Finger osteoarthritis – symptoms, diagnosis and treatment

Osteoarthritis of the hand very often affects the joints in the middle of the finger and the joints closest to the fingertips. Finger osteoarthritis is easily confused with rheumatoid arthritis (RA) so it is important to get diagnosed as early as possible when experiencing symptoms such as pain, stiffness or reduced mobility of the fingers. Both conditions can be treated, but in separate ways.

Symptoms of finger osteoarthritis

Osteoarthritis of the fingers most commonly affects the outer joints of the finger (the distal interphalangeal (DIP) joints) and the middle joints of the finger (the proximal interphalangeal (PIP) joints). It can also affect the joints closest to the knuckles (the metacarpophalangeal (MCP) joints).

The most common symptoms of finger osteoarthritis include: 

  • Pain or tenderness in the fingers 
  • Stiffness
  • Reduced grip strength or hand function
  • Limited range of motion
  • Bone spurs
  • Crooked fingers

A classic symptom of severe finger osteoarthritis is the growth of bone spurs (osteophytes) on the affected joint. These bone spurs look like bony lumps on the fingers and tend to be harmless. The bone spurs that develop on the joints closest to the fingertips are known as Heberden’s nodes. The ones that develop on the middle joints of the finger are known as Bourchard’s nodes.

As the disease progresses, the more pronounced these symptoms become. In late stages of the disease the fingers may completely change shape and look crooked.  Occasionally, harmless ganglions or digital mucous cysts form on the fingers. These cysts form when the joint produces too much synovial fluid. Cysts are not the same as bone spurs. 

If you experience any of these symptoms you should schedule an appointment with a physical therapist, an occupational therapist or a doctor to get a diagnosis. 

Several risk factors play a part

There is no single cause for the development of finger osteoarthritis. Several risk factors tend to contribute to the development of the joint disease. Main risk factors for finger osteoarthritis are female sex, genetics and obesity. The genetic influence of hand osteoarthritis can be as high as 65%. Onset of finger osteoarthritis is most common in postmenopausal women.  Fat percentage has also been linked to osteoarthritis of the hand.

Other risk factors for finger osteoarthritis include previous finger injuries (fractures, dislocations, ligament damage) , extreme sports that require a lot of hand strength (for example, rock climbing) and jobs that require repetitive hand movements (for example, hairdressing).

How osteoarthritis of the fingers is diagnosed

Traditionally, osteoarthritis was diagnosed by X-ray. Today, it is still a widespread belief that this method is necessary for diagnosis. However, according to the World Health Organization and extensive international research, osteoarthritis should be diagnosed by a healthcare professional through an assessment based on the patient’s medical history, joint function and pain level. The healthcare professional will also take risk factors for osteoarthritis into account and keep them in mind when establishing the diagnosis. Advanced finger osteoarthritis is easier to see with the naked eye as the fingers are often swollen and deformed.

An X-ray is only deemed necessary if the patient does not respond to first-line treatment or if the symptoms are so severe that surgical treatment is considered.

Treating osteoarthritis of the fingers

First-line treatment for finger osteoarthritis is patient education (learning more about the disease) in combination with individualized exercises for the hands. These individualized exercises should be coordinated by a physical therapist or an occupational therapist, either physically or digitally. Physical therapists and occupational therapists can also provide practical advice on how to more easily perform daily activities with the use of adapted equipment and braces or splints. There are several adaptive equipment tools that make life easier for someone living with finger osteoarthritis. Such tools include adaptive jar and can openers, utensils, scissors and zipper pulls.

Exercises for the fingers should consistently be adapted to the patient’s abilities based on pain and function level. Individualized exercises can help ease pain, increase grip strength and improve hand function. As a complement to first-line treatment, if the pain becomes unbearable, non-prescription painkillers may be used for short periods of time. You should however always discuss the use of painkillers with your doctor to avoid side effects and drug interaction.

Other treatment methods for finger osteoarthritis

If first-line treatment doesn’t provide satisfactory symptom relief, surgery may be necessary. The most commonly performed operation for osteoarthritis of the fingers is joint fusion surgery.  Joint replacement surgery (arthroplasty) is also a surgical option for some patients.  Most of these operations are performed under local anesthesia. Although surgery can provide good results for many patients, it is never risk-free. All surgery, minor or major, comes with the risk of developing infections. T

Read more about osteoarthritis of the thumb.