Hello Dr. Herazy, I have a question about dupuytrens treatment. I am a 51 yr old women who was just told the small lump in my hand is dupuytren’s contracture. I was told right now there is nothing that can be done because I can still put my hand down flat on a table. My husband found your site and wants me to start the treatment. Can I start the dupuytrens treatment at this early stage of the disease?
Will this keep the lump from getting larger and my fingers from curling?
Thank you for any information you can give me. Roseann
Sorry to hear of your hand problem.
From my experience in working with this form of natural Dupuytrens treatment for almost 11 years I can tell you that the earlier you start self-treatment, the better the results tend to be. All we are attempting to do is to support and reinforce the natural ability of the body to remove foreign tissue; an early start when the problem is as small as possible, makes most sense.
This concept is different from the standard medical approach your doctor is suggesting, because that approach is for radical removal of tissue. The standard medical model is based on the hand contracture being as advanced, debilitating and severe as possible before surgery, so that the surgery is not done too soon in the course of the disease. All surgeons know that the surgery is not a cure, and that Dupuytrens recurrence is inevitable after each surgery, no matter how well done. By waiting to do surgery as long as possible the number of recurrences is minimized.
Our concept is that if surgery can possibly be avoided by doing everything possible to help the hand lump heal with natural Dupuytrens treatment, then a real service has been provided. There is no way for me to tell you if this approach will work for you. I can tell you it has worked for many people, especially when started early in the progression of the contracture. I suggest to you that you use the largest and most aggressive therapy approach you can afford to apply for at least 2-3 months to see if your body is capable of making this Dupuytrens treatment work for you. If it helps you, look at what you have gained. If it does not help you, you will know you have at least tried to do something conservative before undergoing aggressive hand surgery.
Please let me know if I can help you in any way. TRH
Hi Dr Herazy. I have Dupuytren contracture on both hands. I had surgery to cut the contracture and my Dr applied a Digit Widget on my right ring finger. Once my finger gets straighter I will then have surgery to remove all of the cording. I am very interested in your treatment plan to hopefully eliminate the need for that surgery. Which plan do you recommend and how are the products used? Are they all applied topically? Thanks – I’m looking forward to your response. Regards, Vee Cluley.
You are wise to want to avoid Dupuytren’s surgery since none of the operations will cure the problem, and the hand contracture will always come back in a few years.
I always recommend that a person uses the most aggressive plan they can afford, since the more variety and depth of therapy that is used offers greater opportunity for improvement. The Dupuytren medium plan is the most popular, but the large plan gets best results. The greatest cost difference is just getting started, and after that the medium plan averages about $90-105/month to continue and the large plan averages $95-110/month to continue.
Full instructions come with the order that you place; whatever you order we include detailed instructions to use all items so you are comfortable you know what to do.
Some items are applied topically (DMSO, vitamin E oil and Copper peptide, Genesen pens) while the others are taken orally.
Let me know if I can help you in any way. TRH
Successful Dupuytren treatment demands that you know the exact limit of your hand contraction each step of the way
The Dupuytren Hand Contracture Caliper is a requirement for good results with self-directed Dupuytren treatment. You must know how much your hand is contracted and finger movement is limited in order to guide your therapy plan to a successful conclusion. Otherwise you are only guessing about your hand contracture, and that does not help you regain full use of your hand.
People are wrong to only pay attention to the obvious palm lumps and finger cords of their Dupuytrens contracture. The Dupuytren Hand Contracture Caliper makes it easy to know exactly how much their finger contracture is affecting hand movement and flexibility.
The DCI caliper with built-in measurement scale will help you easily and accurately determine reduced finger and hand movement caused by Dupuytrens disease. With it you will document how far your finger contraction is kept flexed toward the palm or wrist, as well as the other important measurement of how far your palm is kept from flattening against a table top or other flat surface. These two numbers are essential baseline measurements to determine progress, or lack of progress, of your self-directed Alternative Medicine Dupuytrens treatment.
If you do not know the true state of your bent finger and hand contracture at the start of care you will never know exactly how much improvement you have made, or if you have made any at all. You must know if you are making actual progress over your Dupuytren hand problem because this information will tell you if and when to change your treatment or perhaps not change it at all.
Many people think, “I’m not stupid. I will know if my finger is improving. I do not need to measure.” But they find after a few weeks of treatment they are totally unsure if the progress they think they have made is real or just a hopeful product of their imagination. Armed with this valuable information you will know if and when to change a treatment plan that is not working, or to keep following a treatment plan that it is working. Either way, for best treatment results you must not guess about any of this.
Using the DCI caliper to measure contracture of the hand:
- The caliper is tightened or loosened by using the large plastic knob at the pivot in the middle. The caliper has two pairs of “legs.” The “inside legs” are used to measure the inner distance of a closed surface, and the “outside legs” are used to measure an outside surface. The inside legs of the caliper are straight but bent only at the very tips to look like the letters “J” and “L.” The outside legs are rounded to look like big pincers or the letter “C.” To measure with either the inner or outer legs the caliper must be positioned so the straight legs are crossed over each other and the curved millimeter (mm) scale to provide a distance reading, just as you see it in the picture, above.
- Adjust the large plastic knob in the center of the caliper so the legs move with moderate resistance; this assures your measurements are accurate. The knob must be loose enough that the legs move with some ease, but tight enough that they do not move once you put them in position.
- Each line on the curved scale represents 2 millimeters (mm). The scale ranges from 0 to 200mm.
- Position the tips of the straight inside legs so the “J” and “L” touch each other. Notice that the edge of the moveable leg touches the “O” on the mm scale, meaning no millimeters. When the tips of the inner legs are 50mm apart the tips of the outer legs are also 50mm apart.
- Either half of the caliper – the “inside legs” or the “outside legs” – can be used to document improvement of your limited finger and hand movement. Use either side or pair of legs that is more comfortable or whichever one works best for your circumstance since the measurement will be the same.
Marking hand and fingers for measurement
Each time the hand is measured the same pair of reference points must be used, and the information must be written down for later comparison using the “Caliper Hand Measurement Chart” you received with your DCI Hand Caliper.
It is best to use naturally occurring landmarks on the fingers, palm or wrist of your hands if they are small enough to make a precise measurement, and if you will be able to easily find the same landmark each time you use the caliper for hand and finger measurements.
Locate a small and easily recognized natural landmark on the involved finger and hand. These two points should be obvious and easily located each time you measure your progress. Carefully place a dot precisely at the point you wish to use each time you measure. Using large dots or different point locations make inaccurate readings that cannot be compared over time, and this does not help you to know if you are progressing or not.
- When taking measurements for the first time write notes or make a quick drawing of the local area that explains each point location in a way that is easy for you to understand and duplicate. For easy reference, write the notes that describe the points you are using on your “Caliper Hand Measurement Chart.
- Mark you skin with a fine felt tip or ballpoint pen to clearly identify the exact points you will use each time to make your measurements.
- Examples of natural landmarks on your fingers, hands or wrists that will increase the speed and accuracy of your measurements:
a. Where a fingernail has a natural vertical ridge or flaw that does not change.
b. Where the fingernail bed and skin touch at the end of the finger (that little corner location where you might sometime get a hang nail). Use the same fingernail corner each time.
c. The very tip of your finger; it is the highest point when you look at your finger from the front and from the side view.
d. At the base of your palm, on or near the wrist crease, find a point where two or three creases meet to form a “V,” “X” or “Y”.
- Slightly bend your wrist. Notice if one or two wrist creases create a nice landmark that will be easy to locate each time you want to measure your progress. A crease or wrinkle of skin may cross over a vein, tendon, scar or blemish, making a precise reference point.
If all else fails you can locate the center of the wrist crease using a ruler, although this is much more difficult and less precise.
Measure distance bent finger flexed toward palm
Each time you how close your finger is kept flexed toward your palm you must use the same two reference points on the finger and palm or wrist. If you have Dupuytren contracture of one finger you will use two reference points. If two fingers are flexed toward the palm of one hand, three reference points are needed (one on each finger tip and a single point on the wrist). Three fingers require four points for measurement. You will make a mark on the fingertip of each involved finger and you will use the same point on the palm or wrist as a reference point for each finger.
- Mark each involved finger – Find a natural landmark or locate the center of the fingertip, as described above, of each finger affected by Dupuytren contracture. Place a small precise mark at each point.
- Mark the palm or wrist – Find a natural landmark or measure for the center of the wrist crease, as described above. This wrist point does not have to be in direct line with the involved finger(s); it can be off to an angle or side of the wrist. The only rule is that you use these same points each time you measure.
a. The wrist point can be located on the palm-side at the center of the wrist, or at an angle off toward the thumb or little finger side of the wrist crease; it can be anywhere on the crease as long as it easy to locate accurately and can be duplicated each time a measurement is made.
b. If two or more fingers are involved on the same hand, the same palm or wrist point is used as the reference point for all fingers of that hand.
c. Open your hand as far as possible.
d. Place the tips of two caliper points (either inner or outer legs) on the small dots you selected at the finger and wrist points.
e. Write the millimeter (mm) distance, as shown on the curved caliper scale, on your measurement record.
Measure amount of hand contracture
Each time you measurement your inability to flatten your hand on a tabletop, you must use the same two reference points.
If you find that only one side of the hand is kept from flattening out, and the other can be made flat, then you need to only measure the side that cannot be flattened. If both sides are kept from flattening, then you should measure both the little finger and index (pointing) finger side of the hand.
- Locate a deep wrinkle or crease that is near the knuckle that cannot be flattened. Place a small dot at the end of the selected crease or wrinkle to serve as the landmark or reference point for that joint.
- Mark the side of the finger joint or knuckle that cannot be flattened against the table top. The 1st point can be anywhere on the side of the knuckle that is a naturally occurring landmark; it does not have to be in the center of the joint.
- The 2nd reference point in this measurement is the tabletop the hand is resting on, and therefore does not have to be marked.
- Place your hand on a table top or similar surface. Press the hand down firmly so the palm is as flat as you can make it.
- Using one leg of the inside caliper (with the long straight legs), allow it to touch the dot on the side of the knuckle.
- Using the other leg, place the tip on the flat surface directly below the mark you placed on the knuckle being measured. Do not place the tip of this leg at an angle or far from the knuckle being measured. If you are not careful with this tabletop point selection you will add a variable to the measurement that will make comparison of other measurements invalid and inaccurate.
5. Write the millimeter (mm) distance, as shown on the curved caliper scale, on your measurement record.
6. To measure the distance the joint on the other side of the hand is being kept from flattening against the tabletop, repeat steps 2-7.
This is the measurement form that comes supplied with the caliper to record increased finger and hand movement. You will need good records because they are essential to know when to alter your Dupuytren treatment plan and how to do it.
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i saw a dr. yesterday. he wants to use the needle procedure xiaflex. after reading DCI information on your website i’m not sure which way to go. if i use the alternative method is it a lifetime treatment?
At this time we have been working with people for only 10 years using Alternative Medicine treatment of Dupuytren contracture. During that time DCI has helped many hundreds of people from around the world improve and overcome their hand contracture problem. And during that time I have not had anyone come back later to say their Dupuytren contracture returned – no one . This either means that people have had their DC come back but they have not told me about it, or it means that their DC has not returned. I cannot say for certainty which it is because we are not capable of doing follow up studies at this time of those people who report improvement of their hand problem.
Injection with Xiaflex to treat Dupuytrens is not perfect; there are inherent risks and problems that occur. While the rate of Dupuytren recurrence after Xiaflex injections is less than after surgery, the hand problem does recur. The makers of Xiaflex hold this finding up to indicate that this means the recurrence rate is low. I think the Xiaflex rate of Dupuytren recurrence is not actually low; it is just not as high as after surgery. Because these injections only make temporary changes to the hand at the specific site of drug action, you will eventually have to do the Xiaflex injections again and again. Actually what they are finding out is that the rate of recurrence of Dupuytren contracture after Xiaflex injections will increase each time you have the injections. This means that the more you use Xiaflex for your hand, the faster it will come back. Each time you use Xiaflex you expose yourself to the risk of accidents and drug reactions in which blood vessels, tendons, nerves, and muscles can be permanently damaged. For more information please read, “What is Xiaflex and what are the risks if I take it?” and “Do Xiaflex injections really have a low recurrence rate?“
I cannot tell you what you should do. But I can tell you that you should spend some time learning the pros and cons of this new procedure and fully understand what it is all about. As a suggestion, you should consider trying a brief therapeutic trial of Alternative Medicine treatment, perhaps for a month or two, such as you see on the DCI website to see if you can respond favorably to conservative care. If it helps you as it has helped many others, you might not have to consider any drug or surgical treatment. If it does not help you, you can go into a drug or surgical treatment knowing that you have tried to be conservative first and now you are ready for more radical treatment. TRH
I STILL HAVE PAIN AFTER DUPUYTREN SURGERY AND CAN NOT WORK. WHAT ARE SOME THINGS I CAN DO?
I AM TRYING TO GO ON LONG TERM DISABILITY
How long ago was your surgery? Is this your 1st surgery, 2nd or 3rd? Why are you not able to work? Is it because of pain, limited finger movement, numbness?
What is the current condition of your hand contracture? Many people have hand surgery only to find that it does very little to improve their problem and often makes matters worse. Is that what happened to you?
I will have a better idea how to reply to you once I understand more about what is happening with you. TRH