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Finger Osteoarthritis (PIPJ and DIPJ)
Understanding the causes, symptoms and treatment options for osteoarthritis affecting the small joints of the fingers.
What is Finger Osteoarthritis (PIPJ and DIPJ)?
Finger osteoarthritis is wear-and-tear arthritis affecting the small joints of the fingers, most often the middle joint (the proximal interphalangeal joint, or PIPJ) and the joint nearest the nail (the distal interphalangeal joint, or DIPJ). As the cartilage in these joints wears down, the joints become painful, stiff and can develop firm bony lumps.
Finger Osteoarthritis (PIPJ and DIPJ) at a glance
What is it?
Wear-and-tear arthritis affecting the middle joint (PIPJ) and/or end joint (DIPJ) of the fingers
Common symptoms
Joint pain, swelling, stiffness and bony lumps at the affected finger joints
Who it affects
More common with age, in women, and where it runs in the family
Is it serious?
Not dangerous, but can affect grip, dexterity and finger appearance over time
Treatment options
Splinting, activity changes, injection, or surgery
First step
A consultation and x-ray to confirm the diagnosis and discuss the options
Symptoms and how Finger Osteoarthritis (PIPJ and DIPJ) presents
The main symptoms are pain, stiffness and swelling at the affected finger joints, often worse in the morning or after activity. Firm bony lumps can develop, known as Heberden’s nodes at the DIPJ and Bouchard’s nodes at the PIPJ. Movement at the joint can become reduced, and a small fluid-filled mucous cyst can sometimes form near an affected DIPJ.
Causes and risk factors for Finger Osteoarthritis (PIPJ and DIPJ)
- Age
- A family history of osteoarthritis
- Being female
- A previous injury to the joint
- Osteoarthritis affecting other joints in the body
How is Finger Osteoarthritis (PIPJ and DIPJ) diagnosed?
Finger osteoarthritis is usually diagnosed from your history and an examination of the affected joints. An x-ray confirms the diagnosis and shows how advanced the joint wear is.
Treatment options for Finger Osteoarthritis (PIPJ and DIPJ)
Mild symptoms are often helped by activity modification, joint protection (avoiding repetitive or forceful gripping and pinching where possible), regular range of movement exercises, heat (for example, warm gloves and a heat pack during winter) or cold, resting and/or splinting the affected joint during flare-ups, ergonomic aids such as jar openers and larger-grip pens, and simple pain relief or anti-inflammatory medication. A hand therapist can help put these measures together for your situation. A corticosteroid injection can help settle a painful flare-up in some cases.
If a joint is persistently painful or deformed despite these measures, surgery may be recommended. This may involve fusing the joint to remove painful movement, or in some cases replacing the joint.
When to see a hand surgeon about Finger Osteoarthritis (PIPJ and DIPJ)
It is worth seeing a hand surgeon if you have persistent severe finger joint pain or stiffness affecting your grip or daily activities despite seeing a hand therapist, or if a joint is becoming progressively deformed.
What to expect at your Finger Osteoarthritis (PIPJ and DIPJ) appointment
At your appointment, Dr Tomlinson will take a history of your symptoms, examine the affected joints, and discuss your x-ray images. Together you will discuss the treatment options that suit your situation.
Frequently Asked Questions
What is finger osteoarthritis?
Finger osteoarthritis is wear-and-tear arthritis affecting the small joints of the fingers, most often the middle joint (the proximal interphalangeal joint, or PIPJ) and the joint nearest the nail (the distal interphalangeal joint, or DIPJ). As the cartilage in these joints wears down, the joints become painful, stiff and can develop firm bony lumps.
What causes it?
Finger osteoarthritis is linked to age, a family history of osteoarthritis, being female, a previous injury to the joint, and having osteoarthritis affecting other joints in the body.
What can I do myself?
Mild symptoms are often helped by activity modification (not overloading the joints), joint protection such as using larger joints to carry load where possible, regular range of movement exercises, the application of warmth or cold, ergonomic aids such as jar openers and adapted utensils, and simple pain relief or anti-inflammatory medication such as paracetamol.
What can a hand therapist do?
A hand therapist can provide advice and treatment either as an alternative to surgery, or in association with surgical treatment. Hand therapy assistance may include activity modification advice, range of movement and strengthening exercises, suggestions on aids, advice on the therapeutic use of warmth/heat, and by fabricating splints for the affected joint(s) during flare-ups to help settle symptoms and maximise function.
What can a hand surgeon do?
Dr Tomlinson will take a history, examine the affected joints, arrange x-rays if these have not already been performed, and discuss options for management. Referral for a corticosteroid injection administered by a radiologist under ultrasound guidance can help settle a painful flare-up in some cases. If a joint is persistently painful or deformed despite non-surgical measures, surgery may be recommended, sometimes to fuse the joint and remove painful movement, or in other cases to replace the joint with a prosthetic joint.
What can I expect from treatment?
The aim and the outcomes of treatment vary. Surgery is generally performed for pain relief, not to improve the range of movement.
What happens if it's left untreated?
Finger osteoarthritis is not dangerous, but it can affect grip, dexterity and finger appearance over time. It is worth seeing a hand surgeon if you have persistent finger joint pain or stiffness affecting your grip or daily activities, or if a joint is becoming progressively deformed.
Related conditions and treatments
Finger osteoarthritis affects the small joints of the fingers. If the joint at the base of your thumb is affected instead, this is usually thumb base osteoarthritis. A firm, fluid-filled lump near an affected end joint may be a digital mucous cyst, which is closely linked to osteoarthritis at that joint.