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What Can You Do About Dupuytren's Contracture?

December 13, 2020

Living with dupuytren's contracture is an uncomfortable experience, and if it gets bad enough it could affect how a person performs their daily activities. Simple things that we often put no thought into the effort it takes to perform, such as holding a fork or picking up a coin, become unbearable for a dupuytren's contracture patient.

There are a number of things you can do to make living with dupuytren's contracture a lot more bearable so it doesn't take over your life. Everyone's case is different, so the treatment option a person chooses should depend on how severe their condition is. You may be able to treat it at home, or your doctor may suggest either a surgical or non-surgical treatment.

What Is Dupuytren's Contracture?

Dupuytren's contracture is a connective tissue disease. When it occurs in a patient, the fibrous tissue under the skin of their palm gets thicker and starts to tighten. A lot of patients will notice hard lumps or a band form under the skin, while these aren't overly painful they still cause a lot of discomfort. 

As the condition gets worse, over time it could begin to pull the patient's fingers towards their palm. This usually happens in the two fingers furthest to the thumb and forms a claw-like shape. Some patients will experience this condition in both hands, and in rare cases it may also affect the feet. 

What exactly causes dupuytren's contracture is still unknown. However, research has found that it is more likely to show up in people who consume a heavy amount of alcohol regularly. Dupuytren's contracture is also more likely to show up in males over 40 and believed to be hereditary, but it can affect any age and gender.  

The disease has also been linked to certain medicines. Some medicines, mainly ones that treat epilepsy, have been known to trigger dupuytren's contracture. It also is more likely to show up in patients who suffer from diabetes. 

What Are The Symptoms Of Dupuytren's Contracture?

Determining the right type of treatment for you depends on how severe your symptoms are. The physical symptoms that you may notice are small tender lumps, a thick band that may contract or tighten, little grooves near the affected finger, or your finger(s) being pulled forward. 

You should always speak with your doctor when symptoms occur so they can determine the best treatment option for you. Until you get the chance to meet up with your doctor, there is a way to see if you may have the condition from home. Try to lay your hand down flat on a hard flat surface, such as a table or countertop.

If you are unable to lay your hand out flat then you may have dupuytren's contracture.  

How To Treat Dupuytren's Contracture: Where To Start

The disappointing thing about living with dupuytren's contracture is that there is no real cure. There are several treatment options, from a dupuytren's contracture injection to surgery. While these have provided patients with relief, many have had the misfortune of the condition returning later on.

Some people only have mild cases of dupuytren's contracture, so they have found relief through nonsurgical treatment and never had the condition worsen or affect their everyday lifestyle. Others who have a more severe case of dupuytren's contracture have had it return, even after surgery. 

Always consult with your doctor about your symptoms so they can work out the best plan to treat your dupuytren's contracture

How To Treat Dupuytren's Contracture: Non-Surgical Treatments

Patients with mild to average symptoms of dupuytren's contracture may be able to get the relief they need from some of the non-surgical treatment options. Many patients have been able to get back to a normal lifestyle without having to go through surgery.

At Home Treatments

For mild cases, patients may be able to tackle the discomfort at home. When the discomfort starts to flare up an over the counter pain reliever, ibuprofen, or anti-inflammatory drug could help reduce the pain. After that you should gently massage the affected area.

Your doctor may recommend some stretches that you can perform at home for your hand. Experts often recommend certain stretches for mild cases of the disease. 

Some people also use vitamin E cream on the affected area, but there is no evidence to prove that it helps to relieve inflammation.

If the dupuytren's contracture disease is in your foot (this condition is called ledderhose disease) there is a way you can make living with the condition a lot easier. Purchase the softest shoe insert that you can find and cut out holes where your lump is. Place this in your shoe and walking shouldn't cause as much discomfort. 

Steroid Injections

Steroid injections are strong anti-inflammatory treatments. They are usually only useful during the beginning stages of dupuytren's contracture. When the condition has worsened and the band is too thick, this injection isn't effective. If used in the early stages, it can help to reduce the size of the nodule. 

These injections have been helpful tostop or slow down the progression of the disease in many patients. However, they will not help with straightening a finger that may be bent due to dupuytren's contracture.

Enzyme Injections

Enzyme injections are usually recommended by doctors if the patient's finger is already bent. The most common enzyme injection that they use is called Xiaflex. These injections are used to help loosen and break up the tightened tissue. Doctors often try to use enzyme injections instead of surgery.

If a patient's finger hasn't loosened up the day after the enzyme injections, then the doctor will stretch the affected finger to help straighten it. Most patients require one or two injections, but patients with highly severe cases may need three to be able to straighten their finger.

Radiation Therapy

Low energy radiation therapy is often used to help prevent the symptoms from worsening. For some patients it has helped prevent skin changes associated with the condition and kept the nodules and cords from getting tighter. 

How To Treat Dupuytren's Contracture: Surgical Treatments

For patients with severe cases of dupuytren's contracture, the above options may not bring them the relief they need. If the condition has progressed to the point where a patient has difficulty opening a can of soda or turning the page of a book, then they may need to seek surgical treatment.

Needle Aponeurotomy

Needle aponeurotomoy is a less invasive treatment compared to surgery. A hypodermic needle is used to cut and divide the affected tissue in the hand. Patients who received needle aponeurotomy have a much quicker recovery time then people who receive open surgery, and usually don't require rehabilitation.

Open Surgery

The two main surgeries performed to treat dupuytren's contracture are fasciotomy and fasciectomy. Fasciotomy involves dividing the divided tissue after the incision is made, where a fasciectomy is when the thickened band of tissues gets removed. The surgeon will then use one of many techniques to close the wound. 

After surgery, the pulling effects of dupuytren's contracture are likely to be corrected and the patient's hand should be back to functioning normally. However, if multiple fingers were affected then it could be difficult for the surgeon to fix the contraction. In this case the surgery could improve the hand's functioning, but not 100 percent correct it. 

Even though surgery may seem like the golden ticket if you have a bad case of dupuytren's contracture, you should be aware that complications could arise. Some issues that patients have faced with open surgery include:

  • Exaggerated reaction in the wound
  • Injured nerves or blood vessels
  • Infections
  • Swelling and soreness
  • Tissue death

One important thing to remember about open surgery for dupuytren's contracture is that it won't prevent the condition from coming back later on. Open surgery and needle aponeurotomy both have ahigh rate of patients who experience their contractures returning.

After surgery, many doctors recommend that a patient wears a splint. These are able to provide the patient with some comfort while helping to improve the finger's positioning. They may even suggest patients see a physical therapist and learn exercises that will help strengthen your hand as it heals while improving how it functions. 

 

Final Thoughts: What Can You Do About Dupuytren's Contracture?

Unfortunately there is no real cure for dupuytren's contracture yet. Since there is no evidence to back up how this condition begins, at this time we know very little about how it can be prevented. If you find yourself suffering from the condition you don't have to spend your life in discomfort.

There are several treatment options available to help with the condition. Your doctor should be able to come up with a treatment plan that will help you get on the path to your hand feeling and functioning like normal again. If you have a mild condition, you may be able to work it out with exercises and massages. More serious conditions may require surgery.

Always consult your doctor for the best treatment advice. 


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