Osteoarthritis of the Finger Joints: Causes, Symptoms, and Treatment of Finger Joint Osteoarthritis

Osteoarthritis of the finger joints refers to the wear and tear of the articular cartilage in the finger joints of the hand. As the condition progresses, the entire bone can be destroyed, leading to the destruction of the joint surfaces. 

The distal and interphalangeal finger joints are particularly commonly affected by osteoarthritis. 

There are three main types of osteoarthritis of the finger joints:

• Heberden’s osteoarthritis: Refers to osteoarthritis of the distal joints
• Bouchard’s osteoarthritis: Osteoarthritis of the middle joints
• Rhizarthrosis: Osteoarthritis of the thumb joint

Osteoarthritis of the middle and distal finger joints is the most common form of osteoarthritis affecting the entire musculoskeletal system. However, many patients also develop polyarthrosis, in which multiple joints throughout the body are affected.

Finger joint osteoarthritis often begins around age 40 @ Moe /AdobeStock

Swelling of the affected joints is characteristic of osteoarthritis of the finger joints. Pain and, in some cases, redness—which worsen with use—are also typical.

As the condition progresses, finger movement becomes significantly restricted. Most patients report increased symptoms in the morning, known as “morning stiffness.”

Very typical and observed in nearly all patients are the protrusions known as nodules. Other symptoms may include a loss of strength in the affected hand and pain when grasping heavy objects.

Women are affected by the aforementioned symptoms more frequently than men. It most commonly affects middle-aged women. An estimated 90 percent of patients are female.

The exact causes of finger joint osteoarthritis are still largely unknown. It is a fact that genetic factors play a role and that this type of osteoarthritis is hereditary. 

Similarly, hormonal changes in women during menopause lead to more severe symptoms. In general, inflammation and irritation in the body contribute to the frequency and duration of symptoms caused by finger joint osteoarthritis.

Inflammation and irritation include:

• Allergies
• Intolerances
• Autoimmune diseases

An injury can also be the cause of finger joint osteoarthritis. If an injury involving the joints is not treated properly, misalignments can result. These misalignments cause the joints to continue wearing down, which in turn can lead to osteoarthritis.

If another injury is the trigger, doctors also refer to this as post-traumatic osteoarthritis of the finger joints.

The diagnosis is usually clear fairly quickly through visual examination and a physical exam: In cases of progressive osteoarthritis of the finger joints, a visible deformity develops in the joint area.

The swelling is then both visible and palpable. An X-ray clearly shows that the joint spaces have narrowed.

X-ray image of finger joint osteoarthritis @ Ladanifer /AdobeStock

The first point of contact for patients with suspected osteoarthritis is a specialist in physical medicine and rehabilitation or an orthopedic surgeon. If the disease is not yet advanced, the doctor will administer conservative therapy.

The following measures are used:

• Anti-inflammatory measures, 
• Physical therapies: laser therapy, shockwave therapy, high-frequency therapy, etc.
• Medications that have a decongestant and anti-inflammatory effect
• Occupational and physical therapy

Splinting is also an option; this immobilizes the affected joint. It is used primarily for the thumb saddle joint. A thumb orthosis is a splint that relieves pressure on the thumb during everyday movements.

Physical therapy for finger joint osteoarthritis @ Andrey Popov /AdobeStock

It is particularly important to identify and stop or reduce ongoing inflammatory processes. In this way, doctors can modulate inflammation, slow the progression of the disease, and achieve the greatest possible relief from pain. This is achieved through anti-inflammatory pain relievers.

All methods aim to preserve finger mobility. Patients can take certain steps themselves to halt the progression of osteoarthritis.

A change in diet, as well as exercises using a softball, have proven just as effective as water aerobics. These primarily alleviate the limited range of motion associated with so-called morning stiffness. 

Some patients also opt for autologous blood injections (PRP or plasma injections) directly into the affected joint.

The serum extracted from the patient’s own blood is a substance produced by the body that contains a high number of platelets. It ensures that the body activates its own repair mechanisms.

In advanced stages of the disease, the quality of life of those affected is usually so severely limited by wear and tear on the joint cartilage that orthopedic surgery is necessary to reduce pain.

There are two surgical options to consider:

• Joint fusion or
• Total joint replacement

Hand surgery is responsible for both procedures. Surgery is a last resort and is not necessary for many patients. It is most commonly performed when the joints in the thumb are affected.

So-called resection arthroplasties are most commonly used. In this procedure, doctors remove part of the joint and replace it with a piece of tendon.

Although this makes the thumb slightly shorter, it relieves the patient of their pain. Another popular surgical method is a thumb saddle joint prosthesis. Similar to a hip replacement, this procedure involves the use of an implant.

Finger joint osteoarthritis should not be confused with arthritis. In arthritis, not only the joint itself but also the surrounding connective tissue is affected. 

Finger joint osteoarthritis, on the other hand, usually follows a benign course and responds well to treatment. Arthritis, however, leads to painful and inflammatory damage to the finger joints, tendons, ligaments, and the joint capsule.

The course of finger joint osteoarthritis varies from case to case. The disease often progresses in recurring flare-ups.

Another characteristic symptom is pain at the start of a new movement. Over time, this pain tends to subside. Some patients experience no pain at all and only notice joint deformity and stiffness.

Patients can certainly influence the course of osteoarthritis themselves: In addition to various physical therapy measures, they must pay attention to their diet. It is best to avoid consuming too much meat and processed meats. 

Red meat, in particular, has been shown to contain pro-inflammatory substances that contribute to osteoarthritis in the finger joints. The same applies to excessive sugar intake.

Instead, focus on eating plenty of fruits and vegetables rich in vitamins, and maintain a healthy, varied diet. You should also avoid fruits and vegetables with a high acid content, such as tomatoes or strawberries.

Once the patient and doctor have decided on surgery and a joint replacement, comprehensive follow-up care is essential.

Immediately after surgery, the patient should begin physical therapy to quickly restore mobility.