This is slow growing inflammatory thickening on the palm of the hand that eventually creates a deformity starting in the ring and little fingers which if not dealt with early can spread across the whole hand. Dupuytren’s contracture was first reported in the Lancet in 1831 by the French surgeon Guillaume Dupuytren. Since then some famous people has experienced this strange disease including Margaret Thatcher. Although medical interventions may be required eventually, we describe here lifestyle and self help strategies which are a good idea to try in the early stages may help delay progression.
Dupuytren’s contracture usually begins as a thickening of the skin on the palm of your hand. As Dupuytren’s contracture progresses, the skin on the palm of your hand may appear puckered or dimpled. A firm lump of tissue may form on your palm. This lump may be sensitive to the touch but usually isn’t painful.
In later stages of Dupuytren’s contracture, cords of tissue form under the skin on your palm and may extend up to your fingers. As these cords tighten, your fingers may be pulled toward your palm, sometimes severely. Once this occurs, the fingers affected by Dupuytren’s contracture can’t be straightened completely, which can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands. Only rarely are the thumb and index finger affected. Dupuytren’s contracture can occur in both hands, though one hand is usually affected more severely than the other.
Underlying causes; The deformity is caused by fibrosis and thickening around the tendon sheaths of the hand which eventual contract. Why these form in the first place is unknown although it is known to be associated with:
- Age; Dupuytren’s contracture occurs most commonly after the age of 50.
- Cancer treatments; Particularly long term hormone therapies such as aromatase inhibitors
- Sex; Men are more likely to develop Dupuytren’s and to have more severe contractures than are women.
- Ancestry; People of Northern European descent are at higher risk of the disease.
- Family history; Dupuytren’s contracture often runs in families.
- Tobacco smoking; Perhaps because of microscopic changes within blood vessels caused by smoking.
- Alcohol; High alcohol intake is associated with an increased risk especially if cirrhosis develops
- Other lifestyle factors: Lack of exercise, high saturated fat and low omega 3 intake low polyphenol intake
- Diabetes; People with diabetes are reported to have an increased risk of Dupuytren’s contracture
- Medication; Drug including phenytoin and aromatse inhibitors
Lifestyle and self help strategies:
- Gently bend your fingers backward from your palm.
- With your fingers on the edge of a table, palm down, then lift the palm upward gradually, keeping your fingers flat.
- Rotate the wrist from side to side
- Put your hand in a prayer position pushing the palms and fingers together
- Do not over stretch and cause pain which may be counter productive
2. Massage / oils
- Before stretching, warm up your hands in warm water or a heat pack
- Avoid heavily scented creams
- Avoid creams with hydrocarbons and artificial irritation ingredients
- Use a natural plant based anti-inflammatory moisturiser (e.g natureMedical Dupuytrens relief balm)
- Massage your palms in all directions on and around the thickening
3. Protect your hands:
- Avoid a tight grip on tools by building up the handles with pipe insulation or cushion tape.
- Use gloves with heavy padding during heavy grasping tasks.