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Pain Relief for Dupuytren's Contracture
The lumps on your palm are formally termed Dupuytren's contracture. Dupuytren's contracture is a condition in which fibrous tissue builds up and thickens in the skin on the palm of the hand. This fibrosing and scarring usually affects the fourth and fifth flexor tendons, or the ring and pinky fingers. Although less frequently, it can also affect the third tendon, or middle finger. Some of the first signs of Dupuytren’s may be nodules or lumps on the hand that may be tender. Over time, the thickening of the palm of the hand can cause the involved finger or fingers to be pulled down, or contracted
Dupuytren’s contracture is most common in northern European males over the age of 50, and it can also be associated with diabetes and other skin fibrosing disorders.
Treatments start with conservative stretching of the flexor tendons to prevent the contracture from developing. In more severe cases, you may need an injection of steroids or an enzyme to dissolve the thickened nodule or surgery to remove the fibrous tissue and loosen the involved tendons.
Are You a Candidate for Nonsurgical Treatment for Dupuytren’s Contracture?
When the nodular lumps in the palm feel tender, a self-massage with lanolin ointment can help to reduce the pain and stiffness. Massage the area in two directions: up and down the tendon, and then across the tendon. Follow the massage by some gentle stretching of your fingers. To do this, place your hand palm side down on a table and lift your palm up, stretching the extended fingers. Hold for 10 to 20 seconds and then bring the palm back down to the table. Repeat this 5 to 10 times at least twice a day. This stretching routine should be done daily by everyone with Dupuytren's contracture regardless of the presence of tenderness.
Q2. My doctor says I have early Dupuytren's contracture. Can I still do activities that put stress on my hands, like weight-lifting and biking?
Dupuytren's contracture is a fibrosing (causing fibrous tissue to form) and scarring condition of the skin on the palm of the hand, usually centered over the fourth and fifth flexor tendons, or the ring and pinky fingers, and less frequently over the third tendon, or the middle finger. The cause is unknown, but it’s typically seen in northern European males over the age of 50. It can also be associated with diabetes and other skin fibrosing disorders, and repetitive trauma may make the condition worse.
Over time, the thickening tissue in the palm can cause the involved finger or fingers to be pulled down, or contracted. Treatments start with conservative stretching of the flexor tendons to prevent the contracture from developing. In more severe cases, you may need an injection of steroids or an enzyme to dissolve the thickened nodule or surgery to remove the fibrous tissue and loosen the involved tendons.
If you have Dupuytren’s contracture, you are not restricted from exercising with your hands, but certainly you should avoid a tight grip on objects. Protect your hands by wearing gloves with palm pads. If your work or exercise routine involves weight against the palm of the hand, increase the size of any handles or bars you use. Biking and weight lifting gloves are also excellent choices to allow you to exercise without aggravating Dupuytren's contracture.
In addition, everyone with Dupuytren's contracture should stretch their hands regularly — but do so gently. Place your hand palm side down on a table and lift your palm up, stretching the extended fingers. Hold for 10 to 20 seconds and then bring the palm back down to the table. Repeat this 5 to 10 times at least twice a day.
Paul Howard, MD, FACP, FACR, is president of Arthritis Health, Ltd, in Scottsdale, Ariz. and is involved in private practice for rheumatology in Phoenix.
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