

Overview

A dislocation is an injury to a joint — a place where two or more bones come together — in which the ends of your bones are forced from their normal positions. This painful injury temporarily deforms and immobilizes your joint.

Dislocation is most common in shoulders and fingers. Other sites include elbows, knees and hips. If you suspect a dislocation, seek prompt medical attention to return your bones to their proper positions.

When treated properly, most dislocations return to normal function after several weeks of rest and rehabilitation. However, some joints, such as your shoulder, may have an increased risk of repeat dislocation.

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Symptoms

A dislocated joint can be:

• Visibly deformed or out of place
• Swollen or discolored
• Intensely painful
• Immovable

When to see a doctor

It can be difficult to tell a broken bone from a dislocated bone. For either type of injury, get medical help right away. If possible, ice the joint and keep it immobile while you’re waiting to be seen.

Causes

Dislocations can occur in contact sports, such as football and hockey, and in sports in which falls are common, such as downhill skiing, gymnastics and volleyball. Basketball players and football players also commonly dislocate joints in their fingers and hands by accidentally striking the ball, the ground or another player.

A hard blow to a joint during a motor vehicle accident and landing on an outstretched arm during a fall are other common causes.

Risk factors

Risk factors for a joint dislocation include:

• Susceptibility to falls. Falling increases your chances of a dislocated joint if you use your arms to brace for impact or if you land forcefully on a body part, such as your hip or shoulder.
• Heredity. Some people are born with ligaments that are looser and more prone to injury than those of other people.
• Sports participation. Many dislocations occur during high-impact or contact sports, such as gymnastics, wrestling, basketball and football.
• Motor vehicle accidents. These are the most common cause of hip dislocations, especially for people not wearing a seat belt.

Complications

Complications of a joint dislocation can include:

• Tearing of the muscles, ligaments and tendons that reinforce the injured joint
• Nerve or blood vessel damage in or around your joint
• Susceptibility to reinjury if you have a severe dislocation or repeated dislocations
• Development of arthritis in the affected joint as you age

Stretching or tearing of ligaments or tendons that support your injured joint or damage to nerves or blood vessels surrounding the joint might require surgery to repair these tissues.

Prevention

To help prevent a dislocation:

• Take precautions to avoid falls. Get your eyes checked regularly. Ask your doctor or pharmacist if any of the drugs you take might make you dizzy. Be sure your home is well-lighted and that you remove any potential tripping hazards from the areas where you walk.
• Play safely. Wear the suggested protective gear when you play contact sports.
• Avoid recurrence. Once you’ve dislocated a joint, you might be more susceptible to future dislocations. To avoid recurrence, do strength and stability exercises as recommended by your doctor or physical therapist to improve joint support.

Sept. 17, 2019

Feeling Out of Joint | NIH News in Health

Special Issue: Seniors

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The Aches of Arthritis

Many people start to feel pain and stiffness in their joints as they get older, often when they’re 45 to 50. It’s called arthritis, and it’s one of the most common diseases nationwide. You may think it’s a disease of old age, but arthritis can affect young adults and even children. In recent years, scientists have made rapid progress in understanding the many causes of arthritis. They’ve also made significant strides in developing effective new treatments for many forms of the disease.

What exactly is arthritis? “Arthr” means joint, and “itis” means inflammation—heat, swelling, and redness. But the inflammation of arthritis isn’t always something you can see.

“Some types of arthritis are very inflammatory and others aren’t as much. But they all involve an element of inflammation,” explains Dr. Joanne M. Jordan of the University of North Carolina at Chapel Hill.

Arthritis comes in many forms. In fact, there are more than 100 types, each with its own symptoms and treatments. The most common form of arthritis is osteoarthritis.

Osteoarthritis occurs when cartilage, the tissue that cushions the ends of the bones within the joints, breaks down and wears away. It most often affects the fingers, knees, and hips.

Osteoarthritis can follow injury to a joint. For example, years after a soccer injury to a knee, you might get osteoarthritis in the knee. Once you’ve had a severe joint injury, it’s important to be careful about what kind of activities you do.

“You should be active because, ironically, being active can help prevent disease,” says Dr. David Felson of Boston University. “But try not to be active in ways that can make your joint vulnerable to injury again.”

For the most part, researchers don’t know a lot about how and why osteoarthritis occurs. Women tend to get it more often than men. You tend to get it as you get older.

“Many factors that affect osteoarthritis are things you can’t control, like how old you are and what gender you are,” Felson says.

But some risk factors are under your control, including your weight. “Even moderately overweight people have an increase in knee osteoarthritis,” says Felson.

Many treatments are available for osteoarthritis. Talk to your doctor about exercises that can help and activities you should avoid. Several pain and anti-inflammatory medicines are available by prescription or over the counter.

Perhaps the most promising treatments for osteoarthritis right now, Felson says, involve ways to block pain. Researchers are working on other approaches as well, including exercise routines and devices that alter the alignment of your joints. For severe cases of osteoarthritis, scientists have developed improved surgeries to replace knees and hips.

Another common type of arthritis is gout. Gout usually affects the big toe, but many other joints may be involved. It’s caused by needle-like crystals that build up in the joints.

People with gout might try to avoid certain foods—including liver, beef, anchovies, and meat gravy—because they can bring on a gout attack in some people. These foods are rich in molecules called purines, which break down in your body and can ultimately contribute to crystal formation. Drinking alcohol, being overweight, and taking certain medications may make gout worse. In older people, some blood pressure medicines can also increase the chance of a gout attack.

Your doctor might do blood tests and X-rays to find out if you have gout. If you are diagnosed with gout, it can be treated several different ways, often in combination.

A very different type of arthritis is called rheumatoid arthritis. In contrast to osteoarthritis and gout, which affect particular joints, rheumatoid arthritis can affect your whole body. It arises when your immune systemThe system that protects your body from invading viruses, bacteria and other microscopic threats. mistakenly attacks your own joints. That can bring pain, swelling, stiffness, and loss of function in joints and bones—most often in the hands and feet. Rheumatoid arthritis may also affect your internal organs and systems. You might feel sick or tired or have a fever.

Laboratory tests for certain immune system activity can confirm whether you have rheumatoid arthritis. The good news is that now there are medications not only to control pain and inflammation, but to actually slow or stop damage to your joints.

A lot of new treatments that have come out in the past 10 to 15 years have revolutionized the treatment of rheumatoid arthritis,” Jordan says.

Some rheumatoid arthritis medications interfere with the immune system’s activity. By interrupting the events that lead to inflammation, these medications help block inflammation and prevent structural damage to the joints.

“If you’re concerned you have rheumatoid arthritis, it’s important to see a doctor fairly soon,” Felson advises. “Your joints can be damaged by the process of arthritis, and that damage cannot be reversed, so it’s important to get treatment as early as possible.”

Researchers continue to explore what causes arthritis. A better understanding of the factors involved might lead to new treatment approaches. GenesStretches of DNA, a substance you inherit from your parents, that define characteristics such as how likely you are to get certain diseases. play a significant role in many types of arthritis. For example, scientists have linked certain immune system genes with a tendency to develop rheumatoid arthritis. Genes involved in how uric acid is processed have been tied to gout.

For osteoarthritis, Jordan estimates that up to 30% to 60% of your risk may lie in the genes you inherited from your parents. “The tricky part, though, is that it’s not a single gene,” Jordan explains. “It’s a lot of different genes that interact with each other and with the environment to cause the disease.”

Researchers are also looking at other risk factors, such as job-related exposures and heavy metals, such as lead, in the environment. They’ve been developing better ways of looking inside joints as well.

If you feel pain and stiffness in your joints, don’t hesitate to bring it up with your doctor. The sooner you act, the better you can prevent damage to your joints. Find out what’s causing your problems now and learn about your options.

Article Review. This special issue is a collection of previously published articles. However, articles were updated and re-reviewed by NIH experts prior to inclusion. Published December 2017.

Joint Dislocations | Risks, Treatment and Recovery

What is a joint dislocation?

Dislocations are usually caused by an injury which produces an impact on the joint, such as falls, accidents involving moving vehicles and collisions during contact sports. Less impact is needed for smaller joints than for larger ones. It can become easier to dislocate joints that have dislocated before, as the surrounding tissues which hold the joint in place may have been stretched. Some people are more prone than others to dislocation.

Which are the most common joint dislocations?

Most joints in the body can be dislocated but some are dislocated more commonly than others. Dislocations of the shoulder (in adults) and the elbow (in children) are the most common. This leaflet discusses the most common dislocations and how they are treated.

Joints allow bones to move against one another (articulate) to allow us to move our skeletons. Some joints, like the shoulder, are especially mobile (having a wide range of movement of the bones). This is particularly so in flexible people like gymnasts and ballet dancers. Some joints, like the ankle or fingertip, have a smaller range of movement, mainly in one direction. Generally there is a trade-off between mobility and stability. Stable joints tend to dislocate less easily as there are more inflexible structures holding them in place.

Mobile and stable joints

Joints which are more mobile tend to be at greater risk of dislocation. Comparing two ball and socket joints – the shoulder and the hip – shows why this is the case. Both are similarly made, consisting of a ball of bone moving in a socket of bone. Ball and socket joints can move in every direction. The price for this mobility is that there are many directions in which the joint could be ‘pulled out’. However, the shoulder is much more easily dislocated than the hip.

The shoulder has quite a shallow socket. This makes it even more mobile. It depends upon muscles, tendons and ligaments to keep it in place. These structures are easily damaged if enough force is applied. The muscles and ligaments around the shoulder tend to be stretchy and relatively vulnerable (compared to those around the hip). Thus the shoulder is relatively easy to dislocate.

The hip is much harder to dislocate even though it is also a ball and socket joint. This is because the socket is deeper and the ligaments and muscles much bigger and stronger. As a result we can’t get the same range of movement from our hips as from our shoulders but in return the hip is more stable and much less likely to dislocate than the shoulder.

What increases the risk of joint dislocation?

Various factors can lead to joint dislocation, either because they weaken the support of the joint (meaning less force is needed to dislocate it) or because they make injury more likely. These include:

• Weakness of the supporting ligaments and muscles through age or lack of fitness.
• Older people may have poorer balance and be more vulnerable to falls.
• Young children can be at greater risk as they have laxer, more elastic supporting ligaments and are prone to falls and other injuries.
• Previous dislocations which have stretched or torn the supporting tissues. Repeated dislocations are particularly likely to follow first dislocation in the shoulder, kneecap and hip.
• Joint hypermobility. Hypermobility is particularly common in children but about 5% of adults have hypermobile joints. It can be caused by weak loose ligaments, weak muscles or shallow joint sockets.
• Inherited conditions which make the elastic tissues more ‘stretchy’ – for example, Ehlers-Danlos syndrome and Marfan syndrome
• Increased risk through choice of physical activity, such as extreme sports and high-speed sports, contact sports with high impact, or sports involving speed with sudden turns on the feet.
• Operating heavy machinery.
• Smaller joints like fingers need less force to dislocate them than, say, the hip, purely because they are smaller.

What is a joint dislocation like?

Dislocation is usually sudden and extremely painful as the ends of the bones dislocate from one another. This is because tissues around the joint are stretched and torn. There will be bleeding and immediate swelling. The joint may look obviously deformed.

When two bones meet there are several structures holding them together. These include

• Strong tissues called ligaments around (and sometimes inside) the joint.
• A joint capsule – a fibrous surround to the joint.
• Tendons and muscles passing around and sometimes through the joint.

If the joint is injured and pulled apart these structures, plus the bones themselves, can be damaged (torn or fractured) as a result. As a result of this and of the displacement of the ends of the bones, the joint cannot function as normal. Limbs and digits can’t be moved, you may be unable to weight bear or, in the case of the jaw joint, open your mouth.

An additional complication is that nerves and blood vessels may be trapped or squashed (compressed) by the abnormally positioned structures. This can result in further, increasing pain and in numbness and tingling. (It also means that dislocated joints need immediate medical attention in order to make sure than the blood and nerve supplies to tissues beyond the joint are still functioning normally.)

What should I do if I have a joint dislocation?

• You need to get medical help immediately.
• Depending on the dislocation, you may be in severe pain and be immobile.
• Do not try to put the joint back yourself – even if you can manage to do this without causing further damage you may trap nerves, blood vessels or other tissues between the bones as you do so.
• Cool the injured area and, if practical and possible, elevate it. Both of these will reduce swelling.

How are joint dislocations treated?

The aims of treatment are to assess the position of the joint and any associated injuries, then to restore it to its normal location without causing any further damage. Imaging such as X-rays may be needed to check for broken bones and you may need painkillers or an anaesthetic before the joint can be manipulated.

Dislocations ideally need to be put back (reduced) by trained healthcare professionals in a hospital setting rather than by able first aiders ‘in the field’. This is because:

• Significant force may be required to pull the bones further apart in order to drop them back into their proper position. The joint may also need to be pulled out and rotated a little before being gently allowed back into place. This needs careful control. It is important that the person doing this knows exactly how to pull and turn the joint.
• The process is generally painful, particularly for large joints like the shoulder – and you will already be in pain.
• You may need X-rays before or after the process, as dislocations are commonly associated with a break (fracture).
• Essential structures like blood vessels and nerves may be put at risk by dislocation. They may be put further at risk if a dislocation is then put back improperly, or manipulated the wrong way, trapping them and possibly cutting off blood or nerve supplies. This could make things worse.

Afterwards treatment focuses on rehabilitation and prevention of further dislocation. You are likely to be offered physiotherapy for the joint involved.

How long does it take to recover from a joint dislocation?

There will be some immediate relief when the joint is back in place. However, the tissues will still be sore, swollen and bruised. The time that this takes to fully recover depends on the size of the joint involved and the amount of associated damage to the supporting structures. It also depends on the treatment that’s needed and on the physiotherapy that you do.

Time to reach complete recovery may vary. It may be only 2-3 weeks in the case of a partial finger dislocation that goes back into place easily. For a shoulder, it may be 12-16 weeks. However, in the case of a hip or a foot, it may take six months or longer. When there are repeated dislocations of the kneecap, the bone may eventually slip so easily back into place that recovery is almost immediate. This is because the muscle has become so stretched that no further damage occurs when the kneecap dislocates.

Healing and recovery time will be affected by factors such as:

• Severity of injury.
• Whether surgical repair is needed.
• Age.
• Weight.
• Strength of supporting muscles and ligaments.
• General health.
• Presence of conditions which may affect healing – for example, poorly controlled diabetes, oral steroid use.
• Compliance with treatment (for example, doing your physiotherapy exercises).
• Whether injury is repeated (recurrent). 

Common joint dislocations: shoulder, elbow, knee

, hip, finger, collarbone, jaw, wrist, ankle and foot

Shoulder dislocation

This occurs when the ball of the upper arm bone (humerus) pops out of the shoulder socket. It is usually caused by a fall on to the upper arm, or during contact sport such as rugby. Usually the dislocated ball pops out at the front of the shoulder joint, where the supporting muscles are at their weakest. It can pop out backwards but this is relatively uncommon.

Forwards (or anterior) dislocations of the shoulder are extremely painful and you won’t be able to move the arm. There may be a deforming bulge in the front of your shoulder area, below the natural shoulder joint. This will be the ball of the upper arm bone, called the humeral head, that has slipped out.

Shoulder dislocations are at high risk of involving nerves and blood vessels. It is also fairly common to find an associated fracture of the upper arm or shoulder, and you should not try to put the shoulder back by yourself as you may trap these important structures.

Treatment of a shoulder dislocation

• Shoulder dislocation is usually treated in hospital. X-rays are done to check for breaks, which are common. The shoulder is then put back (reduced) using either strong painkillers or an anaesthetic. The process takes only a few minutes. If any of the tendons or tough tissues around the shoulder (including the ‘lip’ of the shoulder socket which is called the labrum) have been torn they may need surgical repair.
• After reduction you will normally need to rest the shoulder for several weeks: it is likely to be 12-16 weeks before full strength is regained. This may be longer if bones were also broken.
• You will usually wear a sling for 2-3 weeks to allow the stretched soft tissues to heal.
• After this, gentle arm and shoulder exercises, performed out of the sling, help to regain mobility and strength. A fifteen-minute ice pack and painkillers may be useful before the exercises are attempted.

If you have dislocated your shoulder once, you are more likely to do it again. This is particularly the case if you are under 20 years old the first time. If shoulder dislocation recurs the structures at the front of the joint can become stretched. Eventually a point may be reached, with repeated dislocations, where the shoulder dislocates very easily, even during normal sporting activities like swimming. Sometimes it can even be slipped back in relatively easily by you alone. In such cases physiotherapy or surgery may be offered to increase the support around the shoulder and to reduce the chance of further dislocations.

Elbow dislocation

The elbow is the second most common dislocation in adults. It takes a lot of force to dislocate the elbow – such force that there is often an associated break in one of the bones. Dislocated elbows are at high risk of trapping nerves and blood vessels and need urgent attention.

The most common cause is falling and landing on your outstretched hand or arm, pushing the forearm bone sideways out of the joint. Sports like cycling, roller blading, skateboarding and gymnastics tend to be the most common sports-related causes.

Dislocated elbows look deformed and they hurt. There may be swelling and bruising, especially if there are torn ligaments or broken bones. Injury to the nerves that cross the elbow joint can cause tingling further down the arm or in the hand.

Treatment of an elbow dislocation
This follows the same principles as for shoulder dislocation, above, although the elbow does sometimes relocate by itself, particularly if it wasn’t completely dislocated. Reduction is done by a trained medical person. A sling is worn initially, after which you should be offered physiotherapy to restore normal movements and control.

If essential structures like ligaments have been damaged then surgery may be needed to repair them. If the bones are broken then pinning and wiring may be needed to hold everything stable as it heals. In more complicated cases the elbow may be in a cast or brace for a while before physiotherapy can begin.

Kneecap (patellar) dislocation

The common knee dislocation is actually not a dislocation of the main knee joint. Instead it is of the kneecap (patella) from its position in front ot the main knee joint. Patellar dislocation is particularly common in teenagers, especially girls. It can happen during sport but also when getting up from a chair or the floor.

The kneecap is said to dislocate when it comes sideways out of the groove in which it normally moves over the knee joint. The kneecap is a type of bone called a sesamoid bone. This is a bone sitting in a muscle or tendon over the top of a joint, protecting it by sliding over it to cover the most prominent part of the joint as it moves.

The kneecap sits in the muscle which forms the front of the thigh (the quadriceps muscle). Below the kneecap the quadriceps muscle becomes a tendon and attaches to the front of the shinbone. When dislocated it pops out of the groove – usually outwards away from the other leg (laterally), still remaining attached to the muscle, which stretches and moves with it.

A dislocated kneecap hurts and you may hear a crack or clunk. There may be swelling, particularly the first time it happens. You will be unable to move the knee properly or walk. This dislocation does not generally represent a risk to major nerves and blood vessels.

Kneecap dislocation tends to be repeated (recur). The risk is higher if the quadriceps muscles are not particularly strong, so that they tend to be lax and allow sideways movement of the kneecap. The risk is greater if you are overweight. Over time the dislocation may become less painful, as the stretched tissues are not damaged by the dislocation.

Treatment of a dislocated kneecap
Dislocated kneecaps often treat themselves, popping back into place before you even get to see a health professional. Over time if you have the condition recurrently it will become less painful and you may be able to put it back yourself. This is usually achieved by slowly straightening the leg – or allowing someone else to straighten it for you.

If this doesn’t work, the kneecap dislocation can be put back by a qualified health professional. You will be offered physiotherapy afterwards to strengthen the quadriceps muscles.

Knee joint dislocation

Dislocation of the knee joint itself (rather than the kneecap, as described above) is rare but can be catastrophic. It is most likely to be caused by a road vehicle accident but can also happen in sports, particularly skiing. There is usually significant injury to the ligaments of the knee as well. 

See our separate leaflet called Knee Ligament Injuries for more information about injuries to the ligaments of the knee and how they are treated.

Treatment of a knee dislocation
The knee might have gone back into place on its own at the time of the injury. If it has stayed dislocated it needs to be put back into place urgently but not before an examination has made sure the blood vessels aren’t damaged and an X-ray has made sure that there are no fractures. Damage to the main blood vessel (popliteal artery) that travels down the back of the knee is common and may require urgent surgery. Emergency surgery may also be needed if it is not possible to put the knee joint back in place.

Non-emergency surgery is usually then needed to repair the ligaments that will have been damaged during the dislocation.

Hip dislocation

Sudden hip dislocation is a medical emergency when it occurs in adults. It is very painful and can result in significant bleeding into the joint and tissues. The hip is a stable joint, seated in a fairly deep socket and well protected by large muscles and strong ligaments. It takes a lot of force to pop it out and such severe force is likely to cause other associated injuries.

What you have done may not be obvious by looking at the hip, since the bones are well covered with muscle layers so swelling and bruising may not be obvious. However, you will be unable to stand or move your hip joint and, when lying down, the leg on the affected side will look shorter than the other. Most hips dislocate out backwards and when this happens the whole leg tends to turn inwards towards the other leg.

Hip dislocations are of three main sorts:

• After major injury such as a road accident.
• Dislocation of artificial hips in the period following surgery – this is relatively common as the muscles and ligaments around the false joint ball will be stretched and weakened by the surgery.
• Developmental dysplasia of the hip. This is seen in babies when the hip joint doesn’t develop normally. The hip socket may be too shallow or the ball part may be flattened. These problems make it likely that the hip will slip out. It is more common in babies born bottom first (breech) and in girls. For more information see the separate leaflet called Developmental Dysplasia of the Hip.

In addition, some adults have a shallow hip socket and develop recurrent dislocation, usually in later life when the supporting joints and ligaments are weaker.

Treatment of a hip dislocation
Patients with an injury causing a hip dislocation need pain relief and treatment for other injuries, which may include severe blood loss. The hip dislocation itself will normally be put back under anaesthetic. The risk of damage to blood vessels and nerves is quite significant. There is a chance of permanent interruption of the blood supply to the ball part of the ball and socket joint. This leads rapidly to arthritis of the hip. Traumatic hip dislocations therefore commonly lead to lasting disabilities.

Dislocations following hip surgery and dislocations that are recurrent also require reduction under anaesthesia. They tend not to be as traumatic, as they have not required the same amount of force to cause them.

Dislocated finger

This is a common injury which can affect any finger joint but which most commonly affects the middle knuckle of the four fingers (rather than the thumb). It is usually caused either by over-bending the finger backwards, or by jamming or catching the finger somewhere during fast movement. Typically this happens:

• During sports activities when stopping fast balls with the hand.
• When undressing and catching the finger in clothes.
• When falling on to the hand.

It is usually obvious – the finger will be deformed (crooked and swollen) and will hurt. You won’t be able to move it properly and it may go pale and tingle.

Treatment of a dislocated finger
You should see a healthcare professional if you have a dislocated finger. This is particularly urgent in the following cases:

• The finger is pale or tingling (which suggests trapped nerves or arteries).
• The skin is broken over the dislocation (risking infection in the damaged joint).

You should also remove any rings swiftly, if possible. This is because they may need to be cut off if a finger swells and the rings become too tight.

A dislocated finger is usually put back in accident and emergency. It will probably be X-rayed. Ice is usually applied. Depending on the severity, you may be sent to see a hand specialist afterwards to make sure you get back the full use of your hand.

Dislocated collarbone

This most commonly means dislocation of the outer end joint of the collarbone (clavicle), where it joins with the top of the shoulder. This is called the acromioclavicular joint (ACJ) and the dislocation is also called AC separation. The ACJ is most commonly dislocated by a fall on to your arm when it is straight or on to the tip of the shoulder. It often occurs in physical ‘collision’ sports like rugby and football. It can also occur in sports that risk a fast or long fall, such as skiing and horse-riding.

The dislocation is painful. It may be easier to spot the change in the shape of the joint when the arm is held across the body. It can vary from a small separation of the joint to a wide one, which is more severe.

Treatment of a dislocated collarbone
Treatment of this dislocation depends on how severe it is. This is judged by how widely the bones have separated and how much damage there is to the ligaments. More severe injuries will need to be operated on (surgical reduction and fixation). However, less severe injuries are managed with physiotherapy and painkillers.

Dislocated jaw joint

The joints between your lower jaw and your upper jaw are called the temporomandibular joints (TMJs). They can dislocate quite easily in some people, even when just opening the mouth particularly wide, yawning, kissing, or biting an apple. Pain is felt in front of the ear and it is difficult to open and close the mouth. Usually the lower jaw dislocates forwards. However, in the case of a direct blow to the chin it may dislocate backwards.

Treatment of a dislocated jaw
The joint needs to be put back by a trained health professional. The main chewing muscles (masseter muscles) are very strong. Once the jaw has dislocated they may be in spasm, so muscle relaxants are sometimes used. If the reduction proves difficult or there are other injuries, an anaesthetic may be needed.

You will need to follow a soft diet as you recover from a dislocated or broken jaw, avoiding foods that are crunchy or particularly chewy.

Wrist dislocation

Wrist dislocation means dislocation of any of the eight small bones which make up the wrist. It is usually caused by a fall on to the wrist or the outstretched arm. Symptoms include pain and obvious distortion of the wrist.

There are a number of ways in which the eight wrist bones can dislocate and the lunate bone is usually involved.

Treatment of a dislocated wrist
Dislocation of wrist bones generally involves severe ligament damage and needs treating by a specialist hand surgeon to avoid permanent damage to the wrist. Once the wrist has been put back and the ligaments repaired, a plaster cast is generally necessary to keep everything still whilst it heals.

Important nerves and arteries run through the wrist and if numbness and tingling develops in the fingers when the wrist is dislocated then this is a medical emergency, as it suggests these structures are trapped or damaged.

Ankle dislocation

Dislocation of the ankle joint is a rare injury on its own but can happen in motor vehicle accidents and sports injuries. It is more common when there is an ankle fracture at the same time, as that can make the ankle joint unstable. 

Treatment of a dislocated ankle

Ankle dislocation needs urgent medical treatment as there is a risk that important nerves and blood vessels can be trapped or torn by the injury. Treatment will depend on whether or not there is also a fracture.

You can read more about this in our separate leaflet called Ankle Injuries (Sprained or Broken Ankle).

Foot dislocation

There are many possible kinds of dislocation that can occur in the foot, which contains multiple bones and joints. The common dislocation is called a Lisfranc injury. This is because the group of joints that join the arch area of the foot (the midfoot) to the long metatarsal bones (the forefoot) is called the Lisfranc complex. If bones in the midfoot are broken or ligaments that support the midfoot are torn then dislocations in the Lisfranc area can result.

Lisfranc injury can result from a simple twist and fall. However, more often it occurs following road traffic accidents and other major injuries. It is also seen in some sports and performance arts like American football and ballet, where there is a twisting injury to the feet.

The foot will usually be painful and swollen and the swelling may at first hide the fact that there is deformity of the shape. A Lisfranc injury is often mistaken for a sprain, especially if the injury is a result of a straightforward twist and fall. However, injury to the Lisfranc joint is a severe injury that may take many months to heal and may require surgery to treat.

Treatment of a dislocated foot
Foot dislocation, which usually involves broken bones in the midfoot, needs treatment by a foot specialist. Small dislocations where the bones are not forced too far apart may heal by themselves although the foot needs to be in a cast and completely non-weight-bearing. More severe injuries need surgical treatment to restore the normal function of the foot. 

Partial dislocation (subluxation)

When a joint doesn’t come completely out of joint but is instead only partly out of place, this is called a subluxation.

The most common subluxation in children is of the elbow: 

Partial dislocations of the elbow (‘nursemaid’s elbow’ or ‘pulled elbow’) are very common in children aged 1-4 years. A partial dislocation occurs when the elbow end (head) of one of the forearm bones (the radius) comes out of the looped ligament which holds it in place (the annular ligament). The medical term for this is radial head subluxation. This happens easily in children, as they have a rather lax, stretchy ring-shaped (annular) ligament and the “knob” on the head of the radius isn’t fully formed. A tug on the child’s arm can cause it to slip out from the under the ring. This might occur when holding a child by the hand whilst walking. If the child trips without the adult noticing, they can suddenly dangle by the arm. The child will be in pain at first but often doesn’t seem that bothered by it. However they will stop using that arm. The elbow is quite easy for a trained health professional to ‘put back’ in casualty.

How can I prevent joint dislocations?

The prevention of joint dislocations involves:

• Improved strengthening to muscles around joints – for example, through:
• Fitness training and/or physiotherapy.
• A healthy diet.
• Aiming to be the appropriate weight for your height.
• Improved balance, through fitness and through exercises which strengthen the body’s core muscles.
• Minimisation of risk taken during sporting activities – for example, with appropriate equipment and with specific training on technique.
• Seeking medical advice if dislocation becomes repeated (recurrent). There may be a preventative operation which would stop the dislocations.
• In the case of recurrent dislocation, avoiding the activities and positions which tend to cause it.

To prevent specific dislocations:

• Jaw dislocation: in the case of jaw dislocations brought on by yawning, the risk can be reduced by supporting your chin when you yawn.
• Partial elbow dislocation in a child (‘pulled’ or ‘nursemaid’s elbow’): avoid swinging a child by their hands or forearms.

90,000 Joints – Anatomy and Symptoms

Nutrition of the articular cartilage is carried out with the help of the inside of the articular fluid, so there are no blood vessels in it

There are different types of joints:

• saddle
• spherical and
• blocky

This allows us to make a variety of movements.

There are different types of joints: block (knee, ulnar and between the phalanges of the fingers), cylindrical (between the radius and ulna), saddle (metacarpophalangeal joint of the thumb) and spherical (hip and shoulder).

The bones in the joints are covered with dense cartilaginous tissue. The fibers of the ligaments and tendons form a protective sheath around the joint – the joint capsule.

The inner surface of the articular capsule is lined by the synovial membrane.The synovial membrane secretes synovial fluid into the joint space, which nourishes the cartilage.

Articular cartilage covers the ends of the bones and removes minor irregularities. Due to its special structure, the articular cartilage absorbs shock loads.

The range of motion depends not only on the type of joint, but also on the structures surrounding the joint (muscles, ligaments, joint capsule).

Arthritis – joint inflammation

The inner surface of the articular capsule is lined by the synovial membrane.The synovial membrane secretes synovial fluid into the joint space, which nourishes the cartilage.

Diagnostics and treatment

Causes and symptoms of joint problems

Joint pain

Healthy lifestyle

Find out which sport suits you best

Sports and recreation

90,000 Pain in Multiple Joints – Causes, Investigation and Treatment | Symptoms

Fibromyalgia
Signs: No joint inflammation.Chronic generalized pain and muscle tenderness (may involve joints and / or back), fatigue. Rarely, irritable bowel syndrome or sleep disturbances. Usually chronic in nature, often affects women. Often depression or other mood disorders.

Infectious arthritis (caused by viruses)
Signs: Joint pain, with or without inflammation, usually develops within hours or days. Other symptoms of a viral infection (for example, hepatitis B can lead to jaundice, hepatitis C can cause bumps in the legs, HIV infection can lead to swollen lymph nodes).

Juvenile idiopathic arthritis
Signs: Chronic symmetrical joint inflammation in childhood. Pain in the lower back. Enlarged lymph nodes throughout the body or hot flashes. Enlarged liver and spleen. Accumulation of fluid around the heart or lungs. Rash or pain and redness of the eyes.

Other diseases accompanied by joint inflammation (Sjogren’s syndrome and systemic sclerosis)
Signs: Pain in multiple joints, with or without mild swelling.

Rheumatoid arthritis
Signs: Chronic symmetrical inflammation of small and large joints. Fatigue and morning stiffness. The end result is deformity of the joints (especially the knuckles and wrists). Sometimes severe swelling under the skin and carpal tunnel syndrome. Most often among young people, but can occur after 60 years.

Serum sickness (reaction of the immune system to the penetration of large amounts of foreign proteins into the vascular bed)
Signs: Pain and inflammation in multiple joints.Fever, rash, and swollen lymph nodes. With the established fact of exposure to foreign proteins (with blood transfusion) within 21 days before the onset of symptoms.

Syndromes leading to unnatural flexibility of the joints (Ehlers-Danlos syndrome)
Signs: Usually pain in several joints. Joint inflammation is extremely uncommon. Increased laxity (looseness) of the skin. With an established fact of previous recurrent displacements or abnormalities in the alignment of the joints.With the established fact of the disease in family members of the patient.

Systemic lupus erythematosus, autoimmune diseases (polymyositis, dermatomyositis, Sjogren’s syndrome and vasculitis (hemorrhagic vasculitis))
Signs: Joint pain with or without inflammation that occurs when the disease recurs. Other symptoms, depending on the type of autoimmune disease (skin changes, abdominal pain, muscle soreness, kidney disease, fluid around the lungs, heart or other organs, dry eyes and mouth).

Ankylosing spondylitis
Signs: Lesion of large joints. Pain in the lower back in most patients. Redness and pain in the eyes (iritis). Achilles tendonitis. Backflow of blood through the aortic valve (aortic valve insufficiency).

Behcet’s disease
Signs: Chronic or recurrent oral and genital ulcers. Sometimes pain and redness of the eyes. Often starts between the ages of 20.

Gout or similar diseases
Signs: Sudden and severe pain, fever, and swelling (especially around the big toe or knee, but almost any joint can be affected).Sometimes the temperature rises. Often only one joint is affected, but sometimes several.

Infective endocarditis (infection of the inner lining of the heart, usually also heart valves)
Signs: Pain and swelling of the joints. Fever, night sweats, rashes, weight loss, and heart murmurs are common.

Osteoarthritis
Signs: Chronic pain, most commonly in the knee, hip and small finger joints, which may also become enlarged and slightly deformed.Lack of redness. Often pain in the lower back and neck.

Psoriatic arthritis
Signs: Psoriasis (sometimes with few or no skin lesions). Sometimes chronic symmetric joint inflammation. Chronic deformities of fingers, toes and nails. Tendinitis, redness and pain in the eyes.

Reactive arthritis and enteropathic arthritis
Signs: Sudden pain, usually involving the large joints of the legs and feet, often 1-3 weeks after an infection of the gastrointestinal tract (gastroenteritis) or urinary tract (urethritis).Sometimes the spine is affected.

Arthrosis of the knee joint – Clinic M53

Development / Treatment / Injection / Procedure

One of the most common chronic joint diseases. Leads to gradual destruction of the knee joint. Often accompanied by severe pain. A person suffering from arthrosis is deprived of the opportunity to perform habitual physical actions: walking, climbing stairs, walking around an apartment.

If you ignore the symptoms, the disease can cause a number of complications, for example, it can cause curvature of the spine with improper load on the sore knee, and also lead to the fact that the joint completely loses its mobility.

You may have arthrosis if you experience these symptoms:

• pain in the joint itself and surrounding muscles,
• enlargement of the joint in size, anatomical deformities,
• decrease in motor activity in the joint,
• starting pain (short-term severe pain after a period of rest),
• decrease in general physical activity,
• muscle atrophy (“weakening”).

Advice: Do not delay your visit to the doctor!

In advanced cases, treatment does not always help. Then the question arises about endoprosthetics. The damaged joint is replaced with an artificial one. The operation is not shown to everyone, as it can cause various complications and require a long recovery. Therefore, it is important at the first suspicion to visit a doctor and start treatment.

How the disease develops

When a joint is affected by arthrosis, the cartilage that protects the articular surfaces of the bones is destroyed.The joint fluid loses its shock-absorbing properties and the bones begin to “rub” against each other. It is arthrosis that can cause “crunching” in the knees, pain and decreased motor activity.

The causes of arthrosis are individual and can only be determined by a doctor.

Two groups of factors contribute to the development of arthrosis

Unmodifiable – Neither the doctor nor the patient can influence them:

• old age,
• genetic factors, hereditary predisposition,
• female,
• the presence of a weak ligamentous apparatus: the joints have high mobility.A person easily performs stretching exercises, without noticing that he receives injuries that can lead to arthrosis.

Modifiable – the patient can influence factors and cope with the disease or alleviate its course:

• increased body weight,
• low physical activity,
• professional activity and its features,
• injuries that may be accompanied by dislocations, injuries of the menisci, fractures,
• excessive physical activity.Microtrauma is the most dangerous. The person does not feel that he has received damage, which, without proper treatment, can become a serious threat to the joints.

One of the main signs of arthrosis development is joint pain. The intensity of pain does not depend on the stage of development of the disease. Minor pains can accompany a severe degree of arthrosis, and severe pains can accompany a mild one.

Treatment of arthrosis

Almost always requires an integrated approach, when non-drug and traditional methods are combined with pharmacological.

Non-drug methods:

• physiotherapy,
• lifestyle change,
• remedial gymnastics,
• weight loss,
• application of orthopedic products.

Pharmacological methods:

• taking painkillers and anti-inflammatory drugs,
• the use of chondroprotectors – a group of agents that improve the structure of cartilage,
• hyaluronic acid injections.

Correctly selected treatment regimen is the key to a successful result. In a patient who feels relief already in the first stages of treatment, not only the general condition of the joint improves, but also the emotional mood. All this helps the patient to recover faster and easier.

Injection method for the treatment of arthrosis of the knee joint

In order to quickly and effectively stop inflammation in the joints, prevent their deformation and restore mobility, modern medicine, along with other methods, uses injections of preparations containing hyaluronic acid.

Hyaluronic acid is present in almost all tissues of the body, including part of the cartilage and joint fluid, which plays a key role in its nutrition and maintenance of the necessary environment in the joint cavity.

Due to its special structure, hyaluronic acid plays the role of “shock absorber” and “lubricant” in the joint.

In arthrosis, all components of the cartilage tissue are affected and the joint fluid changes.The size of the molecules of its own hyaluronic acid decreases, its concentration decreases, as a result of which the resistance of the joint to physical exertion decreases.

To compensate for the lack of natural lubrication, the doctor may prescribe intra-articular injections containing hyaluronic acid.

The introduction of hyaluronic acid can be recommended by a doctor at:

• osteoarthritis of the knee joint at all stages,
• contraindications to joint replacement or patient refusal from surgical treatment,
• ineffectiveness and intolerance of non-steroidal anti-inflammatory drugs.

Procedure

During the procedure, the doctor treats the skin with an antiseptic, inserts a needle into the joint cavity, removes excess fluid from the joint if necessary, then injects a synovial fluid substitute. The whole procedure takes a few minutes.

Immediately after injection
you can go home.

Important!

Products based on hyaluronic acid differ from each other:

• molecular weight (molecule length), which can vary from 0.4 to 6 million.dalton,
• the frequency of administration of the agent: the duration of the effect varies from 2 to 12 months, depending on the prescribed agent,
• number of injections required during the course of treatment: there are single-dose and multi-injectable products.

To find out about the contraindications for a specific synovial fluid substitute, please contact our specialist rheumatologist. He will help you choose a drug based on your health condition.

90,000 Joint treatment in Barnaul, prices

Restoration of joints without surgery for arthrosis, arthritis, injuries! Live without pain!

• intra-articular drug administration
• intra-articular administration of blood plasma (autoplasmotherapy)
• intra-articular injection of synovial fluid prosthesis (hyaluronic acid)

How to forget about joint pain …

• Joint pains limit your movements and a full life …
• You are worried about discomfort, crunching and systematic pain …
• You may have tried a bunch of medicines, creams and ointments …

Intra-articular injections or injections are a procedure for injecting a drug into the cavity of a large or small joint.It is an integral part of the conservative treatment of inflammatory (arthritis) and degenerative-dystrophic (arthrosis) diseases of the musculoskeletal system. It should be noted that treatment of joints by intra-articular injections is not prescribed for all patients. Their use has strict indications and is prescribed by a doctor depending on the specificity and severity of the pathology.

Do not be afraid of injections into the joint – the procedure for administering the drug is not much different from intramuscular or intravenous injections and does not cause much discomfort.

But the benefits of such therapy, if used correctly, can be significant – it will allow you to continue treatment with other methods, stop the development of joint disease, help avoid surgery or postpone surgery. For injections in medical practice, corticosteroids, chondroprotectors and hyaluronic acid preparations are used. Most often, drugs are injected into the knee, shoulder, and hip joints.

Intra-articular glucocorticoid injections

Injections of hormonal drugs, which include glucocorticoids, have been used in rheumatology and orthopedics for a long time.

This is one of the most common treatment options for arthritis that cause inflammation and pain that cannot be blocked by other drugs. In addition, hormonal injections are used for arthrosis, which occur with symptoms of synovitis – inflammation of the synovial membrane of the joint with the accumulation of fluid (effusion) in its cavity.

Without eliminating the pathological process, it is impossible to start other methods of conservative therapy, such as taking chondroprotectors, physiotherapy, massage or physiotherapy exercises.
Glucocorticoid injections are used as symptomatic therapy to eliminate the inflammatory response and pain, but are not a means to influence the true cause of the disease.

Introduction of chondroprotectors

Chondroprotectors are medicinal substances that are used to treat arthrosis, mainly at stages 1 and 2 of the development of the disease. In the advanced 3 stage of the disease, with the complete destruction of the cartilaginous tissue, the drugs of this group are ineffective.

Chondroprotectors belong to the means of etiological therapy – they act on the cause of the pathology, which has a lasting positive effect and stop the progression of the disease. They participate in the metabolic processes of cartilage, help restore its elastic properties and elasticity, cause the normal flow of water and nutrients into the joint tissues, and activate blood flow.

The use of injections into the joint allowed the drug to be delivered directly to the cartilage tissue, which significantly accelerated its action and increased the effectiveness of the therapy.

One of the most popular chondroprotectors for intra-articular administration is the drug alflutop, which contains glucasamine and chondroitin sulfate. It is synthesized from sea fish concentrate, therefore it is a natural medicine. At the beginning of therapy, 5-6 injections into the joint are prescribed at intervals of 6-10 days, and then the drug is injected intramuscularly. There are at least 20 procedures per course of treatment. Thanks to annual courses of therapy, intra-articular cartilage is restored, the synthesis of synovial fluid is improved, pain is eliminated and motor activity is normalized.

Hyaluronic acid injections

Intra-articular injections of hyaluronic acid preparations, which are also called “liquid prostheses”, are considered one of the most innovative and effective methods of treating osteoarthritis today.

Sodium hyaluronate is a natural component of synovial fluid, which prevents friction of the bones in the joints, provides physiological movements of the joint without pain and limiting the amplitude. Hyaluronic acid injections restore the composition of the synovial fluid, thereby preventing the progression of arthrosis and eliminating its clinical manifestations.

Intra-articular injections with drugs of this group are prescribed at any stage of the pathological process. They are considered the best injections to combat degenerative-dystrophic diseases of the musculoskeletal system. Once in the joint, hyaluronic acid envelops the articular surfaces of the bones, improves cartilage nutrition, and normalizes metabolic processes in the tissues of the joint. Most often, drugs are injected into the hip, knee, shoulder joints, but injections can also be used for smaller joints: ankle, wrist, elbow.Thanks to therapy, it is possible to avoid surgical intervention for prosthetics of large joints or to postpone the operation for a long time.

90,000 Treatment Deforming arthrosis of the knee joint (gonarthrosis)

Osteoarthritis is a chronic progressive joint disease characterized by damage to the articular cartilage, followed by changes in the bone, synovium and ligaments. The disease develops at the age of 40-50 years, and women get sick twice as often as men.

SYMPTOMS OF OSTEOARTHROSIS

• Joint pain: pain occurs when the pain is exerted on the diseased joint, when walking, it decreases at rest.Evening and night pains after daytime stress are characteristic. Sometimes joint pain increases under the influence of meteorological factors (low temperature, high humidity and atmospheric pressure, etc.), which cause an increase in pressure in the joint cavity.
• Joint stiffness: in osteoarthritis, joint stiffness lasts up to 30 minutes, in contrast to rheumatoid arthritis (more than an hour).
• The appearance of a crunch in the joints
• Swelling of joints
• Formation of nodules in the interphalangeal joints of the hands (Heberden’s or Bouchard’s nodules), leading to persistent deformation of the small joints of the hands and metatarsophalangeal joints of the first toes
• Difficulty walking up stairs, especially when going downhill

CAUSES OF OSTEOARTHROSIS

• hereditary predisposition
• overweight
• excessive loads on joints
• some sports: athletics, barbell, football
• joint injuries
• other diseases.

WHAT JOINTS ARE DAMAGED IN OSTEOARTHROSIS?

In osteoarthritis, any joints of a person can be damaged, but most often the knee, hip, shoulder, hand joints, ankle joints are damaged.

DIAGNOSTICS OF OSTEOARTHROSIS

• assessment of clinical symptoms by a doctor
• X-ray of changed joints
• MRI of joints
• Ultrasound of joints

TREATMENT OF OSTEOARTHROSIS

1. Conservative treatment: tablets, ointments, injections, injections into the joint
2. Surgical treatment: arthroscopy, joint replacement
3. Physiotherapy: magnetotherapy, ultrasound therapy, electrotherapy, shock wave therapy

TREATMENT OF OSTEOARTHROSIS IN OUR MEDICAL CENTER

Conservative treatment

Long-acting glucocorticoid injections (diprospan, depot-medrol).

Intra-articular administration of hyaluronic acid preparations.

Intra-articular injections of platelet-rich plasma (growth factors) is the modern and most effective method of treating osteoarthritis. The high effectiveness of this method of treatment is due to the action of growth factors – special molecules that play a fundamental role in the healing process of injuries to muscles, ligaments, tendons and bones. Growth factor injections not only reduce pain and inflammation, but, most importantly, trigger the regeneration of damaged tissues, stimulate the synthesis of components necessary for healing and restoration of tissue structure, restore integrity and strengthen the strength of muscles, ligaments, tendons, and bones.

How are growth factor injections performed at our medical center?

Production of platelet-rich plasma (growth factors) takes place directly in our medical center. For this, 20 ml of the patient’s blood and a special centrifuge are used. Blood is taken in special tubes, which are immediately placed in the apparatus.

From 20 ml of blood drawn, about 5 ml of platelet-rich plasma is obtained, ready for administration to a patient.

The cycle of preparation of the drug is closed, which excludes contact of blood with the external environment, and, therefore, any infection.Next, the doctor injects the resulting plasma directly into the damaged area to the patient. In our medical center, the injection of platelet-rich plasma takes place under the obligatory ultrasound control for a more accurate entry into the damaged tissue.

All intra-articular administration of drugs in our medical center is carried out strictly under the control of ultrasound, which guarantees accurate entry into the joint cavity and the introduction of the optimal dose of the drug.
Intra-articular insertion is performed by highly qualified orthopedists with extensive experience, in sterile conditions and in compliance with all safety rules for the patient.

If conservative treatment does not give the desired result and the symptoms of the disease increase, then the only way out for the patient is surgery.

Surgical treatment

Our medical center uses “minimally invasive” surgical techniques. “Minimally invasive” techniques are low-traumatic operations that do not require large incisions or opening of the joint, as in conventional surgery. Local mini-punctures are carried out in the joint area up to 1 cm in size, which allows less trauma to the patient and significantly shortens the period of hospital stay.

Among such minimally invasive methods, arthroscopic joint debridement occupies a special place. The essence of the method is to “clean” the joint under arthroscopic control. After several punctures, the destroyed parts of the articular cartilage, “split off” parts of the bone and other inflammatory elements are removed from the joint. Most often, this operation is used in the early stages of the disease.

Another method of surgical treatment that we use is corrective osteotomy. Compared to arthroscopic “cleaning” of the joint, the effectiveness of osteotomy is generally higher.When performing this operation, the bones are sawn with a special tool and fixed again at a slight angle, restoring the correct axis of the limb. As a result, the distribution of mechanical loads in the diseased joint changes, which leads to a significant decrease in pain, improved mobility in the joint, and a slowdown in the progression of osteoarthritis.

In more advanced stages of osteoarthritis, joint arthroplasty is performed in our medical center.

Physiotherapy

Physiotherapy significantly enhances the effect of other treatments, reduces the risk of complications after surgery, and helps to shorten the recovery period.In our center, procedures such as magnetotherapy, ultrasound therapy, electrotherapy, and shock wave therapy are available.

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Why do joints hurt?

Why do joints hurt?

The human joint is a movable connection of bones to each other, consisting of several structural elements, the function of which is painless free movement. Some of the most common causes are trauma, disease, or degenerative processes.

In case of injury, a person usually experiences pain, which until that moment did not bother him. Traumatic injury to at least one element of the joint is often the cause of severe inflammation, which is accompanied by pain and dysfunction of the joint.

The second cause of pain is a degenerative process, which in the medical environment is called “arthrosis of the joint.” The changes occurring in the joints are associated with a deterioration in the blood supply to the cartilage tissue. The older a person is, the less nutritious his articular cartilage receives, which leads to their gradual thinning and loss of elasticity.The result is damage to the articular cartilage, which occurs on its surface even with a slight load.

Another common cause of joint pain is arthritis – this is a whole group of dissimilar diseases that are united by one symptom – inflammation of the joint tissues. Arthritis can be caused by infectious and systemic diseases, as well as metabolic disorders.

Signs of arthrosis and arthritis

Signs of arthrosis

Arthrosis of the joint is characterized by a gradual increase in symptoms, the main of which are pain and stiffness.A person may not pay attention to minor joint pain and morning stiffness for a long time. However, at this time, irreversible changes occur in the joint, which in the future can lead to the appearance of persistent pain.

Signs of arthritis

For various types of arthritis, a number of common symptoms are characteristic: an increase in temperature in the area of ​​the affected joint, the appearance of edema and redness of tissues in the projection of the joint. It is also characterized by the appearance of sharp pain in one or more joints, depending on the spread of the disease.

Pain can cause a number of other diseases:

Due to pain in the joints, gait changes, overloading the muscles unevenly, as a result of which they weaken.

Painful overstrain appears – hypertonicity.

Due to a violation of the biomechanics of walking, the work of other joints is disrupted – the pelvis, spine, etc.

Can joint pain be cured?

Treatment of joint pain, regardless of its cause, requires an integrated approach to achieve a speedy recovery.The most common treatments include:

• anti-inflammatory drugs
• physiotherapy
• physiotherapy exercises
• manual technicians
• use of special orthopedic products – bandages.

Like the above methods, orthotics (including the use of elastic bands) are widely used to treat joint pain. The advantage of using modern and high-quality bandages is the absence of side effects and restrictions on the duration of use.Moreover, patient surveys have shown that the use of bandages can reduce the duration and / or dose of pain relievers taken.

How to prevent the development of diseases?

More than half of people over 40 years of age regularly experience joint pain, including the joints of the spine. After 70 years, the proportion of people with diseased joints increases to 90%. Prevention is better than cure, so it’s better to take care of protecting your joints, which are regularly stressed, in advance, which will help prevent problems in the future.

Young people who play sports are also at risk, as they are most susceptible to recurrent joint pain. This is due to excessive physical exertion, which exceeds the physiological potential of the articular cartilage and causes its accelerated degeneration.

Bandages can be used to prevent joint pain – they prevent joint inflammation during prophylactic use and allow you to immediately start treatment in case of an existing chronic problem.During movement, the bandage has a compressive and micromassage effect that helps to eliminate edema and improve local blood circulation.

Medi bandages – the best solution for joint pain

The bandage is a medical device that helps to cope with pain and swelling in the joint area. It is important to choose a quality bandage at the very beginning of the disease. The German company medi GmbH & Co, KG has been developing its own quality orthopedic products since the 1980s.Medi’s goal is to create effective medical devices to maximize the quality of life. That is why medi orthopedic products are created in close collaboration with medical practitioners, rehabilitation specialists and experts in the field of human biomechanics.

Effective bandage has a triple effect:

• compression (anti-edema)
• micromassage (blood flow intensification)
• stabilizing joint (limiting excessive or painful mobility).

The compression properties of the knitted fabric allow medi braces to maintain the target pressure level on the joint area throughout the entire period of use. Due to the precise calculation of the compression level, the bandages provide an effective and safe therapeutic effect.

Especially for active people striving to combine sport and fashion, as well as for professional athletes, medi has created a sports line of E + motion bandages. The bandages of the E + motion range are distinguished by an innovative technology of knitting from yarns of increased elasticity, which applies even pressure on the joint, improving blood circulation and tissue nourishment, while giving a feeling of complete freedom of movement.This is especially important for athletes who cannot and do not want to restrict freedom of movement both during training and during sports.

Action of medi bands

Compression tissue creates and maintains a distributed pressure on the joint area throughout the day. Thanks to this, edema decreases much faster, and conditions are created that prevent its occurrence. With regular use of the bandage, the swelling does not recur. The compression effect of the bandage tissue enhances proprioceptive sensitivity – muscular-articular feeling, due to which the work of the muscles surrounding the joint is clearly coordinated, which additionally stabilizes it.Compression also helps activate weakened muscles.

Soft embossed silicone inserts of medi bandages have a micro-massage effect, which improves blood microcirculation in the joint tissues. This increases the supply of oxygen, nutrients and bioactive molecules to inflamed tissues, which reduces pain and speeds up their recovery. This action is best shown when the joint is in motion.

Soft silicone inserts in some bandages also have a stabilizing effect.For example, in the Epicomed elbow brace, silicone inserts act on specific areas of the tendons, reducing the tension on the tendons in the inflamed area of ​​the bone.

The Lumbamed line of lumbar braces includes metal spring-loaded stiffeners that can be modeled according to the individual anatomy of each individual. They stabilize the spine and limit excessive motion in the intervertebral joints, which can lead to painful movements, such as overextension of the lumbar spine or forward tilt of the pelvis.Thus, the spring-loaded stiffeners help to relieve the lumbar spine. They also help relieve excess tension in the muscles of the back (in medical terminology called “hypertonicity”), helping to reduce pain and increase motor activity.

The medi bandages combine all three of the above effects to achieve maximum therapeutic effect when used.

Why medi?

Only due to the high level of comfort a person can and will wear a bandage all day long.A significant therapeutic effect when using a bandage is possible if it is used regularly. A high level of comfort when using medi bands is achieved through the use of our own innovative tying technologies.

Optimized Comfort Zones eliminate the possibility of coarse folds of material that can chafe the skin at the point of contact, thanks to a special knitting in the anatomical fold zones, which takes into account the relief of a particular joint.

The innovative medi patented Clima Comfort bandage technology, made from unique breathable materials, maintains optimal moisture and temperature balance of the skin at any time of the year. The porous structure of the material is well permeable to air, allowing the skin to breathe normally, so that a person always feels comfortable when using a bandage.

To prevent the appearance of unpleasant odors under the fabric of the product associated with the growth of bacteria and fungi, the medi bandages use the patented Clima Fresh technology.The introduction of silver ions safe for humans into the fiber structure prevents the multiplication of microorganisms and the appearance of an unpleasant odor. As a result, the risk of an inflammatory reaction of the skin is significantly reduced with prolonged use of the bandage.

In addition to the comfort in use, the medi bandages are distinguished by the convenience and functionality of use. The design of medi braces is thought out to the smallest detail and includes only those elements that are necessary for the treatment of pain in this particular joint.

Also, the products are provided with elements that guarantee an optimal fit of the bandage on the joint throughout the day. For example, the Genumedi range of knee braces have an anti-slip system that prevents the brace from dropping and rolling during physical activity.

Another unique feature of medi bandages is their durability, which becomes possible due to the content of a large number of compression threads per unit area in the fabric of the product (80 threads per 10 cm of bandage fabric).This reduces the specific load on each of the yarns, ensuring wear resistance.

Modular design implies the ability to use one product at different periods of the disease (acute, subacute, remission). The first multifunctional modular bandage was the Lumbamed disc: this bandage has the ability to install metal plates of varying degrees of flexibility, which can be used in different phases of the disease along with the supplied plastic splint.

Standards and certificates

The safety guarantee of medi bandages is ensured by compliance with strict international standards and requirements.

DIN EN ISO 9001: 2000

Compliance with this standard means that medi products undergo quality control at all stages of production.

Oeko-Tex Standart 100

Standard defining the ecological quality of textile products. This guarantees the absence of allergic reactions in people who use medi orthopedic products on a daily basis.

Rostest

All medi orthopedic products are certified on the territory of the Russian Federation to confirm compliance with Rostest standards.

In order to facilitate the choice of a product and resolve related issues, medi orthopedic salons offer the service “Free consultation with a specialist in orthotics”. A specialist will not only recommend a suitable product, but will also help with the selection of the size, adapt the product to individual parameters, and advise on maintenance and operation. To register, choose a convenient time by filling out the form below.
If you do not have the opportunity to visit a salon to select a product, use the service “Individual selection of orthopedic products at home or in a medical institution.”

90,000 Treatment of arthrosis and bursitis of the joints

Peculiarities of diseases

Arthrosis of the joints is a degenerative-dystrophic disease. As a result of its development, the bone surface covered with cartilaginous tissue is affected. Bursitis is an inflammatory pathology. It develops in the joint capsule (the mucous membrane of the capsule that nourishes, moisturizes, and cushions the joint).

Diseases differ in that bursitis mainly affects the elbow and shoulder joints, and arthrosis – mainly the kneecaps and large hip bones.

Causes of occurrence

Both arthrosis and bursitis develop mainly in elderly patients. They are often the result of joint dysplasia (congenital abnormalities).

Bursitis is often the result of trauma. Less commonly, it develops against the background of mechanical damage to the joints during sports and heavy physical labor. Negative factors are gout, rheumatoid arthritis and other diseases. Arthrosis manifests itself as a thinning of the cartilage tissue.

Symptoms

Common signs of pathologies include:

• Pain syndrome
• Reduction of the amplitude of rotation of the joint
• Swelling in the damaged area

Osteoarthritis is almost never accompanied by inflammation, while bursitis is an exclusively inflammatory disease. Therefore, it is characterized by a local and general increase in body temperature.

Diagnosis of pathologies

Diagnosis of pathologies is prescribed by a doctor – orthopedic traumatologist.At the first stage, anamnesis is collected and the patient is examined. The doctor determines the time of onset of symptoms, the degree of their severity and other features of the course of the disease. Usually, the diagnosis can be made immediately.

Instrumental and laboratory diagnostics reveal inflammation in bursitis, as well as other features of the pathological process.

Typically patients:

• Take a blood test
• Undergo fluoroscopy, ultrasound and magnetic resonance imaging

To determine the type of bursitis, for example, a doctor may prescribe a puncture of the contents of the articular cavity.To confirm the diagnosis and differential diagnosis, arthrography and CT of the joint are performed. These additional examinations, in contrast to the standard X-ray and ultrasound, allow you to get a complete picture of the disease.

If necessary, the patient is referred to specialists of narrow profiles (immunologist, endocrinologist, etc.).

Treatment

Conservative therapy

As a rule, such treatment is aimed at relieving pain and inflammation.It does not allow to eliminate the cause of the pathology. Patients are prescribed analgesics, non-steroidal anti-inflammatory drugs, muscle relaxants, corticosteroids, etc. The drugs are used not only in the form of tablets and capsules. Prescribed and means for external use in the form of ointments, gels, rubbing, etc.

In case of severe pain syndrome in arthrosis and bursitis, the blockade method of therapy is relevant. It involves the introduction of an anesthetic drug directly into the focus of pain (trigger points of the joints, as well as the plexus of nerve endings).

Physiotherapy is also prescribed to patients. It allows you to relieve morning stiffness in the joints, provide micromassage and the necessary tissue nutrition.

Particular attention is paid to exercise therapy. Special programs are developed by experienced doctors, taking into account the patient’s condition, his individual characteristics and the stage of development of the pathological process.

In some cases, they resort to manual therapy. Special techniques for such treatment use reflex mechanisms that improve metabolic processes in the joints and slow down tissue destruction.In addition, therapy is aimed at relieving pain and starting recovery. As a preparation before treatment, massage is used, which helps to warm up the muscles and relieve general tension.

Operational interventions

They are carried out in advanced cases and only when conservative therapy does not give the desired result or is inappropriate. When performing interventions, special attention is paid to modern minimally invasive techniques. They make it possible to quickly recover and reduce the risk of dangerous complications.Many patients can return to activity within a few days after surgery.

Advantages of contacting MEDSI

• Experienced doctors. Our specialists diagnose and treat arthrosis and bursitis at various stages. They successfully relieve patients from the symptoms of diseases and prevent the risks of their further development. Thanks to this, patients can quickly return to their usual life
• Advanced equipment for early diagnosis. The examinations carried out by us allow us to make a diagnosis in the shortest possible time and quickly begin an adequate treatment
• Possibility of effective therapy. It is carried out using both traditional and innovative techniques and tools. If necessary, patients are admitted to a clinic in Moscow. This allows for effective surgical therapy using modern minimally invasive technologies

If you are planning to undergo treatment for arthrosis or bursitis in our clinic in Nizhnevartovsk, call +7 (3466) 29-88-00.