Crooked fingers are most often caused by osteoarthritis or rheumatoid arthritis, which damage the cartilage, ligaments and tendons that hold the finger joints in line. Other common causes include tendon injuries such as mallet finger, trigger finger, Dupuytren’s contracture and old fractures that healed out of position. Many of these changes can be supported with splints, hand exercises and medical treatment, so new or worsening changes are worth getting checked early.
Perhaps you have noticed a finger that no longer straightens fully, a knobbly joint near your fingertip, or fingers that seem to lean to one side. This guide explains what causes these changes, what arthritic fingers typically look like, whether crooked fingers can be straightened, and what you can do to ease pain and keep your hands working.
Each finger has three joints: the joint nearest the fingertip (the DIP joint), the middle joint (the PIP joint) and the knuckle (the MCP joint). The thumb has two. These joints stay straight because cartilage, ligaments and tendons pull evenly on both sides. When any of these structures is damaged, the pull becomes uneven and the finger gradually drifts out of line.
The most common causes are:
Osteoarthritis is the most common type of arthritis in the hands. The cartilage that cushions the ends of the bones thins, the bone underneath thickens, and small bony outgrowths called osteophytes form at the edges of the joint. These changes make the joint larger and can push the finger out of line.
Osteoarthritis in the hands typically affects three areas:
Hand osteoarthritis usually develops slowly over years, most often from the mid-40s onwards. It is more common in women and tends to run in families. Joints often feel stiff for a short time after rest, usually less than 30 minutes, and ache more after heavy use.
Rheumatoid arthritis is an autoimmune condition in which the immune system attacks the lining of the joints, causing pain, swelling and stiffness. It often affects the same joints on both hands, especially the knuckles, the middle finger joints and the wrists. It can start at any age but most commonly begins between 40 and 60, and it is more common in women.
Long-term inflammation stretches the ligaments and tendons around the joints. Over time, this can lead to recognised finger deformities:
Early treatment makes a real difference. Disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, are prescribed by rheumatology teams to control inflammation and reduce the risk of permanent joint damage. If you have swollen, painful joints in both hands and morning stiffness that lasts longer than 30 minutes, see your GP promptly.
The two conditions can look similar at first, but they differ in cause, pattern and treatment:
| Osteoarthritis | Rheumatoid arthritis | |
| What it is | Wear and tear changes in the joint cartilage and bone | Autoimmune condition that inflames the joint lining |
| Joints most affected | Joints nearest the fingertips, middle joints, base of the thumb | Knuckles, middle joints and wrists, usually on both hands |
| Typical appearance | Hard bony lumps (Heberden’s and Bouchard’s nodes), fingertips angling sideways | Soft, warm swelling; swan-neck, boutonnière, ulnar drift, Z-thumb |
| Morning stiffness | Usually less than 30 minutes | Often longer than 30 minutes |
| Typical onset | Gradual, usually from the mid-40s onwards | Weeks to months, most often between 40 and 60 |
| Main treatments | Exercise, topical NSAIDs, splints, joint protection | Specialist care with DMARDs, plus splints and hand therapy |
Mallet finger happens when the tendon that straightens the fingertip is torn or pulled away from the bone, often after the fingertip is struck by a ball or caught on something. The tip droops and cannot be straightened on its own. It is usually treated with a splint worn continuously for six to eight weeks, and it heals best when splinting starts soon after the injury.
Trigger finger causes a finger or thumb to catch, click or lock when you bend it, because the tendon cannot glide smoothly through its sheath. It is more common in people with diabetes or rheumatoid arthritis. Rest, splinting, steroid injections and minor surgery are all treatment options.
Dupuytren’s contracture causes cords of thickened tissue to form in the palm, usually pulling the ring and little fingers towards the palm. It is often painless. Splints alone do not correct it, and treatment, where needed, is usually a needle or surgical procedure to release the cord.
A fracture or dislocation that healed out of position can leave a finger permanently angled. People with joint hypermobility may find their middle finger joints bend backwards too easily, which can look like a swan-neck deformity and cause pain or clicking.
Arthritic fingers often look swollen or knobbly at the joints and may lean sideways or bend at unusual angles. Signs to look out for include:
In the early stages, you may notice stiffness, aching after use or occasional swelling before any change in shape.
It depends on the cause and how long the change has been present. Flexible deformities, where the finger can still be gently moved back into line, can often be supported with splints and hand therapy to reduce pain and improve function. Fixed deformities caused by bony change usually cannot be reversed without surgery. Mallet finger often recovers well if a splint is worn early and consistently. For arthritis, the aim of treatment is usually to ease pain, keep the hand working and slow further change, rather than to fully straighten the finger.
NICE guidance recommends therapeutic exercise as a core treatment for osteoarthritis. Gentle range-of-motion and strengthening exercises help maintain movement and grip. A hand therapist, physiotherapist or occupational therapist can show you exercises suited to your joints.
Splints hold a joint in a better position, limit movement that causes pain and protect the finger during everyday tasks. Different splints suit different problems:
Arthro-Eze oval finger and thumb splints are designed and made in the UK. They are discreet, need no straps or tape and can be worn in water, so they can stay on while you wash your hands or cook. A splint should fit snugly without pinching. Measure carefully, follow the sizing guide, and stop wearing it and seek advice if you notice numbness, colour changes or skin irritation. If you are unsure which splint suits your finger, ask a hand therapist.
For osteoarthritis of the hand, NICE recommends anti-inflammatory gels (topical NSAIDs) as the first medicine to try. Oral anti-inflammatory tablets may be used at the lowest effective dose for the shortest time, so check with a pharmacist or GP before taking them, especially if you have stomach, kidney or heart problems. Steroid injections can ease a particularly painful joint. Rheumatoid arthritis needs specialist treatment with DMARDs or biological medicines, and painkillers alone are not enough.
Warmth, such as a warm water soak or a heat pack, can ease stiffness before activity. Cold packs wrapped in a cloth can help reduce swelling and soothe a flare-up.
Use tools with larger grips, spread loads across both hands, and break up repetitive tasks with rest. Carrying extra weight is linked with osteoarthritis in the hands as well as in weight-bearing joints, so keeping to a healthy weight and staying active supports joint health overall. If you have rheumatoid arthritis, stopping smoking helps, because smoking raises the risk of the condition and can reduce how well treatment works.
Where pain or loss of function is severe and other treatments have not helped, a hand surgeon may recommend joint fusion, joint replacement, tendon repair or, for Dupuytren’s contracture, release of the tight tissue.
Book a GP appointment if you notice:
If a fingertip suddenly droops after an injury, get it checked within a few days, because splinting works best when started early. If a joint becomes hot, red and very painful and you feel unwell or feverish, call NHS 111 or seek urgent care. In many parts of England you can refer yourself to NHS physiotherapy or musculoskeletal services; check your local NHS website. A referral to a rheumatologist usually comes through your GP.
Finger changes become more common with age, and hand osteoarthritis is the usual reason. They are not inevitable, though, and new or painful changes should be checked to rule out inflammatory arthritis or an injury.
You cannot always prevent it, but you can reduce the strain on your joints. Early treatment for rheumatoid arthritis, regular hand exercises, joint protection and well-fitted splints can all help slow further change and keep your hands working.
Splints can reduce pain and improve hand function for many people by supporting unstable joints and limiting painful movement. They work best when the splint matches the joint and the type of deformity, so ask a hand therapist for advice if you are unsure.
Osteoarthritis most often affects the joints nearest the fingertips, the middle joints and the base of the thumb. Rheumatoid arthritis most often affects the knuckles, the middle joints and the wrists, usually on both hands.
Crooked fingers are usually caused by osteoarthritis or rheumatoid arthritis, although injuries, trigger finger and Dupuytren’s contracture are also common causes. There is no cure for arthritis, but exercise, the right medication, joint protection and supportive splints can ease pain and help you keep doing everyday tasks. If a finger joint is unstable or drifting out of line, a well-fitted Arthro-Eze splint may make daily life easier. Speak to your GP or a hand therapist if you are unsure what is causing your symptoms.
This article is for general information only and is not a substitute for medical advice. Speak to your GP, pharmacist or hand therapist about your symptoms.
