I have large bumps on my all of my middle knuckles. They are tender to the touch and tender when put under pressure - like making a fist. They are on all 8 fingers (thumbs excluded). I have tried ice, heat, massage, reike, and anti-inflammatories. I've been to a dermatoligist. I had biopsies done on the pad type material - inconclusive. I've had cortisone injections and tried a topical steroid. No change. I am right handed but the issue is bi-lateral. I have a desk job. Tenderness seems to be greater first thing in the morning due to stiffness but continues throughout the day. I live in a temperate climate (CA). I do sports (run and ultimate frisbee). Abstension does not seem to matter. I've tried diet changes (no red meat, no nutrisweet, no alcohol). No change. Other health issues include high blood pressure, leg (hamstring/periformis), and heel pain. Spirits generally good. I experience fatigue seemingly early in evening. I am at a loss for next step(s) and I am open to suggestions.