Bone Spurs in Hands: Causes and Treatment

Bone spurs, also called osteophytes, are outgrowths of bone that develop within joints over a long period of time. Bone spurs in the hand can develop as a result of injury to the finger joints or more commonly from osteoarthritis, where the protective cartilage covering the joint surfaces of the fingers breaks down and wears away over time. Bone spurs are most common in people over 60 years old, but they can occur in younger people too.

Without adequate cartilage, the bones of the finger joints become irritated and inflamed due to increased friction. As the body tries to repair the resulting joint damage, bone cells produce more bone growth in an attempt to provide more protection to the joint. This results in the formation of bone spurs that can change the appearance of the joint and limit mobility by restricting hand movement.

Types of Hand Bone Spurs

Bouchard’s Nodes

Bouchard’s nodes are bony enlargements occurring at the proximal interphalangeal (PIP) joints, the middle joints of the fingers. These nodes may or may not be painful and can cause swelling and stiffness, limiting the range of motion of the fingers and interfering with a person's ability to perform everyday tasks. People with a family history of Bouchard's nodes are more likely to develop this type of bone spurs. 

Heberden’s Nodes

Heberden’s nodes are bony enlargements occurring at the distal interphalangeal (DIP) joints, the joints of the fingers closest to the fingertips below the fingernails. They are very similar to Bouchard’s nodes, and may or may not be painful. They can also cause swelling and stiffness, limiting the range of motion of the fingers that can interfere with a person's ability to perform everyday tasks. There is also a genetic predisposition to the development of these nodes.

People with osteoarthritis have a decreased response of cartilage cells, called chondrocytes, to activate repair mechanisms when their joints are repetitively stressed. Both Bouchard’s nodes and Heberden's nodes are common in hand osteoarthritis, and have been found to occur more commonly in women and in a person's dominant hand.

Carpal Boss 

A carpal boss, also called bossing, is a bony overgrowth forming a lump on the back of the hand. A carpal boss is a bone spur of the carpometacarpal joint of the index and middle fingers where the bases of the metacarpal bones of these fingers join the trapezoid and capitate, two of the carpal bones of the wrist.

The exact cause of a carpal boss is not known, but it is usually associated with a traumatic injury to the hand and fingers or repetitive hand use. A carpal boss is often mistakenly misdiagnosed as a ganglion cyst because of the similarity in appearance and location, but unlike a ganglion cyst, a carpal boss is not movable under the skin.

Most carpal bosses are asymptomatic, although a small percentage of cases result in pain and limited finger mobility and can cause finger joint instability.

Bone Spur Causes 

Bone spurs can form due to joint damage caused by injury or repetitive overuse and wear and tear of the joints over time. Repetitive joint stress leads to osteoarthritis, where the cartilage between the joints of the fingers begins to break down. Cartilage is a protective cushioning between joints, and when it starts to break down, the bones are subjected to increased friction as they rub against each other. When this occurs, the body creates new bone as it tries to repair itself, resulting in an overgrowth of bone in the joint spaces of the fingers. Bone spurs can develop in any part of the fingers, including the thumb at the carpometacarpal (CMC) joint.

Diagnosis

Bone spurs can be diagnosed with X-ray imaging, which can clearly show any extra bone growth within the finger joints. Your healthcare provider will also perform a physical exam of your fingers and hands, as well as ask you about your symptoms and medical history to help make a diagnosis.

Treatment

Bone spurs are often asymptomatic, and many people are unaware they have them until having an X-ray performed. If a bone spur does not cause symptoms, no treatment is necessary.

Problematic bone spurs, on the other hand, can cause pain, inflammation, swelling, stiffness, and decreased range of motion within a joint. If a bone spur breaks off from the bone within your fingers, it becomes a loose body that can float within the joint space and limit your ability to move your finger joints comfortably.

Treatment options for problematic bone spurs include:

• Rest: Resting the finger joints that have problematic bone spurs by limiting hand use and avoiding activities like gripping, grasping, and pinching can help ease pain and inflammation. 
• Immobilization: Wearing a hand splint to immobilize the finger joints can reduce pain and inflammation.
• Ice: Applying ice to the fingers with bone spurs can help relieve pain and inflammation within the joints.
• Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage symptoms and reduce pain.
• Rehabilitation: Your healthcare provider may refer you to physical or occupational therapy to improve the mobility of your finger joints, increase the strength and flexibility of your hand muscles, and apply therapeutic modalities to alleviate pain, stiffness, and swelling.
• Corticosteroid injections: Your healthcare provider may suggest administering a corticosteroid injection into the finger joints to help decrease inflammation and relieve pain if other methods are not effective at improving symptoms.
• Surgery: If consistent pain persists, surgery may be recommended to remove the bone spurs or loose bodies irritating the finger joints. If severe osteoarthritis of the thumb joint is present, a trapeziectomy may also be performed to remove the trapezium bone of the thumb and any bone spurs or loose bodies to improve hand function. It is important to note that bone spurs may return over time as they are a common symptom of arthritis, which is still present and can progress even if a bone spur is removed.

A Word From Verywell

A bone spur in the hands is a commonly occurring condition as a result of osteoarthritis or injury to the hands and fingers. While bone spurs are often asymptomatic, other times they can cause significant pain, stiffness, and swelling that interfere with your ability to use your hands for everyday tasks.

If you notice any changes in the physical appearance of your hands or fingers or have difficulty with your ability to move your fingers due to pain or stiffness, make sure to talk with your healthcare provider to determine a possible diagnosis and discuss treatment options to address your symptoms.