Heberden’s nodes are bony swellings that form in the joints of the hand. They most commonly occur in people with osteoarthritis as a result of friction and wearing away of cartilage in finger joints.
Osteoarthritis is a clinical condition that damages multiple joints, including the ones in the hand.
Osteoarthritis causes pain, swelling, stiffness, and deformation of joints. When osteoarthritis affects the hands, it typically leads to the formation of Heberden’s nodes.
What are Heberden’s nodes?
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Heberden’s nodes are bony swellings that form on the hands of many people with osteoarthritis. They often occur on the distal interphalangeal joints, which are the finger joints closest to the fingertip.
Heberden’s nodes are generally firm and may cause pain when touched. They are common in individuals who have osteoarthritis of the hand.
What causes them?
Osteoarthritis of the joints in the hand is the major cause of Heberden’s nodes.
Osteoarthritis is a degenerative condition that causes the cartilage layer in joint spaces to erode, which causes the bones to contact each other. Consequently, the bones rub against each other, resulting in pain and inflammatory changes in the affected joint.
The body responds to the damage on the bony surfaces by stimulating the formation of new bony growths, which present as Heberden’s nodes. Heberden’s nodes are typically common in severe cases of osteoarthritis affecting the hand.
The risk factors of osteoarthritis of the hand vary but generally include:
prolonged repeated stress to the fingers
increasing age, especially in older adults ages 50 and above
recreational or occupational activities that cause hand injuries
family history
What are the symptoms?
The symptoms in individuals with Heberden’s nodes typically vary. Some common ones include:
loss of motion of the fingers
pain
stiffness
weakness
inflammation in the finger joints
stiffness in the affected area
changes in finger shape
enlargement of fingers
Some people may have a single or multiple Heberden’s nodes in the finger, and a few others may experience mild symptoms or are asymptomatic.
The presence of these nodes may also interfere with the performance of routine activities. Talk with your doctor if your Heberden’s nodes symptoms are limiting your ability to perform daily tasks. They can discuss new or revised treatment options.
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Diagnosis of Heberden’s nodes usually begins with a clinical history. Your doctor will likely take a medical history to ask about your symptoms and conduct a physical examination.
Generally, the doctor examines the joint for the characteristic bony protrusion. After that, an imaging study of the hand, such as an X-ray, may be necessary for accurate diagnosis.
Your doctor may request additional laboratory tests to rule out other possible causes. After diagnosis, your doctor will discuss your treatment options based on your individual diagnosis.
What is the treatment for Heberden’s nodes?
Treatment for Heberden’s nodes aims to manage the inflammatory changes associated with osteoarthritis and relieve symptoms.
oral non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
acetaminophen, which is often the drug of choice for older adults ages 50 and above who have the condition since it does not affect the kidneys the way NSAIDs do
topical NSAID or arthritis creams for mild cases
local therapy using injecting anti-inflammatory medications
massage of the area
surgical correction in severe cases
Many treatment options are available for Heberden’s nodes. Your doctor can discuss possible treatments in the context of your diagnosis, including their benefits and risks.
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Your doctor may counsel you on lifestyle modifications if certain factors put you at risk of Heberden’s nodes. These changes can help reduce pain and discomfort that could occur with severe cases of Heberden’s nodes.
The following lifestyle changes may help people with Heberden’s nodes:
Hand exercises: Practicing gentle hand exercises can reduce joint stiffness by enhancing joint mobility.
Dietary changes: Eating fruits and vegetables and foods rich in omega-3 fatty acids can reduce joint inflammation.
Hand splints: If you engage in physical activities, wearing a hand splint can support your hand and protect it from injury.
In addition to a rheumatologist, your care team may include other types of healthcare professionals, such as physical therapists or occupational therapists. These clinicians can show you exercises and other steps to help improve mobility in your hands.
Summary
Heberden’s nodes are bony growths found in the hands of some people with osteoarthritis. They usually occur on the finger joints close to the fingertip. Heberden’s nodes are often firm and may be painful.
In addition to your clinical history, your doctor may request an X-ray of the hand to make a diagnosis. Treatment includes using pain relievers such as ibuprofen, topical arthritis creams, local therapies, and physical therapy to relieve symptoms. In severe cases, surgery may be necessary.
Lifestyle modifications, such as hand exercises and hand splints, can also help protect the joint and reduce the risk of further damage.
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