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Can Dupuytren's Contracture Go Away By Itself?

March 06, 2021

Named after the French surgeon Guillaume Dupuytren, Dupuytren's contracture is a slow, progressive condition that affects the palms of the hands. It is also known as Morbus Dupuytren or the contracture of the palmar fascia - a disease that makes manual tasks difficult to perform.

   

Because of the impact that Dupuytren's contracture can have on the sufferer’s daily life, it can be a burdensome disease. Thankfully, there are treatments and ways to reduce the diseases’ symptoms. 


The answer, then, is No, Dupuytren's Contracture will not go away by itself. But, it may go away with natural methods, like a naturalDupuytren's contracture cream.

An Overview of Dupuytren's Contracture

Dupuytren's contracture is a connective tissue disorder wherein the finger joints cannot be totally straightened. This limits the fingers to only move in flexed or bent positions. 

The deformity results from the thickening and shortening of the connective tissues in the hand - as well as the fibrous tissue called fascia. These changes also affect the skin, thus leading to restrictive movements in the affected area.   

Who are More Likely to Suffer From Dupuytren's Contracture?

Dupuytren's contracture affects as much as 5% of people in the US. 

The risks are 3-10 times higher in those of Northern European descent, thus the moniker 'Viking disease' and 'Celtic hand'. As such, it is more common in people who come from Northern Scotland, Norway, and Iceland.     

Dupuytren's usually affects men in their 40s to 50s. As for women, the disorder occurs much later - with the symptoms being less severe.

Although Dupuytren's often happens in old age, it can manifest in younger people - with some developing it during childhood. Sadly, those who have it early often have a more severe form of the disease. 

Dupuytren's usually affects one hand - with the right hand being involved 2x more than the left hand. In the end, about 80% of sufferers eventually develop the condition in both hands.   

What Causes Dupuytren's Contracture?

The exact cause behind Dupuytren's contracture remains unknown. Experts, however, believe that the genes related to cell growth and differentiation play a big role in its development. 

People with Dupuytren's contracture usually have excessive amounts of myofibroblasts. These contain myofibrils - the basic units of muscle fibers that enable them to contract. 

An increase in myofibroblasts makes the fascia or fibrous band contract abnormally. In response to this, the body more produces more type III collagen, a type of connective tissue.  

The abnormal contraction - coupled with the increase in type III collagen - brings about the deformities and movement issues seen in Dupuytren's contracture. 

Since genetics likely cause Dupuytren's, it can occur in the following generations. In fact, inheritance is present in 70% of the cases.

Even with the lack of family history, Dupuytren's can also occur in people who have:  

  • Thyroid disorder
  • Tuberculosis
  • Diabetes
  • High cholesterol levels
  • Smoking problems 
  • Excessive alcohol intake
  • Liver disease
  • Previous hand injury 
  • Taken medications such as metoprolol, tetracycline, isoniazid, and other anti-epilepsy drugs

Diagnosis and Grading

Doctors usually use the Hueston tabletop test to diagnose Dupuytren's. The result is positive if the patient is unable to lay his/her palm flat on the table. 

After confirming the diagnosis, the physician will grade the severity and progression of the disease according to the following: 

  • Grade 1:Presence of thickened nodules and bands that cause skin pitting, pucking, or tethering
  • Grade 2: Presence of a peritendinous band that limits the extension of the affected finger
  • Grade 3:Onset of flexion contracture - a joint that cannot be totally straightened

Symptoms of Dupuytren's Contracture

The first symptoms include the presence of small, hard bumps under the skin of the palm. Some often mistake these for calluses. However, these eventually grow larger and become more painful - fooling some people into thinking that it's cancer.   

While Dupuytren's nodules - which can last for months or years - remain to be the only symptom in some people, the disease is likely to progress in most. 

Through time, cords or tight tissue bands develop - thus causing the surrounding skin to shrink. This event pulls the fingers down so they end up drawn towards the palm. Once the disease progresses, the patient is no longer able to extend or straighten the affected finger. 

Dupuytren's contracture often affects the ring (fourth) finger, followed by the little (fifth), middle (third), and index (second) fingers. In some people, the thumb develops a contracture as well. 

Apart from the inability to extend the affected fingers, those who have Dupuytren's contracture can also suffer from the following:

  • Inflammation
  • Tenderness
  • Burning
  • Itching
  • A bruising pattern similar to a resolving wound
  • Pressure or tension when straightening the fingers

How Dupuytren's Contracture Affects Daily Living

If left untreated,Dupuytren can progress to more severe contractures that direly affect daily living.

People who need a flat, stretched palm to stretch their fingers usually notice the symptoms first. As such, musicians who play reed instruments or the keyboard are quick to note the difference. 

As the disease progresses, simple things such as putting on a seat belt or placing hands in tight denim pockets become more difficult.

As the fingers bend further to 70-80 degrees, flattening the palm is no longer possible. This makes activities such as shampooing or shaving hard to do. 

Washing the face and putting on gloves also become a challenge once the fingers bend to 90 degrees. 

When the fingers bend to 135 degrees, hygiene becomes an issue. That's because it will be harder to dry the affected skin folds. In the end, this can result in a fungal infection similar to that of athlete's foot. 

Other Risks Related to Dupuytren's Contracture

Unfortunately, having Dupuytren's contracture means an increased risk of developing other connective tissue disorders:

  • Garrod pads or bumps on the knuckles
  • Frozen shoulder, where scar tissue causes stiffness and pain
  • Ledderhose disease,which affects the feet
  • Peyronie disease or the abnormal curvature of the penis in males

What Are the Treatment Options for Dupuytren's Contracture?

As mentioned, Dupuytren's contracture does not go away on its own. Although this is the case, the following treatments can help reduce symptoms and improve function: 

Modifying Tools

Those with mild Dupuytren's barely require intensive treatment. However, they will benefit a lot from modifying tools. 

Padded gloves and cushioning handles, for example, can help with grasping. Massage and hand exercises, on the other hand, help reduce pain and improve hand function. 

Cortisone Injection

Injecting cortisone to the affected areas may temporarily delay the progression of the disease.  As such, this treatment is best done during the early stages of Dupuytren's - particularly when the nodules have just appeared. 

Additionally,research has also shown that cortisone treatment may help reduce the need for invasive surgery. 

Creams

For those who dislike injections and other invasive treatments, the application of Dupuytren's contracture all-natural cream may help.

The product, which contains Aloe Vera, Sunflower oil, Tamasul oil, Vitamin E, and Arnica-Montana, may help reduce inflammation. 

For best results, apply the cream to the affected areas 1-2 times daily. 

Enzyme Treatment

The injection of the enzyme collagenase (Clostridium histolyticum) helps soften the cord on the palm. This makes the cord easier to break - which then allows the doctor to straighten out the patient's bent fingers. 

As it is minimally invasive, enzyme treatment reduces the need for big incisions. It can address multiple fingers at the same time - and does not require physical therapy right after.

Sadly, enzyme treatment is not available in all medical facilities. You may have to travel far to find a specialist who offers this procedure. 

Needle Release 

Also known as needle aponeurotomy, this less-invasive treatment involves the creation of small incisions. Here, needles with Triamcinolone acetonide work by breaking apart the stiff tissue.

For best results, the patient will need 3-4 shots to experience improved hand function. 

Compared to surgery, recovery is quicker and complications are less severe. After repeated injections, however, tenderness, color changes, and atrophy (decrease in tissue size) may occur. 

While effective, the downside to this treatment is that it only suits certain Dupuytren's patients. It's only done in certain areas since the needle could potentially damage a tendon or nerve. 

Radiation

Here, the technician beams high doses of X-rays towards the affected areas. While this can help delay the progression of the disease, it's only good during the active phase. That being said, it's best done when the nodules are growing and the cords are forming. 

More than just preventing contractures, radiation may also help reduce the symptoms of tenderness and itching. 

Surgery

In this procedure, the surgeon will work to remove the thickened bands. 

As with any other surgery, this has risks such as stiffness and nerve injury. Add to that, the recovery time can last for 3 months. As such, surgery is only recommended for those with severe contractures (30 degrees and above) that significantly limit daily activities. 

Unfortunately, even with surgery, the disease can recur. This is especially the case for people who develop Dupuytren's early on in life.


Sadly, Dupuytren has no cure - meaning that the contracture won't go away by itself. Although this is the case, treatments such as creams, injections, and surgery may reduce discomfort and movement limitations.


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