What did Ronald Reagan, Margaret Thatcher and Samuel Beckett have in common? The answer is Dupuytren’s contracture, a progressive, slow-moving condition that affects the connective fibrous tissue in the hand. Thatcher was the odd person in this group, since the condition normally strikes men of Northern European descent over the age of 50 and is more common in people who smoke heavily or use alcohol.
People suffering from Dupuytren’s contracture usually become aware of the condition when the skin on the palm of their hands starts to thicken; they may notice lumps, puckering or dimpling of the skin before any pain or discomfort develops. As the condition progresses and more tissue is affected, forming tight “bands” that can force fingers (typically the fourth and fifth fingers) to curl, patients may find that shaking hands or grasping objects becomes more difficult.
Although Dupuytren’s contracture is typically painless, treatment may help relieve discomfort and preserve the hand’s range of motion. Treatment depends on the severity of the condition and the rate of progression. Surgery can remove fibrous tissue in extreme cases, but the hand will require extensive physical therapy as part of the healing process. Common nonsurgical interventions include
- corticosteroid (anti-inflammatory) injections to soften or flatten the thickened tissue on the palm of the hand
- a procedure whereby needles puncture and break up the thick cords of tissue that cause fingers to contract
- njections of an enzyme called collagenase to soften the thick cords of tissue, allowing the physician to gently manipulate the hand and stretch the fingers back into normal position
For mild cases or to support other treatments, physical therapy is a safe, effective way to alleviate symptoms of Dupuytren’s contracture. We can design a program that utilizes massage, stretching and tissue mobilization to treat the condition. We will also show you ways to use therapeutic tools, splinting or alternative movements to more easily handle such everyday tasks as writing, placing your hands in your pockets, putting on gloves or shaking hands, despite the deformities caused by Dupuytren’s contracture.