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What Are Heberden’s Nodes?

Osteoarthritis

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.

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Heberden’s nodes

Heberden’s nodes

Heberden’s nodes are bony swellings that form on your hands as a result of osteoarthritis. They were named after physician William Heberden, Sr., a doctor in the 1700s. He came up with an explanation for these swellings.

These bony growths generally occur on the finger joints nearest the fingertip, also called the distal interphalangeal joints. Similar swellings located on the lower joints, or the proximal interphalangeal joints, are called Bouchard’s nodes.

Causes

How Heberden’s nodes form

Osteoarthritis typically occurs in the spine, knees, hips, or fingers. These locations in particular have cushiony cartilage in the joints that protects the surface of your bones. Osteoarthritis may occur due to the wear and tear of cartilage in these areas that comes with aging or as a result of an injury.

In the case of Heberden’s nodes, swellings and a general crookedness occur in your finger joints as the softening cartilage begins to disintegrate or wear away. The cartilage eventually becomes coarse and can’t protect your bones, which 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, your fingers may have become stiff, and the pain may have lessened. Heberden’s nodes occur after obvious and serious joint damage, so they’re often viewed as a marker of advanced osteoarthritis.

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Signs and symptoms

Signs and symptoms of Heberden’s nodes

If you have Heberden’s nodes, you can clearly see them by examining the end joints on your fingers. Tiny bone outgrowths may extend from the knuckle closest to your fingernail. In many cases, your fingers may twist or become crooked as the nodes form.

Symptoms include:

  • loss of motion
  • pain
  • swelling
  • stiffness at the location of the node

Some cases of Heberden’s nodes may be asymptomatic, or only cause mild or 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.

Risk factors

Risk factors

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 by Heberden’s nodes and Bouchard’s nodes more often than men. In fact, women with osteoarthritis are 10 times more likely to develop these nodes than men.

You’re also more likely to get Heberden’s nodes if you have a family history of them. Obesity is also a risk factor. If you participate in sports or have a physically demanding job, your risk increases as well.

Other risk factors include:

  • hereditary conditions, like malformed joints
  • diseases that involve abnormal cartilage changes, like rheumatoid arthritis and gout
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Treatment

Treatment options

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 depend on your medical history and current medications.

Lifestyle changes

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 occupational therapy or physical therapy to help you learn new methods of performing daily activities due to limited motion or stiffness in your fingers. These alternative methods are directed at controlling excess pressure and pain.

If you’re 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. This will increase your ability to move around.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin (Bufferin) or ibuprofen (Advil), 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 medications may include antidepressants to help alleviate sadness or feelings of hopelessness associated with osteoarthritis.

Surgery

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:

  • removal of excess bone growths
  • joint reconstruction
  • joint fusion, which fuses the bone to the joint and reduces motion in your finger
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See your doctor

Seeing your doctor

Before beginning any treatment, you 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 try to determine if you have another condition with similar symptoms. 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.

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