What are Heberden’s Nodes?
These are bumps on the joints at the tips of the fingers, also known as the distal interphalangeal joints or DIP. Heberden’s nodes are a symptom of advanced finger osteoarthritis (OA), a degenerative disease. The name comes from Dr. William Heberden, Sr., a physician who differentiated these nodes from other types of arthritis like rheumatoid arthritis and gout. When the cartilage or the smooth, rubbery material that covers and cushions the ends of the finger bones (phalanges), wears away or break down, it causes pain, inflammation and stiffness in the joints of the fingers. This condition is known as finger osteoarthritis. With the progress of the disease, the cartilage wears away completely, leading to bone rub on bone. This is followed by painful bone growths called osteophytes at the DIP joints, resulting in joint damage and misaligned and crooked fingers. After the hip and the knees, the hand and finger joints are the most common joint to be affected by arthritis.
What Causes Heberden’s Nodes?
The main cause of Heberden’s nodes is finger osteoarthritis. However, there are several factors that increase the risk of developing Heberden’s nodes such as, long-term repetitive stress to the fingers, family history of osteoarthritis, genetic defects in the fingers or cartilage, increasing age (particularly after 65), gender (women are 10 times more likely to get it), being overweight and previous injuries or surgeries.
What are the signs and symptoms of Heberden’s Nodes?
The typical bony bumps on the joints at the tips of the fingers are signs of Heberden’s nodes. They are a symptom of severe finger osteoarthritis. Crooked or twisted fingers, swelling in the tips of the fingers, reduced range of movement, and pain while carrying out routine activities, like turning a key or doorknob, writing, gripping the steering wheel of a car, are other symptoms. Weakness in the fingers and stiffness and difficulty in moving the fingers, particularly where the nodes are, in the morning or after periods of inactivity are all symptoms of Heberden’s nodes.
How are Heberden’s Nodes treated?
Treatment for this condition consists of three main options, medications, physiotherapy and surgery. However, it is important to address the underlying condition of finger osteoarthritis. Medications cannot be taken for a long period of time, and generally, carry side effects, while surgery is only a last resort. Non-steroidal anti-inflammatory medications include (NSAIDs), like Ibuprofen or naproxen and topical medications administered are sprays, gels and creams. Surgery for Heberden’s nodes is rare, and only taken when all other less invasive methods are ineffective. Physiotherapy is important for rehabilitation.
Physiotherapy for Heberden’s Nodes
The purpose of physiotherapy for Heberden’s nodes is to prevent disability and progression of the disease. It is a non-surgical and drug-free treatment that has been found to reduce arthritis pain. Physiotherapy helps in reducing pain, increasing joint function and mobility and improving quality of life. It is based on individual requirements. Physiotherapy for Heberden’s nodes may consist of stretching, strengthening and range of movement exercises, in addition to functional retraining and activity modification and various pain-relieving therapies. Bracing, splinting and patient education are part of physiotherapy. Other therapies include Interferential current therapy (IFC) or TENS therapy, Heat and cold therapy, Occupational therapy, Hand therapy and Acupuncture. At our clinic we have notice by using Simply Align Technique which includes advance physical modalities, activity modification and specific exercises we have faster, longer lasting results with reduced healing time.
Are you looking for physiotherapy or a Chiropractor? If Yes, then visit Simply Align Rehab Physio in Scarborough/Toronto or Woodbridge/Vaughan or you can always call or text us for your Physiotherapy or Chiropractor needs in Toronto at (416) 438-3230 or For Physiotherapy or Chiropractor need in Vaughan (Woodbridge) at (905) 638-9840.
Can Heberden’s Nodes go away?
No. Heberden’s nodes cannot go away as there is no cure for the condition. However, progression of the disease can be delayed or stopped with appropriate treatment. Treatment consists of minimizing activities that are repetitive and put pressure on the hands, using assistive devices while doing routine tasks, application of heat and cold therapy and wearing a splint or brace as support during the day and while sleeping. Hence, reducing activities like knitting and gardening, using key turners, jar openers, using larger pens, zipper pulls, kitchen utensils and tools with large handles, and an ergonomic keyboard and mouse, are possible measures that can be taken.
Can Heberden’s Nodes be prevented?
Yes, Heberden’s Nodes can be prevented. Treatment of the underlying condition of finger osteoarthritis is extremely important to reduce or prevent the chance of developing Heberden’s Nodes. Regular exercises, particularly stretching exercises like tai chi or yoga, for at least 30 minutes a day, maintaining a healthy weight and taking a non-inflammatory diet, by avoiding refined and processed foods, and drinking plenty of water are beneficial.