Heberden’s nodes are swollen, tender protrusions of bone and cartilage tissue that develop in finger or toe joints. They are a consequence of osteoarthritis, and often one of the first signs of the degenerative joint disease. In most cases, nodes develop gradually over several months or years, but the acute onset of pain and swelling is possible. While there is not a cure for osteoarthritis, taking anti-inflammatory drugs and avoiding putting too much stress on the fingers can help relieve symptoms. Surgery may be necessary if Heberden’s nodes significantly impair a person’s ability to manage daily tasks.
The distal interphalangeal joints, the last joints in the fingers and toes, are susceptible to Heberden’s nodes. They are often accompanied by protrusions in the middle joints as well, known as Bouchard’s nodes. It is unclear exactly why the nodes develop or what triggers the underlying osteoarthritis disease, but doctors believe that a combination of genetic and environmental factors are responsible. People with family histories of arthritis are more likely to develop problems at some point in their lives. Wear-and-tear on the finger joints may also contribute to the onset of this condition.
A developing node is characterized by mild swelling on one or both sides of a finger joint. Over time, swelling worsens and the protrusion becomes hard and tender to the touch. Heberden’s nodes can cause stiffness in the fingers that limits the hand’s range of motion. Constant pain and progressive weakening of the fingers can make even the simplest activities such as typing or gripping a pen very uncomfortable. Most people who have osteoarthritis in their fingers or toes also experience pain in their knees, hips, wrists, and ankles, though symptoms may be less noticeable in other joints.
An individual who experiences worsening pain and swelling in his or her fingers should visit a doctor. A specialist can physically inspect the fingers and order x-rays to study the internal structure of the joints. X-rays may reveal damaged or deteriorated cartilage and unusual bony projections. The doctor may also decide to perform blood tests or extract a sample of joint fluid to rule out other types of arthritis and other possible causes of joint swelling.
Once a diagnosis has been made, the doctor can explain different treatment options. Most patients are instructed to take anti-inflammatory drugs when their symptoms are the worst and try to avoid using sore fingers as much as possible. If swelling is severe, a physician can inject a corticosteroid directly into a joint to bring down swelling and numb pain. Persistent Heberden’s nodes can be treated surgically by excising the protrusion and realigning the joint.