Symptoms and Significance of Heberden's Nodes

Heberden's nodes are small, pea-sized bony growths on the joint closest to the fingertip (the distal interphalangeal joint or DIP).

A common sign of osteoarthritis, Heberden's nodes may or may not be painful depending on the stage of development they are in. While they are developing and growing, you may experience pain. However, once fully formed, the nodes typically do not hurt.

Treatments for Heberden's nodes include laser therapy, splints, and over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain. Ice, heat, and physical therapy can also be effective, though some people may require surgery.

This article discusses Heberden's nodes, why they occur, and what you can do if you develop them.

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.

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.

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) NSAIDs like Advil (ibruprofen) or Alleve (naproxen), 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.

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.