Clubbed Fingers as a Symptom of Cystic Fibrosis

Cystic fibrosis (CF) is a genetic condition that causes the body to produce too much mucus. This can lead to blockages, infections, and organ damage. In the United States, there are about 35,000 people living with cystic fibrosis. This condition most commonly affects the lungs. As a result, oxygen is no longer being efficiently delivered to the rest of the body, and one side effect of low oxygen levels is the clubbing of the fingers.

This article discusses clubbed fingers as a complication of cystic fibrosis: why it happens, what it looks like, and how to treat it. Clubbed fingers can also result from other lung conditions that affect oxygen exchange as well.

Why Does Cystic Fibrosis Cause Clubbed Fingers?

Cystic fibrosis is a condition caused by a gene mutation that affects the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This gene creates a protein that helps regulate fluids and ions moving in and out of cells. Mutations produce defective proteins (or no proteins at all) that cause thick mucus to form.

Thick mucus can block the airways, causing physical damage to the lungs. It also traps bacteria, which can lead to infection. The lungs are vital for air exchange; carbon dioxide is released from the bloodstream and breathed out while oxygen is passed from breathed air into the bloodstream for delivery to the rest of the body.

Cystic fibrosis interferes with air exchange. This means that less oxygen is delivered throughout the body. Lower levels of oxygen in the blood can lead to clubbing of the fingers and changes in fingernails.

Appearance and Symptoms of Clubbed Fingers

Clubbed fingers are enlarged at the tip with downward, sloped fingernails. The angle between the nail and the cuticle becomes sharper.

The nail bed (the layer underneath your nail that protects the tip of your finger) gets soft, which can make it appear like your nail is "floating" rather than being firmly attached. The area might also feel "spongy" when pressured.

Clubbed fingers can begin to appear within a few weeks of low oxygen levels. In later stages of finger clubbing, skin on the fingertip can appear shiny, and ridges can develop on the nail.

Treatment

There is no specific treatment for clubbed fingers, and the clubbing can be reversed if lung function improves. Cystic fibrosis is not curable but it is treatable. Symptoms in the lungs are treated with medications and airway clearance techniques. In severe cases, lung transplant surgery is required.

Medications may include:

• Anti-inflammatory drugs: These can include over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) or Aleve (naproxen) and prescription steroid medications.
• Inhaled medications: Bronchodilators are one type of inhaled medication that helps relax muscles and open the airways. Mucus-thinning medications are also inhaled and make it easier for the body to clear mucus from the airways.
• CFTR modulators: These medications target the faulty CFTR proteins, improving lung function.

Airway clearance techniques include:

• Chest percussion: This technique is performed in a position that uses gravity to help mucus drain out of a specific part of a lung. A partner then performs "clapping" with a cupped hand on the area of the body that corresponds to the affected part of the lung. This helps to move the mucus out of the lung so it can be coughed out.
• Expiratory positive airway pressure (EPAP) devices: These devices provide resistance (through a mask or mouthpiece) when a person breathes out. This helps mobilize mucus from the walls of the airway.
• Airway clearance vest: This device provides high-frequency chest wall vibration. It is typically used for 20–30 minutes at a time, to improve coughing effectiveness.
• Exercise: Being physically active can help slow the progression of lung disease with cystic fibrosis.

Summary

Cystic fibrosis is a genetic condition that causes the body to make thick, sticky mucus. This disease usually affects the lungs. Mucus can cause inflammation that interferes with the body's ability to deliver oxygen to the rest of the body. This can lead to clubbed fingers.

Clubbed fingers are enlarged at the tips with nails that slope downward. There is no treatment for clubbed fingers, but as lung function improves, the condition can be reversed.

A Word From Verywell

Cystic fibrosis is a serious medical condition, and clubbed fingers can indicate that the condition is affecting the lungs. Medications, airway clearance techniques, and lifestyle changes (including regular exercise) can improve lung symptoms. Though cystic fibrosis is a life-threatening disease, researchers continue to explore new treatment options to reduce symptoms and improve quality of life for those who have it.