Osteoarthritis is a painful, degenerative joint disease that can affect almost every joint in the body. When you have it in your hands, you may begin to notice some crookedness to your fingers and bony swelling around the top finger joints called the distal interphalangeal joints. These nodules are called Heberden’s nodes, named after physician William Heberden Sr., a doctor in the 1700s, who came up with an explanation for these swellings. They can be unsightly. And, they hurt.

Causes

Because Osteoarthritis is a degenerative joint disease, the cartilage within the joints begins to disintegrate, diminishing its protective nature. The unprotected bones begin to rub against one another, destroying more bone in the process. As the cartilage breaks down, more bone grows alongside the existing bone causing those bony outgrowths called Heberden’s nodes, an indicator of advanced osteoarthritis.

Symptoms

Some cases of Heberden’s nodes create mild or few symptoms. Unfortunately, for others, the symptoms can restrict motion and impact activities like opening jars, buttoning a shirt, putting in earrings, gripping keys to open doors, sewing, anything that requires gripping or pinching an object. Symptoms include:

  • Swelling
  • Pain
  • Stiffness
  • Loss of motion

Risk Factors

The exact cause of the bone outgrowth is not known, but what is known is that these nodes only develop on people with osteoarthritis. There are risk factors for the condition which include:

  • Family history
  • Age
  • Joint injuries
  • Obesity
  • Conditions that are related such as gout

Treatment

There is no specific for treatment for the nodes, so management of the symptoms provides the most success. The first line of defense is pharmaceutical. Some form of pain relieving medication is usually required to treat Heberden’s node, mostly because they are indicative of severe osteoarthritis and severe osteoarthritis is painful. In addition, a non-steroidal anti-inflammatory (NSAID) like ibuprofen, is usually in order to reduce swelling.

Several lifestyle changes also help to minimize the symptoms, with the most effective being exercise. No one wants to hear they need to exercise especially when they’re in pain. It sounds counterintuitive, doesn’t it? But the truth is exercise works in several ways to reduce symptoms. Resistance exercises will help increase muscle strength, which in turn, reduces pressure on the joints. It will also promote bone flexibility. Exercise can also help someone lose weight which also reduces pressure on one’s joints.

Keep in mind that exercise should be tailored to the individual and a structured and consistent program should be developed, avoiding exercises that place more stress on the affected joints.

Sometimes surgery, that involves removing the affected nodes and reconstructing the joints, is needed when the symptoms become too severe and the above interventions are no longer helpful.

As with any health issue, consult your doctor, especially when the pain is great and the nodes are interfering with day-to-day activities. They can decide the best steps to take and keep track of your progress.


Research

1. What Are Heberden’s Nodes? Heathline.
https://www.healthline.com/health/osteoarthritis/heberdens-nodes

2. Heberden’s and Bouchard’s nodes. Annals of Rheumatic Diseases.
https://ard.bmj.com/content/58/11/675

Featured image courtesy of Drahreg01 at Wikipedia
https://commons.wikimedia.org/wiki/File:Heberden-Arthrose.JPG