Hi Dr. Herazy,
I noticed a small bump on my right palm which I expect to be Dupuytren’s Contracture. I am getting it checked out by a Orthopedic Surgeon tomorrow but would like to get your insight so I can assess treatment options if my lump does indeed turn out to be Dupuytren’s.
I understand from reading your website that the solutions recommended by the Surgeon’s often have a high recurrence rate for those inflicted. What I haven’t got a sense of from reading this website is the recurrence rate of those who have followed the Alternative Medicine plan outlined by your Institute. I’d like to get an idea of whether the treatment offered by your institute can (for some, if followed correctly) eliminate Dupuytren’s Contracture or if your plan simply reduces the impact of the contracture and allows people to resume activities while managing the contracture.
Long story short, is there a way to get rid of this thing for good? I appreciate your time and insight.
Great question about Dupuytrens treatment results with Alternative Medicine, thanks for asking about this important topic.
As I have written and said many times as I communicate with people who have Dupuytren’s contracture, I am unable to conduct the level of research that is commonly associated with large universities, drug manufacturers or hospitals; DCI does not have any way of regulating or monitoring the Alternative Medicine treatment of any individual, nor do we have any way of evaluating outcomes from that treatment other than what I am told by those who use this method of treatment. In fact, no one is obligated to communicate at all with me in regard to any aspect of their care. As a result I only know what I am told voluntarily by people before, during and after their Dupuytrens treatment, and this is sometimes sketchy. For this reason I do not have outcome data that you might expect to use to judge treatment results, as would be available from a billion dollar institution doing a multimillion dollar research project. It is unfortunate that the anecdotal information coming in cannot be independently confirmed for better evaluation. It would be great to be able to generate decisive statistics and numbers that we both are looking for, but that is the best I am able to do at this time.
Having explained all of that, based on the current limitations I work under, there are four important aspects of Dupuytren treatment outcome after using a DCI-based Alternative Medicine treatment plan I can definitely share with you that you can evaluate as you deem appropriate:
1. I receive 10-12 emails and phone calls of a positive nature (people reporting various levels of improvement from total reduction of Dupuytren palm nodules and cords, or full and normal finger mobility, to only slight to moderate changes of those same aspects of previous hand problems), for every one email or phone call of a negative nature (people reporting no improvement of Dupuytren palm nodules and cords, or continued loss of the same degree of finger mobility). Considering how people tend to complain more than they compliment, I take the 10/12:1 ratio of positive to negative reports after DCI treatment to be a strongly positive outcome.
2. As I talk or email to those people who report a negative outcome after using a DCI type Alternative Medicine treatment plan for their Dupuytren problem, I consistently find that they have not used a very large plan or they used their plan incorrectly in one or more fundamental ways that would tend to me make me consider that they did not use their plan correctly or at least not as described on the DCI website or as suggested in the information DCI and Online Natural Medicine provides to these folks. Many times I learn this is done out of financial limitation, other times it is simply due to misunderstanding or obstinance against “being told what to do” although we never prescribe treatment but only make suggestions and offer ideas, or they are simply people who are only looking for a “quick fix” and are not inclined to do the work needed for thorough and effective treatment.
3. While doing this work since 2002 with people who have Dupuytren’s contracture I have not had one person, not one, come back to me a year or two or ten later to report their hand lumps or cords or finger contracture have returned. I am unaware of any recurrence from people who have improved after using the DCI concept of Alternative Medicine treatment to help their recovery from Dupuytren’s contracture. Recurrence might happen after DCI treatment, but I have not been told by any of these folks that their hand problem returned. It is my assumption that if recurrence does happen, I would be told about it by some percentage of these people many times during this many years; this would be especially true if you consider, as I mentioned previously, that people do tend to complain more than they compliment. I also do not ever notice that someone who was ordering products from DCI several years ago will suddenly begin to order therapy products again after a several year absence. This would further tend to support the idea that people do not experience recurrence of their DC problem after this method of treatment.
4. Many of the people who come to the internet for help with their Dupuytrens begin their search only after the recurrence starts after their first hand surgery. Many are alarmed to find their hand problem recurred just six months or a year after surgery, and they are looking for alternatives rather than risk losing more hand tissue to the surgeon. I speculate that approximately half of the people who are following a DCI treatment plan have already had one hand surgery, and occasionally even two or three surgeries. For any of these people to experience improvement, and be able to avoid additional surgery, is truly wonderful and a testament to how the body is able to recover from a serious problem when given a little assistance with Alternative Medicine. Natural recovery after having hand surgery is usually not as satisfactory as those who have never had hand surgery. This reduced outcome makes sense since after hand surgery they have less normal and healthy tissue available.
Which home ultrasound unit do you recommend for treating Dupuytren’s contracture?
First, I do not recommend that a person uses any one single treatment method against a problem so difficult and stubborn as Dupuytren’s contracture. Using just vitamin E, or just doing hand stretching, or just DMSO applications, or taking just acetyl-L-carnitine, is not going to help recovery very much, if at all. The same with ultrasound therapy. The palm lumps and cords that develop with Dupuytrens are not going to change if you try a single therapy approach.
Secondly, it is my experience after working with people from around the world since 2002 that complete or partial recovery from Dupuytren’s is possible when following an aggressive treatment plan consisting of a wide and diverse range of different therapy approaches, as outlined on the DCI website. Following this kind of approach for a few months works well in a surprisingly high percent of cases.
Lastly, the ultrasound unit that was added to the DCI lineup of treatment methods in November of 2012 is the 3MHz ultrasound machine made by Bellaire Industry, model HS-3040. It is a great little unit; it is the only portable 3MHz machine that is made with a stainless steel sound head; on top of that it is the only portable 3MHz machine that has received FDA approval as a medical device. Go here to get details about this 3MHz ultrasound machine.
Some people make the mistake of trying to use the more popular and more common 1MHz size ultrasound machine but these machines do not put the therapeutic effect of the sound waves where they are needed in Dupuytren’s contracture. It is necessary to use a 3MHz unit to assure the ultrasound effect is placed toward the surface where the problem of DC is located. TRH
Have you ever used therapeutic laser on this condition? Have you had success with laser and do you recommend it? I have access to laser treatment and have used it twice on my bumps (2 on the right palm.) Thank you.
The great majority of therapies DCI recommends that are used together in a Dupuytren treatment plan have been researched with some degree of positive or favorable outcome. This is not true of cold laser therapy; it has never been researched directly for treatment of Dupuytren contracture.
In the past I have considered conducting a private research program with volunteer members from DCI to test the efficacy of non-penetrating or cold laser therapy on palm lumps and cords, but have refrained due to cost and logistical issues. If you are interested in participating in such as study please contact me personally and I will investigate this issue for your benefit. I would be interested to look into such a laser project since I have had often thought it might hold promise. TRH
Which is worse if you have Dupuytrens, cords or lumps?
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.
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 (4th) and/or little (5th) finger, although the middle (3rd) and index (2nd) 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.
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.
Will I have to have the alternative treatment the rest of my life?
That is a great question; thank you for asking.
There are actually a few things to be said about how long a person must use alternative medicine for Dupuytren’s contracture after the hand lumps and cords are gone and the fingers can once again be straightened.
1. The Dupuytren Contracture Institute has only been using Alternative Medicine since 2002, and has all been limited to non-research type work that relies on voluntary cooperation of people who I have no way to control or verify their treatment technique; each person goes about treating their DC in slightly different ways. For this reason I do not know when, if and how any treatment is being done – by anyone. I do not know how far a person takes himself or herself into reversal or recovery from DC when they decide to stop their treatment. For all these reasons I do not have sufficient knowledge of our hundreds and hundreds of successful cases to judge their recovery or if additional or ongoing treatment is ever needed.
Having said all that, I can definitely tell you that in these many years of working with people from around the world who have been helped with their DC, I have never had one person contact me to say that their DC has come back after it was eliminated the first time. Please keep in mind what I said above about working with volunteers over whom I have no control for reporting. I am only told what people chose to tell me. And at this point no one has told me they have needed to continue taking their Alternative Medicine therapy. Maybe they have, and maybe they have not. This is the best and most honest answer I have for you at this time.
2. When a surgeon operates on someone with Dupuytren’s contracture there is a high probability that the condition will recur over time. It is said that half of those who receive surgery will have it recur in five years. Every doctor knows that Dupuytren’s contracture is well known for recurrence after surgery; this is a great problem that is discussed frequently in the medical literature. If it did happen that Alternative Medicine had to be continued for someone to keep it under control, is that much different than having to be operated on every five years or so?
Actually, the answer to the question is that Alternative Medicine treatment for Dupuytrens is much different. The difference is that repeated hand surgery is not a good situation because with each surgery that is done there is less normal healthy tissue that is left behind and more scar tissue that builds up. After just one, two, three surgeries a person might find that no more surgeries can be done. These are the people who are left with useless claws for hands, or those who are told that amputation must be done. The further difference is that if you must have to use Alternative Medicine for the rest of your life to keep the hands in good shape, you avoid this problem. For this reason we suggest that everyone at least tries our DCI concept for natural health care to see if surgery can be avoided.
Please let me know if you need help getting started with natural treatment for Dupuytren’s contracture. TRH