What Causes Bone Spurs in the Hand?

Bone spurs, also called osteophytes, are outgrowths, or bumps, 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 wears away and the bones rub together, causing bone spurs.

This article discusses the types of bone spurs, as well as causes, diagnosis, and treatment.

Types of Hand Bone Spurs

There are several types of hand bone spurs, including Bouchard's nodes, Heberden's nodes, and carpal boss. Bone spurs can develop in any of the joints in the fingers, including the thumb at the carpometacarpal (CMC) joint.

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.

These nodes 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, which can interfere with a person's ability to perform everyday tasks. There is also a genetic predisposition to the development of these nodes.

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 wrist at the base of the index (pointer finger) or long middle finger.

Most carpal bosses are asymptomatic, although a small percentage of cases result in pain and limited finger mobility and can cause finger joint instability. Carpal boss 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. Unlike a ganglion cyst, a carpal boss is not movable under the skin.

Bone Spur Causes 

Bone spurs are more common in older people, but they can occur in younger people too. Osteoarthritis and joint injuries can cause joint damage that leads to bone spurs.

Osteoarthritis

Bone spurs can form due to wear and tear of the joints over time. People with osteoarthritis have an imbalanced response of cartilage cells, called chondrocytes, to activate repair when their joints are repetitively stressed.

Cartilage is a protective cushioning between joints, and when it starts to break down, the bones of the finger joints become irritated and inflamed due to increased friction. When this occurs, the body creates new bone as it tries to repair itself, resulting in an overgrowth of bone (bone spur) in the joint spaces of the fingers.

Injury and Overuse

Bone spurs may also occur when the body tries to heal itself after an injury or due to repetitive overuse. For example, athletes who have added stress to their muscles, ligaments, and tendons can develop bone spurs.

Activities that cause repetitive joint use and stress in the hands—typing, or playing sports like tennis, golf, and baseball—can cause cartilage between the joints of the fingers to break down, causing damage that leads to bone spurs.

When to See a Healthcare Provider

If your hands or finger joints show any of the following, call your healthcare provider:

• Severe swelling
• Redness
• Warmth
• Drainage (bone spurs at the joints near the fingertips can get infected and begin draining)
• Generalized fever
• Malaise

Fever and malaise may be signs of a more serious medical condition such as infection or an inflammatory type of arthritis like psoriatic or rheumatoid arthritis. Consult with your healthcare provider to get an accurate diagnosis and treatment.

How Are Bone Spurs Diagnosed?

Your healthcare provider will 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. An X-ray or other imaging test of the affected joints can clearly show any extra bone growth to make a definitive diagnosis.

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

Bone Spur Treatment

Your healthcare provider will recommend treatment for bone spurs that cause symptoms, such as pain, inflammation, swelling, stiffness, and decreased range of motion.

In some cases, bone spurs may break off from the bone within your fingers. The broken piece becomes a loose body that can float within the joint space and limit your ability to move your finger joints comfortably.

If home remedies or medications aren't effective for symptoms, surgery to remove the bone spur or loose body may be recommended.

Home Remedies and Lifestyle

Some non-invasive remedies include:

• Rest: Resting the finger joints that have problematic bone spurs by limiting hand use and avoiding activities like gripping, grasping, and pinching may 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 may help relieve pain and inflammation within the joints.
• 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.

Medications

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage symptoms and reduce pain.

Your healthcare provider may also suggest a corticosteroid injection into the finger joints to help decrease inflammation and relieve pain if other methods don't improve 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.

Summary

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, talk with your healthcare provider to get a proper diagnosis and discuss treatment options to address your symptoms.

A Word From Verywell

Bone spurs in the hand can be secondary to a number of causes and can result in pain and limited functionality. It's important to meet with your healthcare provider for a full work-up and treatment.

— ANITA C. CHANDRASEKARAN, MD, MEDICAL EXPERT BOARD