Q: I have arthritis in my hands and have developed painful lumps over the small finger joints closest to my fingernails. Some of my fingers actually appear crooked. What can be done?
A: These painful lumps are actually bony growths that developed in the later stages of degeneration of your finger joints.
When the cartilage cushioning the joint between two bones wears out completely and your joint becomes “bone on bone,” the body responds by growing new bone, like bone spurs or nodes.
The growths on your distal finger joints are called Heberden’s nodes secondary to osteoarthritis.
If you have Heberden’s nodes, it is likely that you have advanced osteoarthritis in other parts of your body as well as your hands. The most common places for arthritis to develop are your hands, hips, knees, and spine.
Fortunately, arthritis is not always painful.
You are more likely to notice the pain, stiffness, loss of motion and/or weakness caused by arthritis of the hands and fingers because you use them so much and functional impairment is more obvious. However, some people have severe arthritis in the hands with Heberden’s nodes and have no symptoms.
There is no treatment for Heberden’s nodes other than the standard treatment for osteoarthritis.
Symptom management, lifestyle changes and exercise are important.
Medications such as acetaminophen or ibuprofen (if tolerated) are appropriate options.
Regular exercise is extremely important to improve flexibility and muscle strength, even in the hands. Hand exercises can be prescribed by an occupational therapist if you are having trouble doing them on your own. You can also find hand exercises on-line.
Exercises like repetitively making a fist, bending your fingers and thumb towards your palm, bending your fingers and thumb away from your palm, and squeezing a ball can be helpful if done daily. Exercises may help you improve functions like gripping and opening jars and typing comfortably on the computer.
It is recommended to exercise your entire body for flexibility, mobility and cardiovascular endurance.
Be sure to include resistance exercises to reduce age related muscle loss and reduce the demand on the joints.
A physical therapist or qualified personal trainer can help you design an appropriate exercise program.
Swimming and stationary biking are good for cardiovascular fitness and are easy on the joints. Weight loss can improve symptoms of arthritis in people who are obese. A healthy diet with plenty of fresh fruits and vegetables is important for everyone.
Your risk of osteoarthritis (and Heberden’s nodes) increases as you get older, if you have had joint injuries, are overweight, diabetic, have gout or have a family history.
Heberden’s nodes rarely require surgery. Some people benefit from cortisone shots into the joints for temporary relief.