What are Heberden’s Nodes?
Heberden’s nodes are bumps on the joints at the tips of your fingers (the distal interphalangeal joint, or DIP), and are a sign of advanced finger osteoarthritis (OA), which is a degenerative joint disease.
They are named after Dr. William Heberden, Sr., a physician in the 1700’s who differentiated the nodes from other types of arthritis like gout and rheumatoid arthritis.
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 Heberden’s nodes, painful bone growths called osteophytes form at your DIP joints, which cause joint damage and can cause your fingers to become misaligned and crooked.
The hand and finger joints are the third most common joint to be affected by osteoarthritis, just after the knees and hips.
What Causes Heberden’s Nodes?
Heberden’s nodes are caused by finger osteoarthritis.
There is no one cause of finger OA, but several factors that increase your risk of developing it, along with Heberden’s nodes, include:
- 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 Heberden’s nodes than men
- Family history of osteoarthritis and/or Heberden’s nodes
- Previous finger injuries or surgeries
- Genetic defects in the cartilage or fingers
- Being overweight
What are the Signs and Symptoms of Heberden’s Nodes?
The main sign of Heberden’s nodes are the characteristic bony bumps on the joints at the tips 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 the tips of your fingers
- Stiffness and difficulty moving your fingers where the nodes are, especially first thing in the morning or after periods of inactivity
- Weakness in your fingers and difficulty gripping
How are Heberden’s Nodes Treated?
Treatment for Heberden’s nodes aims at treating the underlying condition of finger OA.
Options include medications, physiotherapy, and surgery, though 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 Heberden’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 Heberden’s nodes, but if it is necessary after other less invasive treatments have not helped, physiotherapy is an important part of rehabilitation
Physiotherapy for Heberden’s Nodes
Physiotherapy is a drug-free and non-surgical treatment that has been proven to reduce arthritis pain.
The goal of physiotherapy for Heberden’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 Heberden’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 Heberden’s nodes? Book an assessment today.
Can Heberden’s Nodes Go Away on Their Own?
Unfortunately, no. There is no cure for Heberden’s nodes or finger OA, but with proper treatment, the disease can be managed effectively and progression stopped or delayed.
If you have Heberden’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 door knobs 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 Heberden’s Nodes?
There are many steps you can take to prevent or reduce the chance of developing Heberden’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 Heberden’s Nodes Today
Concerned about symptoms of Heberden’s Nodes? Book an assessment with a physiotherapist today.