Bone spurs, medically termed osteophytes, commonly occur on the fingers. These bony projections are outgrowths of new bone tissue that form along the edges of bones, usually where they meet to form a joint. While many bone spurs do not cause discomfort, those in the finger joints can lead to significant stiffness, pain, and loss of mobility. The formation of these outgrowths is the body’s response to damage and stress within the joint structure.
Specific Locations and Names in Finger Joints
The fingers contain several small joints where these bony growths frequently appear, and their location determines the specific medical name. The joints closest to the fingertip are the distal interphalangeal (DIP) joints. When bone spurs develop here, they are known as Heberden’s nodes. These nodes often manifest as small, hard, and knobby swellings on the back of the joint. The formation of Heberden’s nodes can cause the finger to become misaligned or crooked over time.
Bone spurs that form at the proximal interphalangeal (PIP) joints, the middle joints of the fingers, are referred to as Bouchard’s nodes. Both Heberden’s and Bouchard’s nodes can cause the fingers to look enlarged and stiff. When actively forming, they may be accompanied by swelling, tenderness, and a reduced range of motion in the affected finger.
Underlying Cause: The Role of Osteoarthritis
The primary reason for bone spur formation in the fingers is the degenerative condition known as osteoarthritis (OA). This condition is often described as “wear-and-tear” arthritis because it involves the gradual breakdown of the joint’s protective tissues. Normally, smooth, flexible cartilage covers the ends of the bones, allowing for frictionless movement. As OA progresses, this cartilage thins and wears away, causing the bones to rub against one another.
This increased friction and instability irritate the bone tissue beneath the joint surface. The body attempts to stabilize the damaged joint by creating new bone tissue at the edges of the existing bone. This process results in the osteophytes, or bone spurs, visible as Heberden’s and Bouchard’s nodes. Age, genetic predisposition, and previous joint injuries increase the risk of developing hand osteoarthritis.
Treatment and Management Strategies
Treatment for finger bone spurs focuses on managing the symptoms caused by the underlying osteoarthritis, as the spurs themselves cannot be naturally dissolved. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are commonly used to reduce the pain and inflammation associated with the bony enlargements. Applying cold packs to the affected joints can also help in reducing localized swelling and tenderness.
Physical or occupational therapy is beneficial for maintaining joint function. Therapists can suggest exercises to improve flexibility and strength, and they may recommend splinting the joints to provide support and stability during periods of inflammation. For more intense pain, a physician may administer corticosteroid injections directly into the joint to provide temporary anti-inflammatory relief.
Surgery is typically reserved for severe cases where the pain is debilitating or the loss of function makes daily activities impossible. Common surgical interventions for the small joints of the fingers include arthrodesis, which is a joint fusion procedure to permanently stabilize the joint. Another option is arthroplasty, which involves replacing the damaged joint surfaces with an implant to restore motion.