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Heberden's Nodes: Symptoms, Causes, and Treatments

Medically Reviewed by Melinda Ratini, DO, MS on August 20, 2020

Heberden's nodes are hard bony lumps in the joints of your fingers. They are typically a symptom of osteoarthritis.

The lumps grow on the joint closest to the tip of your finger, called the distal interphalangeal, or DIP joint.

Causes

The main cause of Heberden's nodes is osteoarthritis. That's a form of arthritis that happens when the tissue that covers the ends of your bones -- called cartilage -- wears away.

Your cartilage can break down because of slow wear and tear over time or if you have an injury to the joint. The result is that the smooth cushioning of your joints gets rough and causes pain, stiffness, and inflammation.

This friction often causes bony growths called bone spurs to form around the joints. If you have these bone spurs in your fingers, they can lead to Heberden's nodes.

If these bumps show up on the middle joint of your fingers, doctors call them Bouchard's nodes.

Symptoms

Besides the visible bumps, you may have some pain from Heberden's nodes when they first develop. The pain usually goes away over time. You might still hurt from your osteoarthritis, though.

Once you get Heberden's nodes, they typically stick around for good.

The nodes might also lead to joints and fingers that are misshapen, along with other symptoms of osteoarthritis like loss of cartilage, loose ligaments, and swelling,

Other symptoms of osteoarthritis in your hand might include:

Stiffness. As the disease moves further along, it may get harder to use your hands. You might have trouble opening and closing your fingers all the way.

Pain. It comes and goes at first, but it can sometimes get worse over time. It might hurt more when you first wake up.

Swelling. The irritation and damage from bone-on-bone friction can lead nearby tissues to get swollen and tender to the touch.

Weakness. Pain, swelling, misshapen joints, and loss of motion can make your hands weak over time. It might get harder to do things like turn a key or open a jar.

Crepitus. This is grinding, cracking, or clicking that happens when you move your hands.

Diagnosis

The appearance of Heberden's nodes at your DIP joints is a common first sign of osteoarthritis.

Your doctor will ask about your symptoms and your family history and might take some X-rays of your joints to look for bone spurs and cartilage that's worn away.

Treatment

You can treat pain and swelling with rest, splints, ice, physical therapy, and pain medicines like nonsteroidal anti-inflammatory drugs (NSAIDs).

In rare cases, your doctor might suggest surgery to remove the nodes, or replace or fuse one of the joints in your fingers.

Other than that, they will likely treat the osteoarthritis that is the root cause of your Heberden's nodes.

Show Sources

SOURCES:

American Academy of Family Physicians: "Painless Nodules in the Fingers."

American Society for Surgery of the Hand: "Osteoarthritis."

Annals of the Rheumatic Diseases: "Heberden's and Bouchard's nodes."

Arthritis Foundation: "Osteoarthritis of the Hands."

Cleveland Clinic: "Is There Any Help for Hard, Painful Bumps on Your Fingers From Osteoarthritis?"

Encyclopedia of Molecular Mechanisms of Disease: "Heberden's Nodes."

Vermont Orthopaedic Clinic: "Osteoarthritis of the Hand."

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