Symptoms and Significance of Heberden's Nodes

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Heberden's nodes are bony swellings of the joint closest to the fingertip, just below the fingernail. It's also called the distal interphalangeal joint (DIP).

Heberden's nodes are not always painful. Whether they hurt depends on the stage of development they are in. When they are fully formed, the nodules don't hurt. However, people may not like how they look.

This article will discuss why Heberden's nodes happen and what you can do if you have them.

A pair of elderly hands close up
Camille Tokerud Photography Inc. / Getty Images

Heberden's Node Symptoms

Heberden's nodes are more common in women than in men. They usually form on the index finger of a person's dominant hand.

The signs of developing Heberden's node usually start around menopause for women and in middle-age for men.

The symptoms include:

  • Pain
  • Stiffness
  • Limited range of motion in one or more finger joints
  • Warmth and swelling (signs of inflammation)

The pain and inflammation usually get better in a few years. Then, you'll be left with a bony painless bump on your finger—a Heberden's node. If you get a bump on the joint in the middle of your finger, it's called a Bouchard's node.

Finger joints with Heberden's nodes may go off to one side. For example, an index finger with a Heberden's node may point toward the middle finger instead of straight out.

Recap

Heberden's nodes affect the joints in your fingers near your fingernail. As they are developing, they can hurt and may feel stiff. Fully formed Heberden's nodes aren't painful but you may not like how they make your hands look.

Causes

Heberden's nodes are a classic sign of hand osteoarthritis (OA). A study in 2012 found a link between Heberden's nodes and changes on an X-ray that signal a person has osteoarthritis in their fingers.

According to the study, the odds of an X-ray showing signs of OA are higher on a finger that has a Heberden's node than on a finger that doesn't have the nodes.

Recap

Heberden's nodes are common in people who have osteoarthritis in their hands. The fingers affected by OA tend to form the nodes.

Treatment

There is no set treatment for Heberden's nodes. People who have them can do many of the same things that are recommended for people with hand arthritis.

A 2016 study of people with Bouchard's nodes, Heberden's nodes, and OA found that having five to seven treatments with low-level laser therapy (LLLT) reduced pain and swelling. Some people could also move the affected finger better.

Heberden's nodes can hurt while they're forming. During this time, rest, splinting, over-the-counter (OTC) pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs), and heat or ice therapy can be helpful.

A 2020 study of women with hand OA found that wearing hand supports called orthoses at night also helped reduce pain and improve hand function. 

You may want to work with a physical therapist or occupational therapist as well. They can use hand therapy to reduce pain and teach you how to use the fingers affected by the nodes.

Surgery for Heberden's nodes is only done if a person's symptoms don't get better or they cannot use their finger at all. Sometimes, surgery can replace the joint. A surgeon can also take out the inflamed parts of the joint and put the joint back together. This is called joint fusion. 

The good news is that once the bony node has formed, the pain goes away. At this stage, the node is more of a cosmetic problem than a physical one.

Recap

The pain and stiffness from Heberden's nodes can be treated with OTC pain relievers, heat and ice therapy, and wearable supports. You might benefit from working with a physical therapist if the nodes make it hard to use your hands.

Rarely, surgery is needed to replace the joint or take out the parts that are inflamed.

Summary

Heberden's nodes are bony swellings of the joints in the hand that are closest to the nail. When they are forming, the nodes can hurt. Once they are fully formed, the pain goes away. However, a person might be bothered by their appearance.

There is no way to simply fix how the nodes look. However, if a person has Heberden's nodes because they have hand OA, surgery on the joint might help them use the finger better.

There are also ways to manage the pain that do not involve surgery, like taking OTC pain relievers and using heat therapy. Working with a physical therapist can also help people use hands that are affected by arthritis.

A Word From Verywell

While they can be painful and odd to look at, Heberden's nodes can be helpful in some ways. Since they are easy to see, the nodes can help a person get diagnosed with hand osteoarthritis.

If you think you have a Heberden's node and/or hand osteoarthritis, talk to your doctor There are other health conditions that can look like hand osteoarthritis but are not. Once you have a sure diagnosis, you can get the right treatment.

Frequently Asked Questions

  • Can I prevent Heberden's nodes?

    If you're at risk for developing hand arthritis with nodes (nodular), you'll probably get Heberden's nodes eventually.

    However, you can protect your joints by eating a nutrient-rich diet, staying physically active, losing weight if your healthcare provider advises you to, and not smoking.

  • Does rheumatoid arthritis cause Heberden's nodes?

    People with rheumatoid arthritis (RA) may have swelling and redness from the inflammation in the finger joints when the condition flares up.

    However, Heberden's nodes typically are not a sign of RA. The exception is when people develop osteoarthritis and RA.

  • Will glucosamine or chondroitin supplements help treat Heberden's nodes?

    There is not enough evidence to support claims that these supplements protect all joints. The American College of Rheumatology recommends that some people with hand arthritis take chondroitin supplements. However, you should talk to your doctor before you try them.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. National Institute on Aging. Osteoarthritis.

  3. Baltzer AW, Ostapczuk MS, Stosch D. Positive effects of low level laser therapy (LLLT) on Bouchard's and Heberden's osteoarthritisLasers Surg Med. 2016;48(5):498-504. doi:10.1002/lsm.22480

  4. Arthritis Foundation. Osteoarthritis of the hands.

  5. Silva PG, de Carvalho Silva F, da Rocha Corrêa Fernandes A, Natour J. Effectiveness of nighttime orthoses in controlling pain for women with hand osteoarthritis: A randomized controlled trial. Am J Occup Ther. 2020;74(3):7403205080p1-7403205080p10. doi:10.5014/ajot.2020.033621

  6. American Society for Surgery of Hand. Osteoarthritis.

  7. Cleveland Clinic. Arthritis of the hand.

  8. Creakyjoints.org. Osteoarthritis vs. rheumatoid arthritis.

  9. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee [published correction appears in Arthritis Rheumatol. 2021 May;73(5):799]. Arthritis Rheumatol. 2020;72(2):220-233. doi:10.1002/art.41142