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How is Dupuytren's Disease Prevented?

January 18, 2021

Dupuyten's Disease is also known as Duyputren's Contracture. This is a fitting descriptor because as the disease progresses people who are afflicted with it often experience one or more of their fingers involuntarily bending either outward or, most commonly, inward and down toward the palm of their hand.

There is no known way to prevent you from acquiring this disease. There are, however, treatments that may improve or remedy your condition.

What is Dupuytren's Disease?

Dupuytren's Disease is hand deformity that develops slowly over time when an excessive buildup of collagen causes the fascia in your palm to thicken. Fascia is the connective tissue in your hand that is located just beneath your skin.

The first sign of Dupuytren's Disease is the formation of a hard lump in the area where your fingers meet your palm.

As the disease progresses, it can cause the formation of a thick band that can run from your palm to your fingers. These bands can contract, causing your fingers to bend, which is called a flexion contracture. Dupuytren's most commonly affects the little finger and the ring finger. 

Only about 20% of people who have Dupuytren's Disease progress from having a new lump to the need to get treatment for contracture. The need for treatment increases with time by an estimated 20% to 40% per decade.

The more aggressive form of this disease is called Dupuytren's Diathesis. This affects both hands and is commonly accompanied by other conditions affecting the fascia, such as Ledderhose's Disease, which is the formation of nodules or contractitures in the soles of the feet, or Pyronie's Disease, which causes curvature of the penis.

Is Dupuytren's Disease common?

According to the Dupuytren Research Grouphttps://dupuytrens.org/, about fifteen million Americans over the age of thirty-five suffer from Dupuyten's Disease. Of these, an estimated three million have fingers that are bent.

What causes Dupuytren's Disease?

The specific cause of Dupuytren's Disease is unknown. It is believed to be hereditary but you aren't preordained to acquire it because it may skip generations.

It has also been linked to certain diseases, habits, and conditions, so your likelihood of being afflicted with Dupuytren's is increased if you suffer from diabetes or alcoholism, if you smoke, if you are taking certain medicines to treat seizures, or if you have nutritional deficiencies in your diet.

According the the Mayo Clinichttps://www.mayoclinic.org/, there is no evidence to suggest that hand injuries or occupations that involve extensive vibrations to the hand cause Dupuytren's.

Is Dupuytren's Disease painful? 

Generally, people who have Dupuytren's Disease do not experience pain. This is a bit of a mystery because you'd think that nodules and contractures would be painful. Nobody knows why there typically is no pain.

A small portion of people have reported that they have experienced pain, but they say that it is similar to the pain you might experience from a mild case of arthritis or a mild case of tendonitis. Each of us, of course, has their own pain tolerance so these reports are subjective.

It is also worth noting that other hand conditions can cause pain, so it is important to understand that while you might have Dupuytren'ts Disease and experience some pain, your pain might not be caused by your Dupuytren's.

An even smaller portion of people have reported some mild itching in the area of their Dupuyten's Disease.

It is interesting to observe that the younger you are at the onset of Dupuyten's Disease, the higher the probability that you could experience pain or itching. This has led to the hypothesis that this pain and itching could signal a more aggressive form of the disease.

Who is most at risk?

Although this disease affects a small percent of the population, it is worth identifying the characteristics of those who are most susceptible. These are eight factors that could place you most at risk:

  • Your age matters because people who get Dupuytren's tend to be 45 or older, although it can strike earlier
  • Genes matter, too, because most cases of Dupuytren's are hereditary
  • Your gender is important because males are more likely than females to be afflicted with Dupuytren's
  • If your family roots trace back to Scandanavia or Northern Europe, you could be at higher risk
  • If you have diabetes, you may be more susceptible
  • If you have epilepsy and take seizure medication, you're at greater risk
  • You could be at greater risk if you smoke, perhaps because of microscopic changes in your blood vessels
  • You could also be a greater risk if you abuse alcohol

What are the symptoms of Dupuytren's Disease?

You always want to consult your healthcare provider for a professional diagnosis because the symptoms of Dupuytren's Disease can mirror the symptoms of other conditions. Generally, though, you can look for any of these five signs:

  1. You develop a small, tender lump, or several lumps, on your palm. These nodules will become less tender over time, but they are still worth paying attention to.
  2. The lumps in your palm change by hardening or contracting. This may cause some thick bands to appear, which run from your palm up one or more fingers.
  3. You will have moved into the contracture stage if you observe that you can't lay your hand flat with your palm down  on a table or counterrop
  4. You might notice that one or more fingers - usually your little finger or your ring finger - are starting to pull forward toward your palm, or in some cases, bend outward
  5. You find that your hand doesn't work as well as it used to. You might have trouble grasping larger objects. If you are further along, you might even notice some difficulty slipping your hand into your pocket.

Is treatment always needed?

You doctor may be able to treat early stages of your disease with steroid injections to ease any pain and halt the progression.

You may not need any treatment for Dupuytren's Disease if:

  • Your disease is progressing very slowly
  • You aren't experiencing any pain
  • Your disease has little or no impact on your ability to use your hands as you go about your daily business

If this is your case, just pay attention to see if your condition progresses to the point that you start to experience contractures. 

What if you need treatment for Dupuytren's Contracture?

Your first step is to make an appointment with your primary healthcare provider. Your doctor can usually diagnose your condition by looking at and feeling your hands and may perform a simple test like having you place your palm flat on a counter. You may be referred to an orthopedic surgeon.

What are the treatments for Dupuyten's Contracture?

With Dupuytren's Contracture, there are cords in your hand that are causing your fingers to bend. Treatment simply involves breaking those cords to return your hand to normal. There are several ways to break the cords, and your provider will decide which is best for you based on the severity of your condition and other considerations affecting your overall health.

Here are the common treatments:

Needling

The doctor inserts a needle into the hardened cord to separate and break it, thus releasing your contracted finger. There's no incision and the doctor can often work on more than one finger at the same time. And there's very little physical therapy needed afterward.

The only potential disadvantage to needling is that the doctor may not be able to insert the needle in some areas because of potential nerve or tendon damage.

Enzyme Injection

This is another simple procedure, during which your doctor injects enzymes to break down the hardened tissue and dissolve the thickened cord. This is often a two-day process. On the second day, the doctor will manipulate your hand in an attempt to break the cord and straighten your finger. Enzyme treatments have the same advantages and disadvantages as needling.

Surgery

This is for when you have an advanced condition that is progressing and you have very limited use of your hand. 

Your surgeon will remove the tissue from your palm that is affected by the disease. Surgery is a last resort, but it has the advantage of providing the most effective and complete release. The downside? You'll probably require physical therapy and your recovery will take longer.

Are there any home remedies?

If you have a mild case of Dupuytren's, you can take steps at home to help deal with your condition.

  • Apply products that are designed to relieve the discomfort associated with mild cases of Dupuytren'shttps://dupuytrensco.com/products/dupuytrens-all-natural-cream 
  • If you're going to do any tasks that require serious grasping, wear heavily padded gloves
  • Wrap cushioning around the handles of your tools so that you don't have to grip as tightly

Conclusion

There is no way to prevent Dupuytren's Disease, but there are a number of treatments that can ease early discomfort and help stop its progression. You can use lifestyle changes and home remedies. You should see your healthcare provider if you experience contractures.


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