Finger Arthritis

What it is

Overview

Interphalangeal joint osteoarthritis is a common type of arthritis that affects the small joints in your fingers—the proximal interphalangeal (PIP) joints (middle knuckles) and distal interphalangeal (DIP) joints (near the fingertips). It happens when the smooth cartilage that cushions the ends of the bones wears down over time, causing the bones to rub together.

This leads to pain, stiffness, and changes in the joint’s shape. It’s often called “wear and tear” arthritis and is more common as people get older, especially in women.

Common signs and symptoms include:

Pain in the affected fingers, especially during or after use (like gripping objects)
Stiffness (reduced movement), particularly in the morning or after rest
Swelling and tenderness around the joints
Lumps on the joints—These are called Heberden’s nodes (near fingertips) or Bouchard’s nodes (middle knuckles)
Reduced grip strength and difficulty with everyday tasks, such as opening jars or buttoning clothes

When to see specialist

Symptoms often start mildly and worsen gradually.

Causes & risk factor

The exact cause isn’t fully understood, but several factors contribute to the development of interphalangeal joint osteoarthritis.

COMMON RISK FACTOR

Age — the risk increases significantly after age 50 as cartilage naturally wears down
Genetics — it often runs in families, with a stronger hereditary link in hand and finger joints
Previous trauma or injury — past fractures, dislocations, or damage to the finger joints can lead to uneven wear and arthritis later
Overuse or repetitive strain — jobs or activities involving repeated hand movements (like heavy manual labour) can accelerate joint damage
Other factors like smoking (which may impair cartilage health) and diabetes (linked to faster progression in some studies) may also play a role

It’s usually a combination of these rather than a single cause.

Treatment Options

There is no cure for interphalangeal joint osteoarthritis, but treatments can effectively manage pain, improve function, and slow progression. Many people start with non-surgical options, which help the majority control symptoms.

non-surgical

First-line Option Treatment

Lifestyle changes (resting the hands, avoiding activities that flare pain)
Splints or braces to support the joints
Hand exercises and therapy
Pain relievers like Paracetamol and Ibuprofen
Steroid injections for flare-ups

Success rate

These approaches provide good symptom relief for 70-80% of patients, especially in mild to moderate cases.

surgical

If non-surgical options fail and pain severely affects daily life

Joint fusion (arthrodesis) — the two bones that make the joint are permanently joined. This eradicates pain, but also eradicates any movement at that joint. This is more common for the DIP joints (near the fingernail.)
Joint replacement (arthroplasty) — an artificial implant replaces the damaged joint. Some joint movement is still possible after the operation, but it usually doesn’t return to a completely normal amount of movement. These implants may wear out over time.