What are Bouchard’s Nodes?
Bouchard’s nodes are bumps on the joints in the middle of your fingers (the proximal interphalangeal joint, or PIP), and are a sign of advanced finger osteoarthritis (OA), which is a degenerative joint disease. They are named after the French pathologist Charles-Joseph Bouchard, who studied arthritis patients in the late 1800’s.
Finger OA occurs when the smooth, rubbery cartilage that cushions the ends of your finger bones (phalanges) begins to break down and wear away, causing pain, stiffness and inflammation.
As the disease progresses, eventually the cartilage wears away completely, causing bone to rub on bone. In the case of Bouchard’s nodes, painful bone growths called osteophytes form at your PIP joints, which cause joint damage and can cause your fingers to become misaligned and crooked.
Bouchard’s nodes are less common than Heberden’s nodes, which occur in the joints at the tips of your fingers.
The hand and finger joints are the third most common joint to be affected by osteoarthritis, just after the knees and hips.
What Causes Bouchard’s Nodes?
Bouchard’s nodes are caused by finger osteoarthritis.
There is no one cause of finger OA, but several factors increase your risk of developing it, along with Bouchard’s nodes, including:
- Long-term repetitive stress to the fingers, whether occupational or recreational
- Increasing age, especially being over 65
- Gender – women are more likely to develop OA, and women who have finger OA are 10 times more likely to develop Bouchard’s nodes than men
- Family history of osteoarthritis and/or Bouchard’s nodes
- Previous finger injuries or surgeries
- Genetic defects in the cartilage or fingers
- Being overweight
What are the Signs and Symptoms of Bouchard’s Nodes?
The main sign of Bouchard’s nodes are the characteristic bony bumps on the middle knuckles of your fingers which indicate severe finger OA.
Other signs and symptoms include:
- Decreased range of motion and/or pain while doing routine activities such as opening jars, turning a key or doorknob, writing, or gripping the steering wheel of a car
- Twisted or crooked fingers
- Swelling in your fingers
- Stiffness and difficulty moving your fingers, especially first thing in the morning or after periods of inactivity
- Weakness in your fingers and difficulty gripping
How are Bouchard’s Nodes Treated?
Treatment for Bouchard’s nodes aims at treating the underlying condition of finger OA, which includes medications, physiotherapy, and surgery.
However, surgery is considered only as a last resort, and many drugs carry serious side effects and are not meant to be taken over a long period of time.
Treatments for Bouchard’s nodes include:
- Medications, including:
- Non-steroidal anti-inflammatory drugs (NSAIDs), either prescribed, or over-the-counter, such as ibuprofen (Advil, Motrin) or naproxen (Aleve)
- Topical medications such as creams, sprays or gels
- Surgery – surgery is rare for Bouchard’s nodes, but if it is necessary after other less invasive treatments have not helped, physiotherapy is an important part of rehabilitation
Physiotherapy for Bouchard’s Nodes
Physiotherapy is a drug-free and non-surgical treatment that has been proven to reduce arthritis pain.
The goal of physiotherapy for Bouchard’s nodes is to prevent disability and the progression of finger OA, reduce pain, regain strength, and increase joint mobility, function, and quality of life.
Depending on your individual needs, physiotherapy for Bouchard’s nodes can include:
- Stretching, strengthening, and range of motion exercises
- Activity modification and functional retraining
- Splinting or bracing
- Patient education so you feel in control of your condition
- Cross-disciplinary pain-relieving therapies such as:
Are you seeking physiotherapy for Bouchard’s nodes? Book an assessment today.
Can Bouchard’s Nodes Go Away on Their Own?
Unfortunately, no. There is no cure for Bouchard’s nodes or finger OA, but with proper treatment, the disease can be managed effectively and progression stopped or delayed.
If you have Bouchard’s nodes, there are things you can do to make daily living easier, including:
- Minimizing activities that put stress on your hands, such as gardening or knitting
- Applying heat and cold therapy
- Using assistive devices such as jar openers, key turners, and large zipper pulls; using larger pens; using kitchen utensils and tools with larger handles
- Replacing doorknobs with levers that you push down on, not turn
- Using an ergonomic keyboard and mouse
- Wearing a splint or brace for support while sleeping or while doing repetitive motions during the day
Can You Prevent Bouchard’s Nodes?
There are many steps you can take to prevent or reduce the chance of developing Bouchard’s nodes and its underlying condition of finger OA, including:
- Exercising regularly, including stretching exercises such as yoga or tai chi (at least 30 minutes every day)
- Eating a non-inflammatory diet (avoiding sugar, and processed and refined foods) and drinking plenty of water
- Maintaining a healthy weight
Book a Physiotherapist Consult for Bouchard’s Nodes Today
Concerned about symptoms of Bouchard’s Nodes? Book an assessment with a physiotherapist today.