This condition presents as a lump (nodule) in the palm of your hand which becomes larger and resembles a cord over time. The lump is often painless but occasionally may become tender and cause a degree of discomfort, which normally resolves over some months, despite the nodule or cord remaining present. The nodule or cord may subsequently go on to affect one or more fingers, causing them to bend up (contracture). When mild the contracture usually causes no functional problems in using your hand, but if the contractures become more severe, hand function is compromised.
Who gets Dupuytren’s?
This condition can occur in almost any adult, but due to its genetic origin, is more common in people of northern European decent. Dupuytren’s disease is more common in patients with some diseases including diabetes, liver disease, smokers and individuals taking anti-epileptic medications.
What causes Dupuytren’s?
The skin of the palm of your hand is different to that of most areas of your body, as it requires firm anchoring to the deeper structures to allow for the grasping of objects. To enable this anchoring to be present, a network of thick fibrous structures called the palmar fascia is present, connecting the skin to the bones in your hand. In Dupuytren’s disease, the palmar fascia becomes thickened and contracts causing the abnormalities mentioned above. Research is underway to look at the mechanism of Dupuytren’s disease in the cells of the hand. Although the mechanisms are becoming clearer, treatments to prevent this condition or reverse it without injection or surgery are still a long time away.
Dupuytren’s Treatment options
Dupuytren’s disease is not infectious or cancerous, and there is no cure for the condition as it is a genetic condition. Nevertheless, it is possible to influence what happens within your palm with regards to the disease. Patients are not compelled to seek treatment for this condition, but opting for treatment may help straighten your finger(s). If you have a mild case, especially if it is not progressive, you are probably best advised to avoid initial treatment. Should the contracture become more significant, collagenase injection, or surgery and expert rehabilitation are usually the best options. If you can place your hand flat on a tabletop and your palm touches the table, then usually treatment is not worth your while but once your palm no longer touches the table it is worth speaking to Mr Jarrett about treatment options.