My 25 year-old son has Dupuytren’s contracture. What treatment would you recommend?

Hi Dr. Herazy,
I came across your website while searching for more information on Dupuytren Contracture. My son had intricate surgery on his finger in June and recently noticed a small lump on the palm of his hand. It’s not painful, but the doctor said it looked like Dupuytren Disease. He is only 25 years old and I am very concerned about the future. Have you seen this before in someone his age and can he stop the progression of this disease with your products? What treatment would you recommend for someone his age? There also may be a predisposition to this as I have a painful lump on the bottom of my foot that I will be checking out with a doctor. Thank you very much.
PG

 

Greetings PG,

You are a good parent.  Once a parent, always a parent.  My youngest one of three is soon to be 38, so I know how this goes.

My guess is that you have a genetic predisposition to this excessive fibrous tissue response that your son has inherited from you.  This is made even more so if both you and your husband/wife are also genetically predisposed with families coming from Northern Europe or Scandinavia.  If this is true it would explain why some one who is so young has developed this problem.  Perhaps your son has unknowingly made himself susceptible with other factors that increase the odds for Dupuytrens:  diabetes, cigarette smoking, alcoholism, and prolonged hand stress  like with manual labor.  I also notice that many serious musicians who play piano or guitar seem to develop DC more than the average population.  Any of these might explain this problem developing so early in his life. 

I have seen this before in people in their mid-20s and it is usually accompanied by factors as I have explored above.

I would recommend the largest and most aggressive treatment he can sustain for at least 3-4 months of faithful and diligent work.   If this problem is to respond at all to Alternative Medicine methods the treatment approach must be significant to make an impact on his condition.  Please read Can I treat Dupuytren’s contracture naturally without surgery or drugs?       Dupuytrens is a tough problem.  Half efforts are usually a waste of time.  Allow me to explain why I think someone such as your son should be extremely interested – far more than most all other people – in avoiding surgery and getting natural conservative treatment to increase his ability to eliminate his hand nodule.  

Hand surgery for Dupuytren’s contracture is not a cure; any good surgeon will tell you that needle aponeurotomy, palmar fasciectomy or Xiaflex injection are just a temporary measure; the Dupuytren’s contracture problem will always recur – it is a matter of when the recurrence will develop, not if.  When someone in his 60s or 70s develops DC and has surgery, the Dupuytren recurrence factor is not as important because frankly at that age this person might not live long enough to develop the recurrence and have it evolve over a few years to the point that a second surgery is important to them.  Many elderly people get their first DC surgery and just ride out the effects of the recurrence as they try to ignore a growing hand problem.  But with a 25 year old person all of this strategy is changed.

A young person has a lifetime to not only develop one recurrence of Dupuytren contracture, but several or many.   Some people can have a recurrence in just just 2-3-4 years and a few have recurrence in a year or less.  With each surgery recurrence usually is made to come more quickly; with each hand surgery the rate of recurrence increases.  It is as though the irritation and instability created by the surgery speeds up the recurrence phenomenon.    Many times after a few surgeries are done it does happen that eventually amputation is the only viable option that remains. 

With someone in his mid-20s this can be a great problem, since there are so many wonderful years that lay ahead.   For this reason it is my opinion your son should do absolutely everything possible to avoid entering upon this slippery slope.  I suggest that your son start as soon as possible to see if he can increase his natural ability to remove this foreign fibrous palm lump.  As with anything in healthcare (like Dupuytren’s hand surgery) there are no guarantees this will work, but when you consider the fact that his approach is without side effects, that in almost 11 years we have not had one report of recurrence after successful treatment, and that surgery can also be used at a later time if  necessary.

I suggest he does some reading on the DCI site to learn how this approach is done.  Let me know if you have any questions.  TRH

Is my hand problem a cyst or Dupuytren contracture?

dear dr. herazy, 

my name is mark c, and  i have a question concerning my hands.  on my left hand, immediately under my ring finger, it look’s like i have a cyst! very hard to open my hand fully. in the middle of the hand i see something like a tendon sticking out and it appears to be  connected to the cyst. i also have a little one starting on my left hand. i can’t fully extend my left hand flat out because of the cyst.  i have heard there are alternative procedures for my ailment, like cortisone shots, etc. i do not know if i have a cyst or dupuytrens.

thank you for your time,

 mark c.

 

Greetings Mark C,

Thank you for writing to ask about the problem with your hand.

Based on the way you describe your hand problem, and the fact that you did not say so, I will assume that you have not seen a doctor at this time for the problem you are having with your hand.  This is a mistake.  You should see a doctor in your area about your hand so you will know exactly what the problem is that is causing your complaints.

Further, since you are having a problem of a mass located near the base of your ring finger and trouble flattening your hand and cannot open your hand fully, along with the appearance of what looks like a tendon connected to the palm lump, your description does make it sound like you have Dupuytren’s contracture.   

If it turns out that you do have Dupuytren’s contracture it would be helpful to determine if you can increase the ability of your body to remove the dense fibrous tissue that is developing in both of your hands by using Alternative Medicine methods as are outlined on the DCI website.  Many people find improvement after aggressively following a plan of treatment for a few months of self-administered care.   If after this time you do not see improvement in your problem then you can always consult with a surgeon to discuss hand surgery, although Dupuytren surgery is always eventually followed by recurrence of the same problem – usually within a few years.

Once you know the exact cause of the problem you will know how to proceed.    TRH

What do you suggest for a palm bump that might not be Dupuytren’s contracture?

Hi Dr. Herazy,

I am a 46 yr old white female who has had this hand problem for @10 yrs . My left hand (palm) has a large bump then right underneath that a section of straight bone-like section, about 2 yrs ago I developed a knuckle pad which is the same finger extending to the palm area. This pad can be moved but is painful at times very and swells larger some days.  My grandfather (on my moms side ) had dupys and my dad has dupys.  I went to an orthopedic  surgeon about the knuckle because of the pain and he said it was a ganglion cyst and wanted to drain it, now that I’ve read this I don’t believe that diagnosis.  This cause me pain the palm does not.  I am a Medical technologist for over 20 yrs doing a lot of repetitive hand movements which are now becoming more difficult, what do you suggest? 

Thank you,

Martha Burke

 

Greetings Martha,

It is certainly possible for someone with a family history of Dupuytren’s contracture to develop a hand cyst of some type.  As you describe your palm lump problem you do not create a clear impression that you have Dupuytrens contracture.  You do not mention inability to extend your involved finger, and you do mention the variable size of the swelling on your palm that changes from day to day; these factors are not like DC.

Since your orthopedist already gave you a diagnosis of a ganglion cyst, and you do not agree with that diagnosis, I suggest you do to someone you have respect for and ask for an examination and diagnosis.  This way you will have no doubt what you are dealing with.  TRH

Any side effects taking the supplements to treat Dupuytrens?

Any side effects taking the supplements to treat Dupuytrens?

 

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

Is this lump in my palm anything to worry about?

Lump on palm of hand should be investigated

As a general rule, anytime you discover something new happening to your body you should be concerned enough to quickly determine if the new situation has important short- and long-term consequences.   In the case of a bump, nodule or lump on the palm of the hand that appears without reason, it could be important and should not be dismissed.

Of course, the first explanation for a palm lump or nodule is that it could be a simple callus.  If a callus makes sense based on new or greater manual work you have been doing recently, especially without the protection of gloves, then that is probably all the concern that is necessary.

However, if you have not been using your hands more than usual lately, then you should do a quick mental inventory of any other recent symptoms you have noted about your hand:

  • Can’t extend or straighten one or more fingers
  • Can’t open hand completely
  • Can’t lay palm flat down on a table top
  • Fingers won’t open up after being used
  • Fingers won’t straighten
  • Fingers are restricted in full movement
  • Fingers curling in toward palm
  • Pinky finger or ring finger won’t extend fully
  • Lump, bump or nodule on the palm of the hand
  • Can’t open hands without pain
  • Stinging or burning pain in hand
  • Feels like a swollen tendon in the palm of hand
  • Feels like hand constricting and won’t open easily

If you note one or more symptoms that reduce your ability to use your hand and fingers, then you could have a fairly common condition known as Dupuytren contracture.

Lump in palm of hand common Dupuytren contracture finding

Dupuytren contracture is a problem of the soft tissue characterized by thickening and shortening of fibrous bands located in the deep tissue of the palm of the hand (palmar fascia), caused by an excess amount of a tissue protein called collagen.  As this progresses a cord of tissue will develop below the surface or a lump in the palm on the surface, resulting in reduced mobility and contracture of the hand and finger.  This involvement can affect one or both hands, and a variable number of fingers.  Dupuytren contracture presents in a wide variation, from a mild and slowly progressing contracture of a single finger, to severe and rapidly progressive involvement of several fingers of both hands, or many variations in between.

Alternative medicine treatment when combined into an aggressive assembly of natural therapies (vitamin E, PABA, acetyl-L-carnitine, massage, stretching, copper peptides, systemic enzymes, etc.) are often effective in reducing or eliminating the excess collagen cord or nodule formation and the subsequent finger contracture that so often prevents the 4th and 5th finger from being able to extend or open fully and keeps the involved fingers curled in toward the palm.   For information about using natural treatment methods to treat Dupuytren’s contracture, and to possibly avoid the need for Dupuytren release surgery, click natural Dupuytren Treatment Plan.

One or more dimpled and thickened bumps on the palm are most often caused by Dupuytren’s contracture.  This is especially true for any unusual small nodule or lump on the hand that appears on the palm at the base of the 4th (ring) or 5th (pinky) fingers, especially if the involved finger or fingers won’t completely straighten out.  Although it is always advisable to get a medical diagnosis of this kind of health problem, it is possible to develop a strong suspicion the problem is Dupuytren disease if several indicators and factors are present in your history:

  • Ancestors who came from England, Ireland, Scotland, Wales, or a Scandinavian country
  • One or more family members also have Dupuytren contracture
  • Palm lump located immediately at the base of the ring and/or pinky finger
  • Age 45 plus
  • Male
  • History of manual labor doing heavy or repetitive work, often with hands unprotected
  • History of tobacco smoking
  • Diabetes
  • Alcohol abuse or liver disease
  • Epilepsy

Dupuytren contracture will often return or recur within a few years after surgery that releases the finger contracture by removing the cords or lumps on the palm.  In fact, some forms of Dupuytren surgery have am 80% recurrence rate 3-5 years after the first operation, and even faster recurrence for a 2nd or 3rd surgery.  Hand surgery should not be seen as a solution or cure for Dupuytren’s contracture since recurrence is such a common problem not only for hand surgeons, but also the patients they serve.

Many surgeons voice the opinion that in many cases Dupuytren hand surgery seems to accelerate and worsen the development of cords and lumps on the palm.  For this reason it is suggested that a person who has Dupuytren cords and lumps should first attempt a therapeutic trial of aggressive Alternative Medicine to determine if the body is capable of reversing or even eliminating the tissue changes that makes the fingers curl in toward the palm and prevents the hand from opening completely. If after two or three months of natural treatment no change is seen, Dupuytren surgery can always be done at a later time.

Natural alternative therapies such as suggested by the Dupuytren Contracture Institute do not receive evidence-based research because of their limited profit potential and easy access by laypeople, and so have little support from the medical profession.  Even so, with a little independent research on this website it should be obvious that these natural healing ideas make sense and do not interfere with subsequent medical treatment.

 

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