What Are Heberden’s Nodes?
Heberden’s Nodes is referred to as bony swelling that occurs near the fingertips at what is known as the DIP joint. This joint is located immediately underneath the fingernail. Heberden’s Nodes can at times cause pain in the affected finger and once they have fully developed they may look unsightly for people. Most studies indicate a direct link between Heberden’s Nodes and osteoarthritis of the fingers. This signifies that fingers that have osteoarthritic chances on radiographs are more likely to develop Heberden’s Nodes than other fingers.[1]
In fact, it is believed to be the main presenting feature of osteoarthritis of the fingers. An individual is said to have finger osteoarthritis if the cartilage that cushions the finger joints gets degenerated. This leads to the bones of the fingers rubbing against each other causing damage to the bone. It also results in decreased mobility of the fingers and severe pain with any activity involving the fingers like gripping or grasping an object.[1]
When osteoarthritis gets to a level where the old bone is completely lost the body starts growing new bone in that area. However, due to the joint being damaged due to osteoarthritis the new bone formation looks more like a deformity and that deformity is what is referred to as Heberden’s Nodes.[1]
What Causes Heberden’s Nodes?
The primary cause of Heberden’s Nodes is osteoarthritis. As stated, osteoarthritis occurs when the cartilage cushioning the joints get degenerated. This results in the bones rubbing against each other causing symptoms. The constant rubbing of the two bones also results in the bones getting damaged significantly. This loss of bone triggers the body mechanism to produce new bones at the affected area. These are referred to as nodes.[2]
When the bones of the fingers get affected with OA and there is resultant formation of new bones, it looks like an unsightly lump protruding. This is what is referred to as Heberden’s Nodes.[2]
What are the Symptoms of Heberden’s Nodes?
The primary presenting feature of Heberden’s Nodes is the presence of unsightly bony growths around the finger joints. The fingers look deformed. They may at times be painful as well. In addition, these growths may also produce certain other symptoms to include inflammation and swelling around the finger joint. The joint will also be very stiff with restricted motion. It will become very difficult to use the finger for any sort of activities.[2]
Since Heberden’s Nodes develop only in very severe cases of osteoarthritis, these symptoms may be masked by other prominent symptoms of osteoarthritis. In some cases, people may not have a habit of using the affected finger and may not realize that they are not able to use it for any activities and as such the symptoms of Heberden’s Nodes may go undetected.[2]
How Are Heberden’s Nodes Treated?
The primary mode of treatment Heberden’s Nodes is aimed at treating the underlying cause of it which is osteoarthritis. Since osteoarthritis does not have a cure, treatment is aimed at controlling the symptoms. As Heberden’s Nodes occurs when osteoarthritis becomes severe, it majority of the cases treatment begins with pain medications. Anti Inflammatories like Tylenol and ibuprofen are often quite effective in treating the pain caused by both osteoarthritis and Heberden’s Nodes.[2]
There are also certain lifestyle changes that are recommended by the physician to control the symptoms of Heberden’s Nodes. Physical activity is of utmost importance to keep the symptoms of osteoarthritis at bay. Exercising also is crucial for people with osteoarthritis since it increases muscle strength and reduces strain on the affected joints. It also increases flexibility and mobility of the joints.[2]
Thus it is important with an individual with Heberden’s Nodes to consult with a physical therapist for best exercises to do for the fingers to improve symptoms depending on the severity of the condition and the age of the patient. Diligent exercising is the key for better control of symptoms of Heberden’s Nodes. It is also recommended to avoid exercises which put excess strain on the joints as they will tend to worsen the condition.[2]
In some very rare cases, surgery is recommended for people with Heberden’s Nodes. This is especially in people who do not find relief with conservative approaches and even everyday chores become difficult for them. The surgical procedure for Heberden’s Nodes involves removal of the extra bony growths or the nodes and then reconstructing the joint.[2]
This procedure is normally quite effective and restores some functionality of the affected joint. However, continuous treatment is still required for controlling the symptoms of osteoarthritis which is the primary cause of Heberden’s Nodes.[2]
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