Bone spurs, also known as osteophytes, are outgrowths of bone that can form along the edges of bones, typically where they meet to form a joint. They can develop in the hand.
What Are Bone Spurs in the Hand?
Bone spurs in the hand are localized bony outgrowths that develop on the surfaces of bones within the hand’s joints. The body produces this new bone tissue in response to joint instability or degeneration. They commonly appear in the small joints of the fingers, such as the distal interphalangeal (DIP) joints near the fingertip and the proximal interphalangeal (PIP) joints in the middle of the finger. Osteophytes can also form at the base of the thumb, specifically in the carpometacarpal (CMC) joint, where the thumb meets the wrist. Less frequently, they might develop in the wrist joints themselves.
Why Bone Spurs Form in the Hand
Bone spurs often form in the hand as a response to joint damage or instability, with osteoarthritis being a common underlying factor. Osteoarthritis, a degenerative joint disease, involves the breakdown of cartilage that cushions the ends of bones. As cartilage erodes, bones can rub against each other, triggering the body’s attempt to stabilize the joint by growing new bone.
Repetitive stress or microtrauma to the hand joints can also contribute, particularly in individuals with frequent hand movements. Previous injuries, such as fractures or dislocations, may also predispose an individual to developing bone spurs years later. The natural aging process also plays a role, as joints accumulate wear and tear, increasing the likelihood of cartilage degeneration and subsequent bone spur formation.
Recognizing Hand Bone Spur Symptoms
The presence of bone spurs in the hand can lead to a variety of symptoms. Pain is a frequent complaint, often described as a dull ache that can worsen with movement or activity involving the affected joint. Stiffness, particularly in the mornings or after periods of inactivity, is another common symptom.
Reduced range of motion can occur as the bone spur physically obstructs normal joint movement. Swelling around the affected joint may also be noticeable, sometimes accompanied by tenderness to the touch. In some cases, a palpable or visible hard bump may develop, especially in the finger joints, which can alter the appearance of the hand.
Treatment Options for Hand Bone Spurs
Diagnosing bone spurs in the hand typically involves a physical examination to assess joint tenderness, swelling, and range of motion. Imaging techniques, such as X-rays, are often used to confirm the presence and location of osteophytes, as they clearly show bony overgrowths and joint space narrowing. The goal of treatment is to alleviate symptoms and improve hand function.
Non-Surgical Treatments
Non-surgical approaches are usually the first line of treatment. Pain management often includes over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, which can help reduce pain and inflammation. Activity modification, such as avoiding activities that exacerbate pain, can also provide relief.
Physical or occupational therapy may be recommended to improve joint mobility, strengthen surrounding muscles, and teach joint protection techniques. Splinting or bracing can provide support to the affected joint, reducing movement and alleviating pain, especially during periods of increased activity or at night. For more persistent pain, corticosteroid injections directly into the joint can reduce inflammation and provide temporary pain relief but are not a long-term solution.
Surgical Treatments
Surgical intervention is generally considered when non-surgical treatments fail to provide adequate relief and symptoms significantly impair daily activities. One surgical option is osteophyte removal, where the bone spur is directly excised to restore joint movement and reduce pain. In cases of severe joint damage due to advanced osteoarthritis, joint fusion (arthrodesis) may be performed, which involves permanently joining the bones in the affected joint to eliminate motion and pain. For certain joints, such as the carpometacarpal joint at the base of the thumb, joint replacement (arthroplasty) with an artificial implant or a patient’s own tissue can be an option to restore function and reduce pain.