The distal interphalangeal joint connects the bones at the tips of the fingers. Many people with arthritis experience pain at this location.
People who experience distal interphalangeal (DIP) joint pain may also experience other symptoms, depending on which type of arthritis they have.
Getting a diagnosis for arthritis as early as possible is vital, as early treatment may help slow the progression of the condition and alleviate painful symptoms.
In this article, learn more about DIP joint pain, as well as the treatment options.
The DIP joint is the first knuckle from the top of the finger. It connects the distal phalanx and middle phalanx, which are the two bones at the tip of the finger.
A person experiencing pain in the DIP joint may describe the feeling as:
Other symptoms of arthritis might include pain and swelling in the hand and toes, and a reduced range of motion in the affected joints.
The fingers or toes may look swollen or thick. Some people may experience changes in the nails, such as small indents or discoloration.
Some people may also notice crepitus, which is the cricking or cracking sensations that occur as the joint moves.
If inflammation from arthritis progresses, it may lead to Heberden's nodes, which are bony nodules that form at the DIP joint. The nodes occur as a result of wear and tear and inflammation in the joints.
When someone has osteoarthritis, the cartilage that cushions the joints starts to break down. Eventually, the cartilage cannot protect the bones anymore, causing the bones to rub together. This can be extremely painful. As this happens, bone tissue growth results in the formation of small nodes next to the existing bone.
Heberden's nodes are a sign that a person has more advanced osteoarthritis in the DIP joints. The fingers will likely be very stiff, painful, and have a reduced range of motion.
Without treatment, the inflammation in the DIP joint may lead to permanent deformity.
Along with symptoms in the DIP joint, the person may also experience pain and stiffness in other nearby joints, such as the proximal interphalangeal joint (PIP) joint in the knuckle below the DIP, and the joint at the base of the thumb.
DIP joint pain is often due to arthritis, usually osteoarthritis or psoriatic arthritis.
According to the Arthritis Foundation, arthritis is relatively widespread and is the leading cause of disability in adults in the United States. The overall risk is of developing arthritis is higher in females than males.
Arthritis is also more common in people with other chronic conditions, such as diabetes, heart disease, and obesity. Osteoarthritis is the most common type of arthritis, affecting about 31 million people in the U.S.
Osteoarthritis occurs when the cartilage in the joints wears down and typically does not have an inflammatory cause. The risk of osteoarthritis increases with age.
The Arthritis Foundation estimate that about 50% of all females and 25% of all males will experience symptoms of osteoarthritis in their hands by the time they are 85 years old.
On the other hand, psoriatic arthritis causes inflammation due to a response in the immune system. Psoriatic arthritis also has a link to the skin condition psoriasis, and a person with the condition will likely experience skin symptoms as well.
Diagnosing the underlying cause of DIP joint pain first involves a physical examination. Doctors will ask the person to describe their symptoms. They will inspect the skin for signs of psoriasis that may indicate psoriatic arthritis.
Doctors also use imaging tests to diagnose different forms of arthritis. X-rays may help confirm the presence of Heberden's nodes in the DIP. More sensitive imaging tests, such as MRIs and ultrasounds, help reveal the softer connective tissues in the joints and check for damage.
Treatment for DIP joint pain involves treating the underlying arthritis.
Psoriatic arthritis treatments often include drugs to relieve symptoms and slow the course of the disease, such as:
- disease-modifying antirheumatic drugs (DMARDs)
- targeted biologics
Home remedies may also help control symptoms. These include:
- heat packs to soothe and relax stiff joints,
- cold packs may help reduce inflammation and pain.
- over-the-counter drugs such as ibuprofen (Advil) and naproxen (Aleve) to help reduce pain and inflammation
A study in the journal Rheumatology noted that short term splinting, such as splinting the affected finger during the night, is a safe and straightforward way to help reduce symptoms and help the finger extend.
Exercise and stretching are also an essential part of arthritis treatment. Low impact exercises, such as swimming and cycling, can help improve strength and flexibility in the joints.
A doctor may also recommend targeted low impact exercises near the affected joints, usually hand and finger exercises.
Surgery may be a treatment option if the symptoms are leading to deformity. Surgery may aim to remove bone growths, reconstruct the joint, or fuse bones together if necessary. Surgery can help restore hand function and minimize pain.
DIP joint pain is a common symptom of arthritis, typically either osteoarthritis or psoriatic arthritis.
The person may also experience symptoms in other joints in their hands, feet, or other areas of the body. Someone with psoriatic arthritis might experience symptoms on their skin, as well.
Anyone experiencing DIP joint pain or other symptoms of arthritis should see a doctor. Early diagnosis and treatment can help manage symptoms or slow the progress of the condition.