Michelangelo’s Painful Osteoarthritis

A recent study in the Journal of the Royal Society of Medicine posits that Michelangelo Buonarroti suffered from osteoarthritis that left his hands “gnarled and aching, ” in his old age.

The diagnosis comes from of a group of medical researchers who analyzed the depiction of his left hand in three portraits from different points in his life. Unlike early paintings, the three portraits completed when he was between the ages of 60 and 65 depict his left hand as “limp and deformed—a symptom of the degenerative joint disease osteoarthritis.”

“It is now clear that Michelangelo was afflicted by an illness involving his joints. This interpretation seems corroborated by the vast correspondence with his nephew, Lionardo di Buonarroto Simoni, which reveals that the artist suffered from ‘gout’, an ill-defined general term of the period, encompassing all arthritic conditions. Michelangelo described the symptoms of his nephrolithiasis, with repeated expulsion of stones, and one dramatic acute obstruction, ” stated the Journal article.

The symptoms of “tophus arthritis” were described in the correspondence as a “cruel pain” affecting one foot. The study authors note a portrait of Michelangelo showing a deformed right knee with excrescences (but without clear signs of joint inflammation), seen in Raphael’s fresco The School of Athens, “adds support to these suspicions of ‘gout’.”

The researchers write that lead poisoning has also been suspected in several publications. “This could have been caused either by dye and toxic solvents dripping on his face or by his consumption of wine stored in lead containers. The artist’s transient nistagmus, during his work in the Sistine Chapel, may possibly have resulted from lead poisoning, but more likely it came from prolonged upward gazing in a dim light, responsible also for his reported dizziness and disturbed equilibrium. Lead intoxication could also explain the depression evidenced in his letters.”

All three paintings show the left hand of Michelangelo between the ages 60 to 65 years. They were interpreted by contemporary historians as suggesting left-handedness.

The authors write:

“The portraits show Michelangelo’s hand to be affected by degenerative arthritis, in particular at the trapezius/metacarpal joint level, as well as at the metacarpo/phalangeal joint level, the interphalangeal joint of the thumb, the metacarpo/phalangeal joint and the proximal interphalangeal joint of the index finger levels. These are clear non-inflammatory degenerative changes, which were probably accelerated by prolonged hammering and chiseling. The possibility of ganglion swelling at the dorsal side of the trapezius/metacarpal joint or metacarpo/phalangeal joint is less likely, because it would be expected at the flexor tendon side.

It remains still unknown if the suspected, but unproven, uric acid metabolic dysfunction may have contributed to these changes that are without evidence of tophi and are clearly not inflammatory. Michelangelo’s difficulties with tasks such as writing may have resulted from stiffness of the thumb and the loss of the ability to abduct, flex and adduct it. The swellings at the base of the thumb and the swellings of the smaller joints of the thumb and index are not gouty in origin; they may be interpreted as osteoarthritic nodules. “

Despite the debilitating effects on his primary working tools (his hands), Michelangelo “was seen ‘hammering’ up to six days before he died (18 February 1564) and his final work, the Rondanini Pietà, remained unfinished.”

The authors conclude that the diagnosis of osteoarthritis “offers one plausible explanation for Michelangelo’s old age loss of dexterity, emphasizing his triumph over infirmity, while persisting in his work until his last days. Indeed, it is interesting to note that functionality is maintained and that the continuous and intense work could have helped the Master to keep the use of his hands as long as possible.”