Dupuytren's contracture is a rare hand disorder caused by a thickening of the layer of fibrous tissue beneath the skin of the palm and the finger(s). This thickening causes tendons to tighten (contract), which makes the finger difficult to extend. As a result, the finger is continually "curled up." Although more common in men than women, the cause of Dupuytren's contracture is unknown. However, people who get the condition tend to drink significant amounts of alcohol; have diabetes; smoke; or have seizures similar to those from epilepsy.
Symptoms of Dupuytren's Contracture
The symptoms of Dupuytren's contracture usually come on quite gradually. Symptoms include one or more small nodules that form in the palm. Although tender when they first form, the tenderness often disappears. Nodules can then thicken and contract, forming tough bands of tissue beneath the skin. Eventually, one or more of the fingers may curl toward the palm. Over time, straightening the curled fingers may be difficult, affecting the ability to grasp large objects. Although all fingers can be affected, the two most common are the ring and "pinky" fingers.
Treatment of Dupuytren's Contracture
Dupuytren's contracture cannot be stopped or cured. Because it progresses very slowly, it may not cause problems for years. There is also the chance that, even if nodules form in the palm, they will never progress further. If the condition becomes problematic, both nonsurgical and surgical treatments are available.
Steroid injections are a nonsurgical treatment for the pain caused by nodules. They usually help relieve pain, and may keep the contracture from getting worse. In cases in which fingers are already contracted, XIAFLEX® injections, which contain a mixture of enzymes that helps dissolve thickened tissue, may be used. If Dupuytren's contracture continues to get worse, surgery may be recommended.
If Dupuytren's contracture continues to get worse, surgery may be recommended. During surgery, the bands of thickened tissue in the palm are divided or removed to increase finger flexibility. Postsurgery, physical therapy may be required.
How is Dupuytren's Contracture Diagnosed?
Your doctor will be able to discern quite a bit about your condition just by looking at your hands. The physical examination will look for nodules on the palm. These can be firm and painful when the doctor touches them. The presence of nodules, even before the finger begins to bend, may provide sufficient information to diagnose Dupuytren's Contracture.
Is it Necessary to Treat Dupuytren's Contracture?
Yes. Treatment is necessary for this condition even though it tends to progress gradually. The sooner you receive proper treatment for Dupuytren's Contracture, the less likely it is that you will suffer significant consequences. Because this condition involves nodules and stiffness in the ligaments and tendons of the hand that ultimately causes one finger to remain in a bent position, it will eventually become difficult to grasp objects. Due to the deformity in the finger, the risk of hand injury also increases.
Can Stretching Exercises Help Dupuytren's Contracture?
When the signs of Dupuytren's Contracture are noticed, it's common to look for ways to cure the disease through exercises and home remedies. While this isn't possible, there is value in performing stretching movements every day. Doing so may not slow the progression of the contracture but it may help you remain more comfortable as you decide which clinical treatment would best suit you.
It isn't enough to pull back on the bent finger when dealing with Dupuytren's Contracture. If you stretch with too much force, you may ultimately do more harm than good. If you're interested in performing stretches to improve comfort and hand mobility, it's imperative that you go slow. If a stretch hurts, stop. With this gentle approach, you can stretch the hand several times a day without complication.
Some of the common stretches performed for Dupuytren's Contracture include:
- Finger lifts. With your palm against a flat surface, raise one finger at a time and hold for a few seconds.
- The finger spread. With your palm against a flat surface, just fan your fingers wide and then pull them back together.
- Thumb taps. Press your thumb to the tip of each finger, one finger at a time, working your way from one to the next and back again.
- Finger bends. With one hand held in front of you, palm facing away, use the other hand to gently bend the top two joints of the fingers, near the tips. Hold for a few seconds, then straighten.
Is XIAFLEX® an Alternative to Surgery for Dupuytren's Contracture?
As much as possible, we take a conservative, non-surgical approach to straightening bent fibers. XIAFLEX injections have a strong clinical track record in even more significant cases involving multiple bent fingers. Some studies suggest that the outcome of this therapeutic treatment is comparable to surgery. To determine the best way to free your finger or fingers from Dupuytren's Contracture, your doctor will perform a comprehensive examination.