Are you experiencing pain or stiffness in your fingers? Such pain or stiffness could represent symptoms of osteoarthritis.
Osteoarthritis is a degenerative joint disease. Sometimes, osteoarthritis can affect your hands. When you have it in your hands, you may develop Heberden’s nodes. This condition is usually one of the most obvious signs that a person has osteoarthritis in their hands.
Heberden’s nodes are bony swellings that form on the hands as a result of osteoarthritis. They were named after physician William Heberden, Sr. He was a doctor in the 1700s and came up with an explanation for these enlargements that form on the hands.
These bony growths are generally found on the finger joints nearest the fingertip, also called the distal interphalangeal or DIP joints. Similar joint swellings located on the lower joint, the proximal interphalangeal or PIP, are called Bouchard’s nodes.
Osteoarthritis typically occurs in the spine, knees, hips, or fingers. This happens because these locations, in particular, have cushiony cartilage in the joints protecting the surface of the bones. Osteoarthritis may occur due to the wear and tear that comes with aging or as a result of an injury.
In the case of Heberden’s nodes, enlargements and a general crookedness occur in the finger joints as the softening cartilage begins to disintegrate or wear away. The cartilage eventually becomes coarse. Instead of the bone being protected by cartilage, the bones begin to rub against each other. This process destroys the existing bone and often causes significant pain. As the cartilage continues to break down, new bone grows alongside the existing bone in the form of nodes.
By the time the nodes appear, the fingers may have become stiff and the pain may have lessened. Since Heberden’s nodes occur after obvious and serious joint damage, they are often viewed as a marker of advanced osteoarthritis.
Signs and Symptoms
Heberden’s nodes are clearly viewed by examining the end joints on your fingers. Tiny bone outgrowths may extend from the knuckle closest to the fingernail. In many cases, an individual’s fingers may twist or become crooked as the nodes form.
- loss of motion
- stiffness at the location of the node
Some cases of Heberden’s nodes may be asymptomatic with only mild or very few symptoms.
If you have Heberden’s nodes, you may have difficulty performing some tasks that require gripping or pinching, like turning the key in your car’s ignition or uncapping a soda bottle.
You may feel limited in your daily activities, and it may be hard to complete tasks for work or household chores. This may cause you to experience mental health issues such as depression and anxiety.
Osteoarthritis is the most common type of arthritis. It affects more than 20 million people in the United States. It’s more common among the elderly, but it can sometimes occur in people in their 40s or even younger. Women are affected more often than men. In fact, 10 women to every one man have osteoarthritis.
You’re also more likely to get Heberden’s nodes if you have a family history of them. Being clinically obese is also a risk factor. If you participate in a sporting activity or have a physically demanding job, your risk increases as well.
Other risk factors include:
- heredity conditions, like malformed joints
- diseases that involve abnormal cartilage changes, like rheumatoid arthritis and gout
There’s currently no cure for osteoarthritis or its associated conditions. Treatment for Heberden’s nodes may vary.
Treatment aims to:
- relieve pain
- restore joint function
Your treatment options will vary depending on your medical history and current medications.
Exercise is one of the most effective treatments for osteoarthritis. Physical activity can reduce pain and improve strength and flexibility. Being active may also help with feelings of depression that may accompany this condition.
Your doctor will help determine the appropriate amount and types of exercise you should engage in to maintain health and manage this disease.
You may need physical therapy to help you learn new methods of performing daily activities due to limited motion or stiffness in the fingers. These alternative methods are directed at controlling excess pressure and pain.
If you are overweight or obese, your doctor may also encourage a change in diet. You may be referred to a dietitian who can assist you in developing healthier eating patterns that can help you lose weight, which will increase your ability to move around.
Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin or ibuprofen may help treat pain and inflammation. Many people take NSAIDs without side effects. However, NSAIDs can have serious side effects such as heart failure, kidney damage, and intestinal bleeding. COX-2 inhibitors are another type of NSAIDs. They have fewer side effects, but are more expensive than aspirin or ibuprofen.
Over-the-counter gels or creams may also help eliminate discomfort. Additionally, your doctor may give you a corticosteroid injection. This can provide long-term relief for joint pain.
Other pharmacological treatment may include antidepressants to help alleviate sadness or feelings of hopelessness associated with osteoarthritis.
Surgical treatment is typically used as a last resort after conventional treatment options have proven unsuccessful, and it’s rarely done.
Surgical treatments for managing Heberden’s nodes and osteoarthritis generally involve:
- removing excess bone growths
- joint reconstruction
- joint fusion, which fuses the bone to the joint and reduces motion in the problem finger
Seeing Your Doctor
Before beginning any treatment, you will need to see your doctor for a thorough examination. Your doctor will assess your medical history and medications and give you a physical exam.
If you’re an older adult, your doctor will likely perform a differential diagnosis to determine if any co-occurring diseases are present. A combination of clinical history, physical examination, laboratory findings, and imaging techniques can help your doctor diagnose this condition.
After diagnosis, your doctor will provide information about the disease and implement a treatment plan specifically for you.