Introduction to Heberden Osteoarthritis

Heberden arthrosis is characterized by painful hand and finger joints with nodule formation. Stiff fingers, swelling and pain are the determining factors for the mostly chronic disease.

What is Heberden osteoarthritis?

According to ABBREVIATIONFINDER, Heberden arthrosis belongs to the group of so-called degenerative joint diseases, which affects hands and fingers. Because this form of joint disease occurs as polyarthrosis, both hands and all fingers are usually affected to varying degrees.

As an inflammatory cartilage disease, Heberden arthrosis is progressive, i.e. chronically progressive. The rheumatic disease is named after the doctor William Heberden, who lived in England from 1710 to 1801. It is wrongly assumed that Heberden arthrosis is purely a symptom of old age, but this is not the case, although the disease occurs more frequently after the age of 50.

The wear and tear in the finger joints is already detectable in some thirty-year-olds. In the case of arthritic changes in the large joints, both sexes are equally affected in percentage terms, but this is not the case with Heberden arthrosis, because women are statistically ten times more likely to be affected by this special form of finger joint arthrosis. Like other arthrosis diseases, Heberden arthrosis also develops insidiously.


Finger polyarthrosis is a so-called idiopathic clinical picture, so no clear cause has been found to date. However, there is concrete evidence that genetic disposition is a decisive factor in the onset of the disease.

In addition, the risk of illness increases after the age of 50. After the end of the menstrual period, postmenopause, women are often affected by Heberden arthrosis. It was found out that Heberden arthrosis is based on a defect in the cartilage layer of the finger joints. Skin and hair grow back, but damaged cartilage structures in adulthood do not.

In addition, cartilage damage can only be repaired poorly or not at all with increasing age. On the basis of this cartilage wear, the typical clinical picture of Heberden arthrosis develops over time as a result of inflammatory changes. Mostly the finger middle and finger end joints of both hands are affected, also the thumb saddle joint as well as in the wrist the connections between ulna and radius or scaphoid and radius can be affected by Heberden arthrosis.

Symptoms, Ailments & Signs

Heberden arthrosis takes a gradual course. There are often no symptoms at first, which is why the disease usually goes unnoticed for a long time. As the disease progresses, the pain becomes increasingly severe and can radiate from the hand to the fingers. Fingers feel stiff and tend to swell.

Initially, the symptoms only occur when you move and eventually persist even when you are at rest. The mobility of the fingers is increasingly reduced, although often only individual fingers or certain areas of the hand are affected. Joint swelling, reddening and overheating can occur at times.

If the finger end joints are involved, cystic thickening develops on the fingers from which jelly-like fluid can leak. In the further stages, bony thickening can occur on the right and left of the joints, which is often also associated with severe pain.

If Heberden osteoarthritis is not treated early, it can lead to further symptoms and complications. Typically, after a few months or years, joint wear and tear occurs, which manifests itself in severe pain and restricted mobility. In the advanced stage, the affected hand can no longer be moved or can only be moved with severe pain.

Diagnosis & History

Diagnosis and course of finger joint arthrosis are directly related to early or late symptoms. A medical diagnosis should be made as early as possible in order to promptly initiate adequate treatment and thus slow down the progression of the disease process. However, Heberden arthrosis is not considered curable.

In most cases, the diagnosis can be made by a general practitioner or rheumatologist based on the clinical symptoms. Typical early symptoms are fatigue pain, stress pain and radiating pain. If there is no therapy, the clinical picture solidifies over time and leads to permanent pain, restricted movement, with pronounced sensitivity to the weather and night pain. In many cases, the medical history and visual diagnosis of the typical nodules enable a diagnosis that can be substantiated together with the clinical symptoms and imaging methods.

The conventional X-ray of the hands is still considered the “gold standard” for the reliable diagnosis of Heberden arthrosis. Especially in the late stages of the disease, so-called sclerosing, narrowing of the joint space and osteophytes can be detected in the X-ray image. The course of the disease is usually insidious, progressive and chronic.


In most cases, the patient suffers from severe pain in the hands and joints due to Heberden arthrosis. In most patients, this pain leads to severe limitations in movement and everyday life and thus to a reduction in the quality of life. The joints of the fingers usually become stiff and pain occurs.

The pain can also occur in the form of rest pain and thus cause the patient to have trouble sleeping. Knots also form at the joints of the fingers. The patient’s resilience decreases extremely due to this pain and in many cases those affected withdraw from life. The diagnosis of Heberden arthrosis is relatively easy with an X-ray, so that treatment can begin at an early stage.

In many cases, however, the symptoms are initially ignored if the pain is not particularly severe. However, it is not possible to treat the Heberden arthrosis causally. For this reason, the pain and restricted mobility that occur as a result of this disease are primarily treated. There are no further complications. Surgery is also usually possible.

When should you go to the doctor?

Since Heberden arthrosis leads to a significant worsening of the symptoms and does not heal itself, this disease must be examined and treated by a doctor in any case. As a rule, a doctor should be consulted if the person concerned suffers from very stiff finger joints. These can no longer be moved easily, so that there are severe restrictions in the everyday life of the person concerned. Severe pain in the fingers themselves can also occur and also indicate Heberden arthrosis.

This pain also spreads to the hand. Small knots often form on the finger joints, which are also a symptom of Heberden arthrosis and should be examined. Those affected often also suffer from weather sensitivity or nocturnal pain, which can also have a negative effect on the patient’s psyche.

The disease can be diagnosed by a general practitioner or by an orthopedist. Further treatment depends on the patient’s condition and is usually carried out by means of various exercises or cortisone injections.

Treatment & Therapy

A causal, i.e. cause-related therapy of Heberden arthrosis is not possible. All available therapy measures are aimed at enabling the patient to live as pain-free as possible and to promote the preservation of the mobility of the finger joints as best as possible.

In the foreground of the therapeutic measures are, in addition to the constant improvement of the symptoms and the symptoms, a delay in the progression. The pain symptoms are mainly caused by inflammatory processes in the degenerative cartilage changes. Accordingly, a reduction in pain symptoms can be achieved through the high-dose administration of anti-inflammatory drugs. So-called non-steroidal anti- inflammatory drugs such as ibuprofen, acetylsalicylic acid or paracetamol are used.

In the case of severe disease progression, an inhibition of inflammation can also be achieved with cortisone. Long-term oral medication with cortisone is only indicated in exceptional cases because of the significant side effects. In addition, high-dose glucocorticoids can be injected directly into the affected finger joints.

However, the use of these and other drugs should be limited to periods of inflammation and pain. In addition to these medications, physical therapy with fango packs or exercise treatments is an important part of the treatment. The last option is a stiffening operation on the finger end joints.

Outlook & Forecast

Osteoarthritis is generally considered incurable. Articular cartilage can only regenerate in children. In all other cases, the disease progresses continuously. Therapy can only delay development. The prognosis can therefore be described as mixed. However, thanks to suitable care, patients do not have to suffer any pain. If osteoarthritis is not treated at all, it quickly turns into a loss of motor skills.

Women often develop Heberden arthrosis after menopause. Compared to men of the same age, their risk is ten times higher. They form the largest group in relation to all patients. Statistically, almost 200 out of 100,000 women are affected by osteoarthritis. In the final stage, severe hand movement restrictions are typical. A loss of strength makes everyday movements difficult. Women and men often need help around the house.

Those affected alleviate the known symptoms through general measures, pharmacological treatment and physiotherapy. Physiotherapy in particular has proven to be extremely effective. General measures include orthopedic aids. The consumption of foods with omega 3 fatty acids has also proven itself.


There is no specific prevention of Heberden osteoarthritis. Nor could it be proven that diet or the exercise of specific professional activities could have any influence on the pathogenesis or onset of Heberden arthrosis. In the case of a genetic disposition or frequent family occurrences of Heberden arthrosis, the diagnosis should be made as early as possible in order to delay the chronic course of the disease for as long as possible through appropriate therapeutic measures.


In the case of Heberden arthrosis, there are a number of aftercare measures available to those affected. First and foremost, the early detection and treatment of this disease is important to prevent further complications or symptoms. A doctor should be consulted as soon as the first symptoms and signs of Heberden arthrosis appear in order to prevent further complications or a further deterioration of the symptoms.

Self-healing cannot occur with this disease. Treatment is by taking medication. Those affected are primarily dependent on regular intake and also on the correct dosage of the medication so that the symptoms can be properly alleviated. In the event of side effects or interactions, a doctor should always be consulted first.

Physiotherapy is also often necessary to treat Heberden arthrosis. Many of the exercises from such a therapy can also be carried out at home, which alleviates the symptoms. Patients are often dependent on the help and support of their own family and friends. Above all, psychological upsets or depressions are prevented or alleviated. The life expectancy of the patient is usually not reduced by Heberden arthrosis.

You can do that yourself

Regular exercise helps with Heberden arthrosis to strengthen the finger joints and maintain their mobility. Pressing a softball has proven to be particularly effective. Movement exercises carried out in the water are also very effective and are generally found to be pleasant. Warm baths with the addition of hay flowers or moor substances are also beneficial.

On the other hand, cold applications in the form of ice packs or cold curd compresses should be used to counter an acute flare-up of arthrosis characterized by symptoms of inflammation. In addition, pain and inflammation therapy under medical supervision is usually required, and plant-based medication can be used to support this.

The root of the devil’s claw, which has an analgesic and anti-inflammatory effect, should be mentioned here in particular, and preparations made from nettle, willow bark and arnica can also alleviate the symptoms.

Adhering to a few precautions in everyday life can reduce the force on the finger joints and counteract deterioration. Heavy loads should never be carried on one side or with outstretched fingers.

We recommend using a wringer to wring out wet laundry. When hanging up the laundry, non-spring-loaded clips are preferable to conventional clothes pegs. Craftsmen should prefer large tools that allow the hand to remain wide open when using them. If the mobility of the fingers is already severely restricted, aids such as electric can openers, special bottle openers and pen holders make everyday life easier.

Heberden Osteoarthritis