Why are my fingers starting to bend sideways? Understanding the causes

Over half of women and a quarter of men experience hand osteoarthritis by age 85, a common factor behind joint changes. Knowing the underlying reasons is crucial when asking, why are my fingers starting to bend sideways? This guide will walk you through the potential causes and necessary steps.

Quick Summary

Bent fingers and joint deformities are often linked to arthritis, such as rheumatoid or osteoarthritis, which cause joint inflammation and cartilage breakdown. Other factors include previous injuries, ligament issues, and congenital conditions. A doctor can diagnose the specific cause through physical exams and imaging.

Key Points

• Arthritis is a major cause: Rheumatoid arthritis (RA) and osteoarthritis (OA) are the most common reasons for fingers bending sideways due to joint inflammation and damage.

• Autoimmune versus 'wear and tear': RA is an autoimmune disease attacking joint lining, while OA is a degenerative condition caused by cartilage breakdown.

• Look for specific deformities: RA can cause ulnar deviation (fingers drift toward the pinky), swan-neck, and boutonnière deformities, while OA is associated with bony growths called Heberden's and Bouchard's nodes.

• Don't overlook other factors: Previous injuries, nerve damage, and congenital conditions like clinodactyly can also lead to crooked or bent fingers.

• Early diagnosis is key: A doctor can use physical exams, x-rays, and blood tests to pinpoint the cause and create a tailored treatment plan to manage symptoms and slow progression.

• Treatment options are varied: Management can include medication, supportive splints, physical therapy, and lifestyle adjustments to improve hand function and reduce pain.

Common causes for fingers bending sideways

Many people notice their fingers changing shape over time, and a sideways bend is a common concern. While several conditions can cause this, degenerative joint diseases are the most frequent culprits. Understanding the specific cause is the first step toward effective management.

Arthritis: The most common culprit

Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an autoimmune disease where the body's immune system attacks the joint lining, or synovium. Chronic inflammation can damage the cartilage and bone, weakening the ligaments and tendons that support the joints. In the hands, this often leads to a condition called ulnar deviation, or ulnar drift, where the fingers drift toward the little finger. This can make it difficult to perform daily tasks like holding objects or typing.

Osteoarthritis (OA)

Often called "wear and tear" arthritis, osteoarthritis involves the breakdown of the cartilage that cushions the ends of bones. When the cartilage wears away in the finger joints, bone-on-bone friction causes pain, stiffness, and the growth of bony spurs called nodules. These nodules, known as Heberden's nodes (at the fingertip joints) and Bouchard's nodes (at the middle finger joints), can cause the fingers to swell and bend abnormally.

Psoriatic Arthritis (PsA)

Psoriatic arthritis is a form of arthritis that affects some people with the skin condition psoriasis. It can cause significant swelling and pain in the fingers, sometimes affecting the small joints closest to the nails. Chronic inflammation from PsA can lead to joint damage and result in fingers becoming misshapen or bending sideways.

Other specific deformities and injuries

Besides general arthritis, more specific deformities can cause fingers to bend sideways.

• Swan-Neck Deformity: This condition is characterized by a hyperextended middle finger joint (PIP) and a flexed fingertip joint (DIP), creating a crooked, swan-like appearance. It is commonly caused by rheumatoid arthritis but can also result from a mallet finger injury or loose ligaments.
• Boutonnière Deformity: The opposite of a swan-neck deformity, this involves the middle finger joint flexing toward the palm while the outer joint extends. It can be a result of chronic inflammation, often from rheumatoid arthritis, or an injury.
• Clinodactyly: This is a congenital condition where a finger, most often the pinky, has a noticeable inward curve. It is caused by an abnormally shaped bone and may be present from birth. While generally harmless, severe cases may require surgical correction.
• Injuries: Past fractures or tendon injuries that didn't heal properly can alter the bone structure and mechanics of the finger, leading to a permanent sideways bend.

How a diagnosis is made

If you are concerned about your fingers bending sideways, a medical evaluation is recommended to determine the underlying cause and the best course of action. Here's what to expect:

1. Physical Examination: A doctor will examine your hands and fingers, assessing your range of motion, swelling, and tenderness. They will observe the alignment of your joints and look for specific deformities.
2. Medical History: The doctor will ask about your family history, other symptoms (like fatigue or skin issues), and when you first noticed the change in your fingers.
3. X-rays: Imaging tests, such as X-rays, provide a clear view of the joint alignment, cartilage space, and any bone erosions or spurs, which helps distinguish between different types of arthritis.
4. Blood Tests: For inflammatory conditions like rheumatoid arthritis or lupus, blood tests can detect specific antibodies and markers of inflammation.

Treatment and management options

Treatment for bent fingers depends on the cause and severity. A healthcare provider can recommend a tailored plan.

• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and inflammation. For RA, disease-modifying antirheumatic drugs (DMARDs) can slow disease progression.
• Splints: Special finger or wrist splints can provide support, realign the joints, and reduce stress on the affected areas.
• Physical or Occupational Therapy: A therapist can teach you exercises to improve joint mobility, strengthen muscles, and learn new ways to perform daily tasks to protect your joints.
• Lifestyle Adjustments: Simple changes like using adaptive tools for gripping or modifying your activities can help manage symptoms.
• Surgery: In severe cases, surgery may be an option to reconstruct or fuse joints to improve function and reduce pain.

Comparing rheumatoid arthritis and osteoarthritis

To help differentiate the two most common arthritis types, here is a comparison:

Feature	Rheumatoid Arthritis (RA)	Osteoarthritis (OA)
Cause	Autoimmune disease where the body attacks joint lining	"Wear and tear" over time, causing cartilage breakdown
Symmetry	Typically affects the same joints on both sides of the body	Can affect one or both sides, not always symmetrical
Joints Affected	Small joints of wrists, hands, and fingers (MCP joints)	Any joint, but common in thumb base and finger joints (DIP, PIP)
Symptoms	Warmth, swelling, pain, morning stiffness >1 hour, fatigue	Pain with activity, stiffness after inactivity, grating sensation
Deformities	Ulnar deviation, swan-neck, boutonnière deformities	Heberden's and Bouchard's nodes (bony lumps)

Final thoughts on managing bent fingers

Seeing your fingers bend sideways can be alarming, but it's important to know that many effective treatments are available. Early diagnosis and management are key to slowing progression and maintaining hand function. Ignoring symptoms can lead to more significant joint damage and pain. Consult with a healthcare professional to get an accurate diagnosis and a personalized treatment plan.

For more detailed information on managing hand and joint issues, you can visit the Arthritis Foundation website.

Frequently Asked Questions

What is the difference between ulnar drift and crooked fingers from osteoarthritis?

Ulnar drift, or ulnar deviation, is a specific bending of the fingers towards the little finger, most often caused by the joint inflammation and ligament damage from rheumatoid arthritis. Crooked fingers from osteoarthritis typically result from bony enlargements called nodes at the finger joints, rather than a general drift.

Can finger splints fix bent fingers?

Finger splints can be very effective in managing bent fingers, especially for deformities like swan-neck or ulnar drift. They can provide support, help realign joints, and prevent further progression, but they are most effective as part of a comprehensive treatment plan.

Why do my fingers bend more in the morning?

Increased stiffness in the morning is a hallmark symptom of inflammatory arthritis, such as rheumatoid arthritis. The inflammation worsens during periods of inactivity, causing pain and stiffness that can last for more than an hour after waking up.

Does hand exercise help with bent fingers?

Yes, targeted hand exercises, often prescribed by a physical or occupational therapist, can help. They can improve joint mobility, maintain strength, and reduce stiffness. However, it is important to perform exercises correctly to avoid causing more joint stress.

When should I see a doctor for bent fingers?

You should see a doctor if you notice your fingers bending sideways, especially if it is accompanied by pain, swelling, stiffness, or difficulty using your hands. Early diagnosis is crucial for starting effective treatment and slowing the progression of underlying conditions.

Is bent fingers a normal sign of aging?

While the risk of arthritis increases with age, finger bending is not a normal or inevitable part of aging. It is usually a sign of an underlying condition that can be treated. Joint changes with age are common, but severe bending and pain warrant medical attention.

Can a past injury cause my fingers to bend sideways years later?

Yes, a previous fracture or injury to the tendons or ligaments of the hand that did not heal properly can lead to permanent changes in the joint structure. This can result in a sideways bend or other deformities that may appear or worsen over time.