Until our hands begin to become painful we rarely think about the activities they perform. The joints of your hands are smaller than your knees or shoulders, allowing us to reach into tight spaces, pinch, and manipulate objects. Your joints are supported by ligaments which connect bone to bone and stop the joints from moving into directions they shouldn’t go. They provide support for the joint, allowing the muscle to move the joint correctly. Throughout our lifetime joints can be stressed during activities like carrying a grocery bag, wringing out a washcloth, or twisting off a bottle cap. These activities can stretch ligaments and wear out cartilage in your joints resulting in inflammation and pain. There are simple strategies you can use to protect your joints which will reduce pain during daily tasks.
A Boutonnière deformity is when the finger or thumb is bent down at the middle joint and bent backwards at the end joint (see photo above). This deformity can happen for a couple of different reasons, including:
- A cut tendon on the back of the finger or thumb
- Tearing or weakening of the tendon from a disease such as rheumatoid arthritis
These two reasons are what can cause the middle joint to bend down. The backwards bending of the end joint is caused after the middle joint bends because there is more pull on the end joint of the finger.
Joints are cartilage surfaces that connect bones to each other. This cartilage allows our bones to glide smoothly against one another, allowing us painless movement. There are four joints in each finger, totaling 20 joints in each hand!
The small, ringer, middle and index fingers all have the same four joints:
- Distal Interphalangeal Joint (DIP): The DIP joint is located at the tip of the finger, just before the finger nail starts. Arthritis can develop at this joint, and it is also commonly fractured.
- Proximal Interphalangeal Joint (PIP): The PIP joint is the joint just below the DIP joint. It is located below the top two bones of the finger and allows the finger to bend and extend. This joint can become stiff easily after injury.
- Metacarpophalangeal Joint (MCP): The MP joint is where the hand bone meets the finger bone, referred to as the “knuckle.” These joints are very important, allowing us to bend/flex and spread our fingers.
- Carpometacarpal Joint (CMC Joint): The CMC joint is located at the bottom of the hand bone. This joint varies in each finger. For example, in the index finger, it has little motion. In the small finger, it has a lot of motion. Injuries and problems with this joint are uncommon.
The thumb joints are a little different than the other finger joints. To learn more about the thumb joints and more about the finger joints, visit our online Anatomy section.
Joint replacement surgery is a procedure in which bone and structures that line the joint are removed and replaced with new parts. This procedure is necessary when the articular cartilage (the substance on the surface of a bone) wears out or is damaged, which means the bones will no longer glide smoothly against one another. It may also stem from abnormal joint fluid.
The new parts may be made of metal, plastic, or materials that are carbon-coated. They allow the joints to move again without pain, increase range of motion, and can improve the look of the joints. Finger joints, knuckle joints, and wrist joints are commonly replaced.
After joint replacement surgery, you will most likely work with a hand therapist and could possibly wear a splint. However, with this procedure, there are always risks. There could be an infection, or the implant could fail, causing more joint pain. The implant could also wear out over time, resulting in the need for another surgery. In addition, vessels, nerves or other structures near the surgery site could be damaged. Talk to your doctor about the risks of joint replacement surgery before agreeing to the procedure.
The wrist joints lie between the many different bones in the wrist and forearm. Many wrist injuries (such as fractures, also known as a broken bone) involve the joint surface. There are three joints in the wrist:
- Radiocarpal joint: This joint is where the radius, one of the forearm bones, joins with the first row of wrist bones (scaphoid, lunate, and triquetrum).
- Ulnocarpal joint: This joint is where the ulna, one of the forearm bones, joins with the lunate and triquetrum wrist bones. This joint is commonly injured when you sprain your wrist. Some people are born with (or develop) an ulna that is longer than the radius, which can cause stress and pain on the joint, known as ulnocarpal abutment (impaction) syndrome.
- Distal radioulnar joint: This joint is where the two forearm bones connect. Pain with this joint can sometimes be a challenging problem to treat.
Learn more about the joints of the wrist and also the bones of the wrist in our Anatomy section. You can also visit www.HandCare.org for information on conditions and injuries of the hand, wrist, arm and shoulder.
Dr. David J. Bozentka answers your questions about MP joint arthritis.
What is the MP joint?
The metacarpophalangeal (MP) joint is the large knuckle joint located where the fingers and thumb meet the hand (Figure 1). The metacarpal bones lie within the palm and the phalanges lie within the digits. The metacarpal head, or ball part of the MP joint, meets with the proximal phalanx which makes up the socket part of the joint. The bones on each side of the joint have a cartilage surface that allows smooth gliding. Multiple tendons cross this joint. Flexor tendons and small additional tendons in the hand promote flexion, or bending. The extensor tendons promote extension, or straightening, of the joint. A collateral ligament on each side of the joint provides stability for a pinching motion. The bones, ligaments, and tendons of the MP joint allow motion and stability for optimal hand function.
For this post, we are sharing a video that demonstrates many techniques you can use on a daily basis to protect your joints. In past posts, we’ve discussed joint protection and gave some examples and illustrations of this. (See Protecting Your Joints and Living With(out) Thumb Pain.)
The video below shows some of those examples in action. The video has no sound, so don’t worry about turning up the volume. As you watch, you will be given some practical pointers. There are some questions in the video, so put on your thinking cap and see what ideas you come up with to take care of your joints.
After watching the video, you may have questions about specific activities and how to make changes to decrease your joint pain. Talking to a certified hand therapist can help you apply these principles to your specific activities, which can help you to keep doing what you want in life.
(CNN) – For the past 15 years, Tanya Johnson has been driving her boss nuts.
It’s not her job skills — Dr. Robert Szabo says Johnson is an excellent nurse — but rather her incessant knuckle-cracking that makes him want to strangle her.
“I kept telling her to stop, that it was bad for her,” Szabo said.
You’d think Johnson might have listened, given that Szabo is a hand surgeon at the UC Davis Medical Center and former president of the American Society for Surgery of the Hand.
But she just kept right on cracking.
“I told him, ‘Prove that it’s bad,’ ” she said.