Is Dupuytren's Contracture A Painful Disease?

Dupuytren’s contracture is a condition that affects the hands. Over time, it causes the ring and little finger to stay bent and it can sometimes be very painful. While Dupuytren's can take years to develop, it can compromise someone's range of motion. 

Pain is a very subjective feeling and the level of pain that any condition causes is felt differently by each person. Some people may perceive certain input to be very painful while others may not feel pain at all.

How does Dupuytren’s contracture manifest?

Dupuytren’s contracture is a disorder that gradually affects the hand by hardening the skin and forming thick cords on the palm. These strings pull on the fingers (usually the ring and the little finger), cause instability within the hand, and bring the fingers closer to the palm. This happens because of excessive collagen buildup, which tends to occur after the age of 40. 

Is Dupuytren’s contracture painful?

As with any other type of pain, the one caused by Dupuytren’s contracture can be perceived as very painful or not painful at all. Most patients don’t find it uncomfortable, which has made the treatment of this condition particularly trying.

Most health professionals agree that Dupuytren’s contracture isn’t painful. Unfortunately, as a result, those who do experience pain from this condition are somewhat marginalized by these generally accepted beliefs. In turn, people may experience issues like anxiety, detachment, and even depression from not feeling validated or understood in light of their pain.

Dupuytren’s contracture can cause pain and itching of the skin and nodules that develop. There seems to be a direct relationship between the time when these signs first appear and the level of pain someone experiences. In particular, if someone notices symptoms before the age of 40, they were more likely to experience pain and itching in the hand.

Why is Dupuytren’s contracture painful?

Dupuytren’s contracture is a fibrotic disease. This means that the body will produce a high number of fibrocytes. These are white blood cells that are produced inside our bones, by the bone marrow. 

The fibrocyte’s job is to attack the cells that produce an inflammatory response, which develops as a result of infection or foreign bodily processes. In the case of Dupuytren's, fibrocytes cause the skin to tighten. When they reach the palm, they become myofibroblasts that tighten the skin even more. However, this doesn’t happen in all patients. When it does occur, the immune response can be painful, which is why only some patients report itching and pain.

Furthermore, Dupuytren’s contracture can aggravate other diseases affecting the hands, like arthritis, tendinitis, and even old injuries. The type of pain results indirectly, even if patients associate it with the tightening of the skin in their palms due to Dupuytren's. All in all, statistically speaking, pain resulting from Dupuytren’s contracture is rare.

What is the treatment for Dupuytren’s contracture?

Dupuytren's treatment may or may not help the pain levels of someone experiencing Dupuytren's. Someone may qualify for Dupuytren's pain relief surgery if their condition has severely progressed and if they are in generally good health otherwise. However, doctors may recommend natural approaches first to assist with improved motion and flexibility.

Surgery usually involves a specialist removing excess tissue from the palm, which restores range of motion in the fingers. Doctors usually recommend physical therapy after surgery to ensure that motion continues to be restored after the healing process has ended. Unfortunately, there is no way of knowing if the condition will be completely eliminated after surgery or if it will return.

Nonsurgical approaches are aimed at maintaining as much range of motion of the fingers as possible, which also includes minimizing symptoms such as pain and itchiness. There are a few nonsurgical options that can be used by patients with Dupuytren’s contracture.

Vitamin E

Vitamin E supplementation is one choice that dates back to 1947. This involves doses of up to 300 mg of natural Vitamin E. Research has shown that this method does not help much and studies also show that patients report slight improvements in pain. As with most natural methods, there are little side effects and it is generally thought of as safe.

Stretching

One of the more popular Dupuytren's Contracture pain treatment is stretching. Physicians may also recommend a hand stretching routine for patients with this condition. Studies are in strong support of this method, as results have shown that this plays a big part in the maintenance of mobility.

Steroid injections

Cortisone injections are especially useful in the early stages of the disease. They actively shrink nodules and slow the progression of the condition. However, more than one injection is required, so this can be uncomfortable. Steroids have known side effects and are not recommended for long-term use, so this is not a lasting treatment option for Dupuytren's.

Creams and ointments

There are a few alternatives that may help to improve the pain and itchiness associated with Dupuytren’s contracture. Arnica montana is an herbal remedy that is shown to reduce pain and inflammation for patients who had hand surgery. Furthermore, aloe vera has significant anti-inflammatory effects while also protecting the skin and easing itchiness.

A combination of these natural treatments can be found in creams that are especially beneficial if used alongside other treatments like stretching and injections. What most people don’t realize about Dupuytren’s contracture is that it doesn’t only affect a person’s hands. 

It can also affect the mind by increasing someone's anxiety due to a loss of independence. Furthermore, instances of Dupuytren's contracture that are painful may lead to feelings of sadness due to isolation or being misunderstood by others. 

One of the most important steps to take when addressing Dupuytren’s contracture is to find support and engage with people who are in the same situation as you are. There are many resources both online and in person that can help patients.

Utilizing support groups in your area can help you obtain access to useful information and learn about new, effective treatments. Living with Dupuytren’s contracture is not easy, but the good news is that it has a slow progression and there are many treatment options available. This means that if you address it early, you might never have to learn how much it can impair the function of your hands.

Learn More