Dupuytren’s (pronounced duh-pwee-truhnz) Contracture is a common disease that almost no one has heard of. Dupuytren's Contracture is a deformity of the hand that affects some of the tissue that sits under the palm. With Dupuytren's, the tissue develops knots, which eventually form a thick cord that can permanently pull fingers into a position in which they look bent.
Once the disease has taken control of the hands, it's impossible for someone to straighten out their fingers. This makes someone experience much more difficulty with tasks that were once easy, such as reaching a hand into their pocket, slipping on gloves, or shaking hands with someone. But who treats patients with Dupuytren's Contracture? Depending on the severity of someone's condition, a range of Dupuytren's Contracture specialists and professionals might be able to assist with the treatment of Dupuytren's.
Providers such as occupational therapists (OTs) and physical therapists (PTs) are most known for their work in hospitals and nursing homes to get people ready for returning home after an injury or illness. But these healthcare providers are also part of treatment teams within outpatient clinics, which is where they can help someone living with Dupuytren's Contracture.
Either of these providers might hold an additional credential that makes them a certified hand therapist (which is visible via the letters CHT after the therapist's name). While these providers have extensive training in dysfunction across every part of the body, those who are CHTs have specialized training specific to the hand (and upper body). For this reason, they are especially suited to treat diseases such as Dupuytren's.
Seeing this type of professional is as simple as requesting a referral from your doctor and making an appointment at a clinic near you. Either of these providers will complete an evaluation to determine your current pain levels, strength, and motion in the hand. They work with you to create goals for you to work toward, and then engage you in some light massage, strengthening activities, graded exercises, and the use of equipment to relieve pain and stiffness. Physical therapists and occupational therapists will also offer home activities for you to sustain your recovery beyond your official treatment plan. A standard plan usually lasts between 6 and 8 weeks depending on the condition and how severe it is.
Massage therapists actually have a wider range of experience than most people believe. While massage can be very helpful for people with Dupuytren's in the areas of relieving stiffness and easing pain, massage therapists can also work to mobilize joints further. What does this mean? When joints aren't aligned properly, they move poorly, cause pain, and don't work nearly as well as they should.
While Dupuytren's doesn't directly impact the joints, structures such as nodules and cords can limit the ability of the hand joints to move properly. This causes muscle tension, which contributes to poor joint function. By relieving tense and sore muscles as well as joint alignment issues, massage therapy can make individuals with Dupuytren's Contracture much more comfortable and able to use their hands in a purposeful way.
In many cases, even with all of these non-surgical treatments, surgery will still be necessary to reverse some of the effects of Dupuytren's Contracture. There are two types of surgery available. As noted, the least invasive surgical treatment available is needling, which involves a surgeon using needles to break up the fibrous tissue that causes the fingers to abnormally bend.
The other surgical procedure involves lifting up the skin of the palm and surgically removing all of the abnormal knots of tissue before replacing the skin on the palm. Unlike needling, this type of surgery will require someone to wear a splint for several weeks and see a therapist to help in the recovery process.
When it comes to Dupuytren's Contracture, the overall goal for any treating physician is to help the patient maintain as much hand function as possible. The best way to accomplish that is to catch the problem early, which is why it is best to pay attention to your body and see a hand specialist once you notice any issues.