Greetings,

A growing number of lumps on the palm of the hand often means Dupuytren contracture, especially when they are in the fleshy part of the palm, not over the main joints, and you cannot account for trauma or abuse that might cause callus buildup.   While this is often the case, it cannot be said for sure until you have had a doctor examine you to make an accurate diagnosis.  

Greetings,

In over 10 years of work offering help to those who want to use Alternative Medicine as treatment for Dupuytren’s contracture there has never been a report of adverse effect or complications from this method.    The DCI concept is to introduce a wide range of various vitamin, mineral and enzyme supplements to increase the ability of the body to reduce the Dupuytren cord and palm lump.  The DCI method has a high rate of results for this problem when done as we suggest.   

Let me know if I can help you in any way.  TRH

Greetings,

In addition to the Dusa Sal DMSO and Unique-E vitamin E oil I would recommend that you also use a few internal therapies in your Dupuytren treatment plan. 

Internal therapies are those vitamins, minerals, supplements and enzymes that are swallowed and taken to the interior of the body for distribution to all tissues.  The internal therapies that can be used for Dupuytren treatment are:

1. Factor E 400/400                                     
2. Maxi-Gamma E                                     
3. PABA
4. Scar-X
5. Neprinol                                                     
6. Nattokinase                                               
7. Fibrozym                                                   
8. Quercetin-Bromelain  
9. MSM
10. Acetyl-L-carnitine                            

It is a good idea to use as many of these internal therapies as you think are needed and appropriate for your case.  However, these general and system-wide internal therapies will work better when used with external therapies, just as external therapies applied topically will work better when used with internal therapies.

If you insist on adding another topical to what you are now doing, i suggest that you look at Super CP Serum which is a copper peptide product that will influence repair of damaged tissue and reduce fibrous and collagen tissue build up.

Do not make the mistake of using only external (or only internal) therapies, and thinking you are doing a good job of treating your Dupuytren contracture.  Good treatment is a balance of both Internal and External therapies, and earns far better results than a limited plan.   TRH

Greetings,

Open-hand surgery for palm lumps and cords has a fairly fast rate of Dupuytren recurrence, so I will assume this is the type of surgery he had.  With his three month reappearance of finger flexion he must must be terribly discouraged.   Many people at this point are advised by the same surgeon that another operation should be done to improve the results of the first surgery.

I advise that your father thinks long and hard about the wisdom of multiple surgeries to accomplish the elusive “surgical correction” for DC.   From my experience while collecting reports from people around the world, people who have rapid Dupuytrens recurrence (fingers flexing toward the palm again, return of palm nodules and cords) or otherwise poor results (pain, finger and hand numbness, coldness and weakness) after hand surgery will find that additional surgeries will usually only lead to an even worse outcome, not a better outcome.   If he is at all considering additional hand surgery he should get a second opinion from the best hand surgeon he can find, preferably from someone who is located far outside the area where he lives.  This is a good idea because if you get a second opinion from someone local it will tend to be less honest and objective.

By following a good upper body and hand exercise program, and using a varied Alternative Medicine treatment plan such as you see on the DCI website, it might be possible for your father to support and enhance his ability to reverse some of contracted tissue.  There is no way to know for sure if this will work for him, especially since he has had one hand surgery.  But I do hear from DCI readers who report variable improvement with these conservative methods.  It is my opinion it is worth the time and effort to see if it can slow down the progression and perhaps even reverse some of the tissue changes.  TRH

Knuckle pads or Garrod pads are commonly associated with Dupuytren contracture.  They are well-circumscribed, smooth, firm, and skin-colored slight elevations, papules, or nodules, approximately 0.5-3 cm in size.  They are most commonly found on the back side of the hand at the main knuckles joints (metacarpophalangeal or MCP) and the first joints after them (the proximal interphalangeal or PIP), with the PIP being the most common site.  They are not to be confused with a Dupuytren cord which is a structure associated with the lump on palm of the hand.

When associated with Dupuytren contracture, since they occur in 45-55% of cases, Garrod pads usually suggests a more aggressive representation of the disease (a Dupuytren diathesis).

When firm, the knuckle pads or nodules may be only tender to palpation, otherwise they do not cause pain or other symptoms.   These nodules are closely adherent to the skin in Dupuytren contracture while movement of the nodule during finger flexion/extension suggests an association with the tendon sheath.

A history of repetitive injury to this part of the hand from work or sports activity is often present, as well as occurring without any physical explanation.

Garrod first described knuckle pads in the medical literature in 1893, but knuckle pads have been observed since the Renaissance era; Michelangelo’s statue of David has knuckle pads (Florence, Italy) as well as his statue of Moses (Rome, Italy).

In the U.S and the rest of the world knuckle pads are thought to be a common occurrence.  The prevalence of knuckle pads is difficult to determine because this problem does not cause physical symptoms and so people do not often seek medical attention specifically for them. Knuckle pads can be present in any age group, with the most common in adults 40 years of age and older, especially males who engage in heavy manual labor.  The condition also is seen in young children who suck their fingers.

Some cases of knuckle pads are clearly familial, having no other possible causation.   Most often they are associated with other disease processes such as reported in Dupuytren disease, Peyronie disease, Ledderhose disease, pseudoxanthoma elasticum, esophageal cancer, hyperkeratosis, and oral leukoplakia.

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Greetings,

Sorry to hear of your bad Xiaflex reaction.

Unfortunately, as the use of Xiaflex for treatment of Dupuytrens cords is becoming more common I receive more and more stories like yours from people who call or email the Dupuytren Contracture Institute.  I hear exactly the same type of story in which I am told about permanent injury to muscles, joints, nerves and blood vessels resulting in permanent loss of function, loss of feeling, terrible pain, varying degrees of weakness and tissue destruction, and sometimes eventual amputation.

It is never clear from the information I receive if the fault lies specifically with the Xiaflex drug that is used or with the doctor who performs the operation.   Most of the time these people who come to this website are looking for conservative options after more aggressive drug and surgical treatment have caused them apparent injury.

Another real problem concerning Xiaflex injections is that they have a high rate of Dupuytren recurrence, meaning that it does nothing to correct the actual Dupuytren contracture problem since the contractures, nodules and cords come back in about two to three years for about 80% of the people who undergo this procedure.  So after all these people expose themselves to the risks of injury (such as you have experienced), the only thing they can count on afterward is perhaps to from the problem only temporarily.   To my mind it is not worth the great risk for such temporary relief.   If you wish to read more about Dupuytrens treatment with Xiaflex, please go to “What is Xiaflex and what the risks if I take it?” from the DCI website.

I have referred to Xiaflex injections as surgery, although in the advertising that is done for this drug it is stressed that injecting this drug is a “non-surgical option for Dupuytren treatment.”  I do not agree with that statement and many others in the medical profession also see it as a surgical procedure.  The skin is broken with sterile medical equipment while  sterile technique is used, treatment of a medical problem is attempted, the procedure must be performed by a medical doctor with special training, it can take anywhere form 20-60 minutes to perform, and thousands of dollars are involved – sounds to me like it is surgery.  It is only called a non-surgical procedure to minimize and eliminate  patient resistance to the procedure, making the idea easier for the doctor to “sell” to the patient.

I have no idea about the number of lawsuits pending for Xiaflex surgery that has gone bad.  I suppose a good attorney would have that information for you.  The medical and pharmaceutical industries do not have a good reputation about how they handle drug reaction problems or doctors who hurt patients; they have been known to hide this information for reasons of protecting heir own profit without regard to patient safety and welfare.   Good luck with your hand.  TRH

Why is Xiaflex not indicated for palmar nodules? If it weakens and dissolves the cord, why would it not dissolve a nodule?

Thank you,

RSW

Greetings RSW,

The fact is a Xiaflex injection would weaken and dissolve a palm nodule, but then you would have a hole in the palm of your hand.   For this reason Xiaflex is only used to treat Dupuytren cords which are below the surface of the skin.

Of course, with Xiaflex injections the medical profession knows that the Dupuytren cords will return rather quickly, usually just a few years, and more injections would then be used.  There are two problems in doing this:  1. No one knows what happens to the body with repeated Xiaflex injections.  2. Each time a person has a Xiaflex injection as a Dupuytrens treatment he or she runs the risk of having the Xiaflex dissolve normal tissue and cause problems greater than having Dupuytren’s contracture.  For this reason we strongly suggest that anyone with Dupuytrens contracture first attempts to correct their problem using Alternative Medicine.  TRH     

Dupuytren’s contracture, sometimes called Morbus Dupuytren (MD), is a benign (non-lethal) process in which excessive collagen causes the connective tissue (fascia) to thicken in the palm of the hand; this is later followed by shortening of that same tissue.   As Dupuytren contracture continues, the tissue alters appearance and normal hand function is reduced.   The progression of the problem is fairly straightforward and clear, but the causes and reasons for the various cellular changes involved in the thickening and shortening remain unknown.

There are two well known physical elements of Dupuytren’s contracture.  First, is the appearance of one or more nodules or lumps on the palm of the hand; the palm is sometimes dimpled or puckered over the nodule.  The other is the development of a tight cord-like structure under the skin of the palm.  It has been proposed in recent years that as Dupuytren contracture progresses the various cells and tissue elements of the early nodule convert into the later cords.

Natural treatment of Dupuytren’s contracture

Surgery is not always necessary to remove these palm lumps and cords. Since 2002 the Dupuytren Contracture Institute has worked with people from around the world to use natural Alternative Medicine methods instead of a hand operation.  While surgery is always an option if a brief trial of natural methods is unsuccessful, most people prefer to first use non-surgical treatment to possibly avoid the inherent risks of surgery.

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Dupuytren nodule, lump or bump

One or more lumps or nodules are usually noticed when they are rather small and soft, and not firm and solid feeling as they will become later.  Often the nodule is located in the flexible area of the skin in the vicinity of the diagonal crease at the base joints of the fingers.  When a nodule appears in the lower palm, further down towards the wrist, involving a structure known as the palmar aponeurosis, it typically is less likely to become contracted and lead to reduced hand function and forced bending of the involved finger.

One or more lumps or nodules are usually noticed when they are rather small and soft, and not firm and solid feeling as they will become later.  Often the nodule is located in the flexible area of the skin in the vicinity of the diagonal crease at the base joints of the fingers.

In most cases the nodule will appear at the base of the ring (4^th) and/or little (5^th) finger, although the middle (3^rd) and index (2^nd) finger are occasionally affected, while the thumb is rarely affected.  A Dupuytren bump or nodule can also appear throughout the palm, sometimes in the digits, and in rare cases elsewhere.  When a nodule appears in the lower palm, further down towards the wrist, involving a structure known as the palmar aponeurosis, it typically is less likely to become contracted, or lead to reduced hand function and forced bending of the involved finger.

Pitting and dimpling of the palm of the skin near or within the nodule can also develop during the early phase of disease progression when the lump changes the way underlying fascia connects to the skin.

These Dupuytren bumps or lumps are usually painless, especially during the later phases of the disease progression.  When pain does occur later it is because a lump or nodule presses or rubs against a nearby tendon. As the disease progresses and finger contractures begin, the nodules tend to reduce or disappear.

Dupuytren nodules or lumps are frequently mistaken for calluses because of their location on the palm near other calluses, as well as appearance, general density and adherence to the skin like a callus.

Dupuytren cord

As Dupuytren’s contracture slowly progresses and nodule progression goes from small and soft to large and hard, the next stage is the development of long thin bands of collagen tissue located near and parallel to tendons.  These tough rope-like structures, made of collagen connective tissue, are referred to as Dupuytren cords.

They start out from the pre-tendious bands that are extensions of the normal palmar fascia and eventually thicken over time as the disease progresses. For this reason the Dupuytren cord will develop parallel and near to the tendons of the hand and fingers.

Typically the tissue changes of Dupuytren’s disease tend to stabilize temporarily at some variable mid-point; for some people this can occur within a few months or even years after onset, and remain inactive for months or many years, typically 5-6 years.

Sooner or later at around this 5-6 year point additional nodule or cord growth development starts again at a variable speed and finger contracture worsens.  This is about the time during Dupuytren’s disease that patients become serious about treatment. Eventually as the palmar tissues continue to thicken and shorten, the tendency increases for these structures to pull the involved fingers down or flex toward the palm.   Over time, as the finger remains flex toward the palm, the muscles that straighten or extend the fingers become progressively weakened and eventually undergo atrophy.  The overall effect is a hand that is progressively held in a flexed position.

Common daily tasks become increasingly more difficult to perform as the range of finger movement decreases and the degree of contracture increases.  Dressing, bathing, toilet,  operating an automobile, amongst other many other activities of daily living, are adversely impacted to a degree equal to the numbers of fingers affected by a Dupuytren nodule or cord, and the degree of fingers held in flexion.

Pituitary – 4c 7c 9c
Pineal – 4c 7c 9c
Hypothalamus – 4c 7c 9c

Are these tissues sourced from bovine sources?

Thanks

Greetings, 

Yes, these are of bovine origin.  However, keep in mind that in a homeopathic preparation it is merely the energy signature that is present and not the actual tissue or substance that is listed.   Many vegetarians understand this and know that it does not violate their principles to include Scar-X in their Dupuytren treatment plan.   TRH    

Thank you

Owen Hunter

Greetings Owen,

I have not encountered a problem when I took heavy dosage of MSM and PABA, and none has ever been reported to me.  There is no reason I am aware of that would prevent you from using these two combined for Dupuytren treatment.  TRH