If you feel a tightening in your hands, or if from time to time your hands cramp up for no apparent reason, the cause could be Dupuytren contracture. This is a tightening in the fascia of your hands. Fascia are fibrous tissues that are located inside the palms of your hands, and progressive tightening can eventually result in difficulty using the hand along with an unsightly, claw-like appearance as your fingers begin to curl inward.
Diagnosing Dupuytren Contracture
As you might expect, diagnosis of Dupuytren contracture is done by examining the hand. During the examination, the doctor will usually find a tender nodule in the neighborhood of the third or fourth finger, in the palm. Initially, this nodule may cause pain, but eventually it will go away as the fingers begin to curl inward.
In order to effectively confirm or rule out Dupuytren contracture, your doctor will also take a complete history to determine if there is anything in your medical background that could be connected with the condition. If you consume excessive amounts of alcohol, or if you have diabetes or epilepsy, you are at a higher risk for Dupuytren contracture, although these are simply factors that seem to go hand in hand with Dupuytren contracture – the actual causes of the condition are not known.
What is known is that the condition appears to be hereditary, is more common in men than in women, and usually appears after the age of 45. There also appears to be a genetic component, but having the genetic makeup that is present in Dupuytren contracture sufferers does not necessarily mean that you will develop the condition. Approximately 5% of Americans have Dupuytren contracture. In about half of cases, both hands are affected. Interestingly, when the disorder affects only one hand, it is twice as likely to be the right hand.
Treating Dupuytren Contracture
If the condition is identified before the fingers start to curl inward, injection of a corticosteroid can relieve the symptoms. It is important to note, though, that this will simply ease the symptoms – it will not halt the progression of the condition.
Occasionally, Dupuytren contracture will go away without treatment, but usually at some point surgery will be required. Even after surgery, hand function may be limited. This is because removing the diseased fascia is not an easy procedure – the fascia protects a multitude of blood vessels, nerves and tendons, so the hand surgeon has to err on the side of caution.
The Final Word
If you are experiencing any of the symptoms of Dupuytren contracture, it is important that you see a competent hand surgeon in order to determine if the cause is actually Dupuytren disorder or due to some other condition. Then you can work together to agree on a course of treatment, which could include corticosteroid injections, and which may or may not include surgery. Although Dupuytren contracture does sometimes simply go away without treatment, that is the exception, not the rule.