Heberden’s Nodes: Everything You Need to Know

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

Heberden's nodes are a common sign of osteoarthritis (OA). They 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 occur more often in women than in men. They are more common on the fingers 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. Developing these nodes is a classic sign of osteoarthritis.

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.

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

Causes of Heberden's Nodes

Heberden's nodes often develop in people with hand osteoarthritis. When you have OA, the cartilage in your joints gradually wears away. Without cartilage, the bones in the joints rub together and become damaged over time. 

Your body creates new bone to help compensate for damage to the bones caused by osteoarthritis. Heberden's nodes are one example of this.

Diagnosis of Heberden's Nodes

Your healthcare provider will usually diagnose Heberden's nodes based on:

• Your symptoms
• Your medical history
• A physical exam

Your healthcare provider may also order X-rays to look for worn cartilage or bone spurs.

How Heberden's Nodes Are Treated

There is no set treatment for Heberden's nodes. People who have them can do many of the same treatments 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 Aleve (naproxen), topical agents like diclofenac gel and lidocaine, 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.

Will I Need Surgery?

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. However, range of motion, grip strength, and overall functionality can be limited.

Lifestyle Management Tips

Some of the things you can do to reduce pain of Heberden's nodes and prevent disability include:

• Rest your hand whenever you can.
• Alternate heat and cold therapy.
• Wear a splint that helps support your finger joints.
• Do gentle stretching and strengthening exercises of the hand and fingers as recommended by your physical or occupational therapist.
• Adopt a healthier diet and avoid sugar, red meat, unhealthy fats, salt, and refined grains.
  

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 or limited range of motion.

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

Since Heberden's nodes are easy to see, they can help you get diagnosed with hand osteoarthritis. If you think you have a Heberden's node and/or hand osteoarthritis, talk to your healthcare provider.

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.