Regaining Hand Function From Dupuytren’s Contracture

Dupuytren’s contracture, also known as Dupuytren’s disease, occurs when the skin thickens on the palm around the base of the fingers. As a result of the thickening, the affected area’s fingers may begin to curl in or get stuck in an abnormal position. A cure isn’t available, but steroid injections can help reduce the pain.

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How does one get Dupuytren's contracture?

Unfortunately, Dupuytren's contracture can't be entirely prevented. Researchers believe the condition is hereditary. Risk factors for the disease include smoking, drinking alcohol, nutrient deficiencies, taking seizure medication, and diabetes. The disease is most common in older adults, males, and people with a Northern European background.

Stretches to mitigate the pain

Nonsurgical intervention is recommended before proceeding with more invasive treatment options. Mild cases of the condition can benefit from stretching the hands and fingers. Lifting one finger at a time with the palm down flat on a surface is an easy stretch to improve flexibility. Spreading the fingers or gripping exercises can also improve dexterity and strength.

How do steroid injections work?

Steroid injections contain powerful anti-inflammatory medication that is injected in the Dupuytren's nodule. Steroid injections are recommended to be started during a mild case of the disease. The injections work by reducing the size of the skin thickness. Periodic steroid injections may be necessary to manage the pain.

What about enzyme injections?

Enzyme injections are recommended when a finger is already curled. A blend of enzymes is injected into the tough skin to loosen the tissue and can work in as little as one day. After the injection, a doctor may safely stretch and straighten the finger. Stretching at home after enzyme and steroid injections can improve the outcome.

When is surgery needed?

When Dupuytren's contracture severely limits hand function and daily activities, surgery may be recommended. Surgery involves cutting and removing the thick tissue in the palm to improve finger function, flexibility, and strength. Needle aponeurotomy is a minimally invasive treatment that makes holes in the tissue to reduce the thickness and improve recovery time.

Knowing when to see a doctor

Dupuytren's contracture isn't a condition to be taken lightly. While not deadly, the condition can severely limit the quality of life. People should be aware of the symptoms, such as noticing lumps, contractures, soreness, and limited hand function. With early treatment, the condition can be managed without losing the entire function. For more information, speak with a hand therapist.

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