Stiff & Painful Fingertips? Understanding DIPJ Joint Arthritis

Are the very tips of your fingers feeling stiff, achy, and maybe even sporting a bony bump? Those last joints on your fingers (DIPJ) are some of the smallest in your body, but arthritis in these joints can cause surprisingly big problems. The good news is there are ways to manage it and keep those fingertips working for you.

What Is DIPJ Arthritis Anyway?

  • DIPJ Basics: Your distal interphalangeal joint (or DIPJ for short) is the last joint on each finger. These delicate joints are crucial for fine tasks and precise gripping.
  • Wear & Tear Breakdown: Osteoarthritis (OA) occurs when the cartilage lining these joints starts to wear down, causing pain, inflammation, and those classic bony bumps (called Heberden’s nodes).
  • Other Types: While OA is most common, DIPJ joints can also be affected by rheumatoid arthritis and sometimes even gout.

Key Takeaway: Fingertip pain and stiffness shouldn’t be dismissed as “just arthritis.” Several types of arthritis can affect the DIPJ joints, and getting a proper diagnosis guides the best treatment approach.

Spotting the Signs of DIPJ Arthritis

Close-up of a hand with a swollen index finger and a red frame around it. This is a symptom of DIPJ arthritis, a type of osteoarthritis that affects the joint at the base of the finger. If any of these resonate with you, it’s worth discussing with a hand specialist:

  • Bony Bumps: Those hard bumps on your fingertips are a telltale sign of OA.
  • Stiffness & Reduced Range of Motion: Especially in the morning, or after inactivity.
  • Pain with Gripping: Fine motor tasks like writing, pinching, or handling small objects can become difficult.
  • Fingertip Deformities: Sometimes, the arthritis becomes severe enough to cause changes in the shape of the fingertip.

Key Takeaway: DIPJ arthritis often presents with visible changes to your fingertip, along with pain and impaired function.

Why Do I Have DIPJ Arthritis?

Here are some key factors:

  • It’s in the Family: If arthritis runs in your family, you’re more likely to experience it in various joints, including those fingertips.
  • Old Injuries: Past finger fractures or sprains that may have damaged the joint.
  • The Job: Tasks involving repetitive gripping, fine manipulation, or frequent pressure on the fingertips put those joints under extra strain.

Key Takeaway: DIPJ arthritis often has a combination of genetic predisposition and wear-and-tear factors, so even if it’s not in your family, your daily activities could contribute.

Getting a Diagnosis: It’s Not Just Wear & Tear

Typically, the classic signs of DIPJ OA and an X-ray are enough for a diagnosis. However, sometimes additional tests might be needed to rule out other causes like infection or gout. Key Takeaway: While often straightforward, it’s important to confirm the diagnosis of DIPJ arthritis, as other conditions can cause similar symptoms.

Treatment Time: It’s All About Finding What Works for YOU

Because DIPJ joints are so small, surgical options are more limited. Treatment usually focuses on:

  • Taking the Pressure Off: Modifying or avoiding activities that significantly aggravate your fingertips. [Internal Link: Blog on activity modification]
  • Hand Therapy: Specialised exercises to improve flexibility, strengthen supporting muscles, and reduce pain. [Internal Link: Blog on hand therapy]
  • Splinting: Custom supports can help reduce pain and sometimes improve finger alignment. [Internal Link: Blog on splinting benefits]
  • Medications & Injections: From over-the-counter options to steroid injections for short-term relief.
  • Alternative Therapies: Acupuncture, heat/cold therapy, or supplements may provide some benefit for certain individuals.
  • Surgical Fusion: A Solution for Pain: While nonsurgical therapies are the first line of treatment, in cases of unremitting pain and DIPJ deformity significantly impacting function, joint fusion can be a viable option. This procedure involves fusing the DIPJ bones together, eliminating painful motion within the joint. Although it sacrifices some range of motion, many patients with disabling pain find significant improvement in function after a fusion procedure, especially when performed on the index finger.

Key Takeaway: Despite the small size of DIPJ joints, modern surgical techniques, specifically joint fusion, offer a solution for severe arthritis that doesn’t fully respond to conservative measures. Treatment of DIPJ arthritis is highly individualised. What works for one person may not be as effective for another. Your Expertise I specialise in diagnosing and treating all types of arthritis that affect the hand and wrist, including DIPJ osteoarthritis.  I understand the pain and functional limitations it causes.  My treatment approach is highly personalised, ranging from conservative therapies to advanced surgical techniques. When surgery becomes necessary, I have extensive experience with joint fusion procedures, which can provide significant pain relief and restore stability to the fingertips for improved function. The surgery takes 20 minutes and is done under local anaesthetic! Summary Don’t let fingertip pain and stiffness hold you back. If you are struggling with the effects of DIPJ osteoarthritis, schedule a consultation to explore your treatment options.  Together, we will find the right approach to reduce your pain, improve your finger function, and help you get back to a full and active life. Disclaimer The information provided in this blog is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for diagnosis, treatment recommendations, and any questions related to a medical condition. The author, contributors, and publisher of this blog shall not be liable for any direct or indirect losses or damages related to the use of the information presented herein.

Meet Alistair Phillips, Your Orthopaedic Hand and Trauma Surgeon

Ali Phillips is a fellowship-trained hand surgeon dedicated to educating and empowering his patients. He believes in clear information and shared decision-making. When not in the clinic, you might find him wing foiling or on a cycling adventure. Connect: alistairphillips.co.uk @ali.thehandsurgeon on IG, Twitter/X, Threads, FB and TikTok