Dupuytren’s contracture ultrasound treatment

Posted on June 16, 2023June 16, 2023 by Dr. Herazy

Ultrasound treatment for Dupuytren’s contracture

Dupuytren’s contracture ultrasound treatment is the perfect non-invasive soft tissue therapy. This is true because ultrasound has a great therapeutic effect especially on the soft tissue. In fact, ultrasound therapy is the standard treatment of choice for most soft tissue problems in the sports world. It is used in most worker’s comp related injuries, as well.

You see, ultrasound influences most greatly those tissues with a high protein content. And there is no tissue with a higher protein content than the soft tissue (muscles, tendons, ligaments, etc.) of the body. Scar tissue, similar to the Dupuytren’s palm nodule and finger cord is very similar to scar tissue which has the highest protein content of all tissue. Add Dupuytren’s contracture to that list because DC palm lumps and finger cords are primarily made of collagen and fibrin. Clearly, Dupuytren’s contracture is a soft tissue problem ideally suited for ultrasound treatment.

For these reasons, ultrasound treatment for Dupuytren’s contracture is an effective and popular therapy with DCI customers.

There are many reasons people like treating Dupuytren’s contracture with ultrasound:

No pain; comfortable treatment.
Safe, no side effects.
Convenient, do at home or anywhere, anytime.
Economical; pays for itself by the 2^nd treatment application.
Good reports of effectiveness from thousands of DC users.
Applied directly to the problem tissue.
Also good to treat arthritis of small joints (jaw, toe, finger, ankle and wrist).

Ultrasound treatment for Dupuytren’s contracture was included into the DCI large treatment plan in 2012. That same year DCI started to advise adding ultrasound therapy to any small plan that was not working well. Since then, many times over, ultrasound has made all the difference to previously ineffective plans that needed a big boost.

3 MHZ Ultrasound Information

Does ultrasound help Dupuytren’s contracture?

Because 72% of DCI customers combine ultrasound into larger size plans, they rate their DCI treatment results to be very good. Indications are that ultrasound improves Dupuytren’s contracture treatment results 89% of the time. Overall, 8-10 people report moderate to marked improvement of their DC, for every one report of failure. Indeed, Dupuytren’s contracture ultrasound treatment is an important part of that success.

What is ultrasound?

Ultrasound is not complicated. Simply, ultrasound is sound greater than a frequency of 20,000 Hz. It is so high-pitched (high frequency) that a human cannot hear it. Here is some fun information that explains it a little better.

When discussing sound, the term Hertz is used. Hertz is a unit of measurement to count vibrations that happen in one second. Hertz is abbreviated HZ. One hertz (Hz) means something vibrates one time in one second. 17 Hz means something vibrates 17 times in one second. When something vibrates a million times in a second, or one mega Hertz, abbreviated 1 MHz. Lastly, 3 MHz is three million vibrations per second.

To put things in perspective, the sounds made by the human voice range from 85 Hz to 255 Hz. Further, the human ear can hear within a range of 20 to 20,000 Hz. At 1 MHz, no human can hear ultrasound. Not even a bat can hear at that sound frequency.

When electricity passes through a small mineral crystal, it will vibrate. This vibration creates a sound wave. Like when a bell vibrates and makes a sound. The sound frequency depends on the size and shape of the crystal. As we already know, ultrasound vibrations can go well past a million per second. Once created, ultrasound waves pass from the sound head of the machine, and travel into any tissue it contacts.

Sound energy moves whatever it contacts, making that material also vibrate. Specifically, when ultrasound energy contacts the human body, that part of the body will vibrate at the same frequency. Likewise, ultrasound vibrations will transfer into abnormal or injured tissue. As we will see, this is important because vibrating living cells causes them to faster and better. This is the key to why Dupuytren’s contracture ultrasound treatment is so important.

3 MHZ Ultrasound Information

What does Dupuytren’s ultrasound treatment do?

When tissue vibrates so fast, several things happen that are important to all soft tissue problems, especially Dupuytren’s contracture:

HEATING EFFECT – Ultrasound warms the tissue by vibration and friction, caused by sound waves shaking the tissues at 3MHz. Like rubbing your hands together 3 MHz! However, this heating takes place below the surface where there are no nerve endings. Therefore, the heat cannot be felt. Deep heat stimulates the healing process like a heating pad. But a heating pad only warms the surface. The heat cannot penetrate deeply because blood circulation carries the heat away. Thus, ultrasound warms all tissues deeper and faster than the blood can cool them. In fact, it even warms the blood vessels.
CAVITATION – Formation of temporary gas cavities or voids within body fluids and tissue cells. These gas voids increase the metabolic activity of cell membranes. Cavitation also increases the effect of the acoustic streaming phenomena. These cavities collapse almost immediately, releasing a large amount of energy. In turn, this results in additional deep warming.
ACOUSTIC STREAMING – Small-scale ripple effect of fluid near any vibrating structure, (bathtub, coffee cup, or sick tissue cell). This is an extremely powerful form of fluid movement. Acoustic streaming increases the activity and metabolism of any cell within the sound energy stream. It makes sodium and calcium ions pass more easily through cell walls. In turn, enzymes work better, protein metabolism is increased, and the cells function at a faster rate. Consequently, all these changes “up regulate,” or excite cellular activity. Thus, ultrasound acoustic streaming acts as a trigger to increase the therapeutic outcome of healing and repair.
MICROMASSAGE – Physical shaking is like a cellular back rub. Movement of cells and what is in them to increase tissue fluid interchange.

Not all Dupuytren’s disease ultrasound machines the same

Dupuytren’s contracture is a relatively superficial soft tissue problem. This dense abnormal fibrous tissue is immediately below the skin surface.

Any ultrasound machine used to treat Dupuytren’s contracture must have a particular frequency range to keep the therapeutic sound waves within the palm lump and finger cord.

A 1MHz machine penetrates too deeply to be effective for Dupuytren’s contracture. This sound frequency is good for treating large joint problems of the hip, knee, shoulder and low back. By contrast, a 3 MHz unit penetrates just a little below the surface. Also, it is used for cosmetic problems like small joint arthritis, facial wrinkles and skin discoloration. What is more, making it ideal to treat Dupuytren’s contracture.

To summarize, use 3 MHz ultrasound to treat Dupuytren’s contracture. A faster 3MHz unit produces ultrasound that works near the surface of the skin, where the problem of DC is located. Not deep down. The sound waves of the 1 MHz and 2 MHz ultrasound machines travel too deeply for good Dupuytren’s contracture ultrasound treatment.

Using ultrasound treatment for Dupuytren’s contracture

Full instructions for using our 3MHz ultrasound machine come with each DCI order. You will have all the information you need to use ultrasound correctly for Dupuytren’s contracture therapy. No one complains they do not understand.

Dupuytren’s contracture ultrasound treatment is not a magic bullet or miracle cure for palm lumps and finger cords. Ultrasound is just more tool to assist the healing process. Regardless, it still takes a lot of time and work to get the job done to the best of your ability.

3MHz – Model HS-3040 – Ultrasound treatment for Dupuytren’s contracture

Only portable 3MHz ultrasound machine with stainless steel sound head
Only portable 3MHz ultrasound machine with FDA 510K clearance for medical use
Delivers dependable 3MHz (3 million waves per second) frequency that is ideal for treatment of Dupuytren’s contracture, rather than 1MHz frequency work best on deeper tissue, arthritis and large joint treatment
Select either continuous or pulsed setting
Lightweight
Durable
Portable
Two different power settings available:
U.S.A. – 24V DC, and 110V AC
International standard settings – 24V DC, and 230V AC

Practically all US machines sold on the internet are 1MHz units. They are so popular because they are designed to treat deep tissue joint pain that is covered with many layers of heavy tissue (knees, hips, shoulders), whiplash neck injury, most kinds of arthritis, and heavy muscle pain problems. But the 1MHz size machine is not ideal for Dupuytren’s contracture.

Dupuytren’s contracture is a superficial soft tissue problem, found much close to the surface of the body. For this reason, any US machine used to treat Dupuytren’s contracture must have a particular frequency range to keep the therapeutic effect closer to the skin surface where the DC problems are located.

Dupuytren’s contracture ultrasound treatment has three primary benefits:

Speeding up the healing process by cavitation, acoustic streaming, heating and the increase in blood flow in the treated area.
Decrease pain from the reduction of swelling and edema.
Gentle massage of the area of fibrous tissue formation to soften nodules, cords and scar tissue.

(US Ultrasound orders) 110V Option $160.00 $160.00

(International Ultrasound orders) 130V Option $160.00

NOTE : Contact or coupling gel is needed to treat with ultrasound. Mineral oil or plain ultrasound coupling gel can be used, but for DC the best is DMSO gel because it delivers other therapeutic benefits. If you haven’t used DMSO previously, click HERE to learn more.

Dupuytren contracture pictures

Posted on June 14, 2023 by Dr. Herazy

Dupuytren contracture pictures

What does Dupuytren’s contracture look like?

Pictures of Dupuytren’s contracture show palm lumps, finger cords and finger flexion deformity

Before displaying several Dupuytren contracture pictures, it will be helpful to explain that there are three primary features associated with this chronic hand problem. These are the features that appear in pictures of Dupuytrens contracture:

Dupuytren nodule – these lumps on the palm surface often look like a callus or perhaps melted wax. Typically, they are located at the base of the ring (4^th) or pinky (5^th) fingers. The skin often appears dimpled or depressed along with a slightly raised surface. It will often appear to be a slightly darker color due to the thickening of the tissue that is taking place, similar to a callus. Later, as the condition progresses, more clearly defined edges develop, as well as deeper depressions or dimples, and greater thickness over time.
Dupuytren finger cord – this important feature is not directly not visible on the palm. It is below the surface of the skin. However, the finger cord raises the skin surface like one of the larger ligaments on the inside surface of the wrist or the bend of the elbow, as when making a tight fist or lifting something heavy. A finger cord extends from the upper palm at one end, to the base of the finger at the other end.
Finger flexed and cannot be straightened – as the finger cord becomes thicker sand shorter the finger becomes progressively more bent. Consequently, the finger curls down toward the palm. This interferes with any use of the involved finger(s). Pain is of variable duration and intensity. Over time the finger(s) will slowly and progressively become bent, unable to straighten completely. As a result, the finger(s) take on a claw-like appearance.

For information about DCI treatment plans

Eliminate the Dupuytren’s nodule with safe natural treatment

Great news! It is important for anyone with Dupuytren to understand that Dupuytren can self-heal. The body self-heals an unknown percent of early Dupuytren disease. Also, self-healing can even reduce older, larger palm nodules and cords of Dupuytren’s contracture.

Surgery is not always necessary to eliminate the Dupuytren’s nodule. Since 2002 the Dupuytren Contracture Institute has helped people who struggle with an expanding and tightening lump on the palm. Those who closely follow the DCI treatment strategy early can do rather well. DCI hears from 8-10 people who use our large treatment plan reporting they see moderate to marked reduction of their signs and symptoms of Dupuytren, for every one report of failure.

We find that the larger the treatment plan, and the closer a person follows DCI treatment suggestions, the better the Dupuytren self-heals. For information about DCI treatment plans. Safe natural healing without side effects or recurrence.

>> Testimonials from Dupuytren Contracture Institute

>> How to start Dupuytren treatment with Alternative Medicine

>> Dupuytren Contracture Treatment – FAQs

Purpose of Dupuytren’s contracture photos

No picture of Dupuytren contracture will look exactly like what you might be experiencing. Therefore, these Dupuytren contracture pictures are not a substitute for a medical diagnosis.

The purpose of the Dupuytren’s disease pictures that follow is for your general knowledge. Use them to compare or confirm what you are seeing and experiencing. Also, you can see just how severe the finger contracture and hand deformity can be. In the early stages of Dupuytren’s contracture is worried about the small – and sometimes large – changes in the appearance of the hand. Not knowing about a problem and how bad it can become can be the worst part of a condition like this.

If you have not yet visited your doctor to have your hand lumps examined, allow these Dupuytren pictures to motivate you to seek prompt medical attention and a doctor’s opinion about your problem. Perhaps after studying these Dupuytren contracture images, you will feel relieved you are not so bad off in comparison to other people’s situation.

Please feel free to contribute your own Dupuytren contracture pictures to DCI for inclusion on this page.

Picture of Dupuytren disease, multiple lumps on palms of both hand. Picture of Dupuytren contracture of left hand, showing well developed palm lump and pit formation with moderate ring finger flexion. Dupuytren contracture pictures are helpful to understand finger flexion deformity.

Dupuytren's contracture picture showing finger flexion and palm lump.

Garrod’s Pads Treatment and Dupuytren’s Contracture

Posted on April 5, 2023 by Dr. Herazy

Garrod’s Pads Treatment

>> Testimonials for Dupuytren Contracture Institute

>> Dupuytren Contracture Treatment – FAQs

Garrod’s pads and Dupuytren’s contracture treatment

Since 2002, Dupuytren’s Contracture Institute has worked with over 800 people whose primary complaint was Garrod’s pads. In addition, DCI notes that Garrod’s knuckle pads occur in combination with Dupuytren’s contracture in 20-30% of people who come to DCI for help. Combined, these two groups total of over 2,000 people with Garrod’s pads who have used DCI treatment. They totally eliminated or significantly reduced their knuckle deformity, or at least eliminated all pain and limitation it causes.

Based on the reports of natural treatment progress from people DCI works with, the results are very good to excellent. DCI receives 8-10 reports of moderate to marked improvement of palm lumps and cords for each failure reported, when using the DCI large treatment plan. Improvement of dense and painful knuckle pads is even better. In fact, we often tell people that Garrod’s pads typically improve before they notice a change in their DC.

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Usually, people who use a large DCI treatment plan report that their Garrod’s pads respond faster than their Dupuytren’s contracture.

The typical Garrod’s knuckle pad responds to the large DCI treatment plan by becoming smaller, softer, less painful, less dark, as well as the fingers feeling less stiff and painful, in a few weeks. Rarely do we work with someone whose Garrod’s nodules show some degree or type of improvement. How long treatment takes to reach complete and final improvement depends on a variety of factors like genetic predisposition, severity, age of the individual, duration, if hand surgery was used previously, etc.

While a few got a small amount of improvement, most benefitted to a moderate to great degree. Of course, all treatment was safe and natural. Without drugs or surgery, and no side effects.

About Garrod’s knuckle pads

Typically, Garrod’s knuckle pads are well-defined and smooth lumps or thickening on the dorsal (back) of one or more finger joints. Garrod’s nodules or pads are a form of fibromatosis (excess collagen and fibrin production), just like Dupuytren’s contracture (palmar fibromatosis), Ledderhose syndrome (plantar fibromatosis) and Peyronie’s disease (penile fibromatosis).

Our records show every person with Garrod’s pads benefitted in some way by our natural treatment methods.

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Clinical features

A history of repetitive injury to this part of the hand from work or sports activity is often present. However, it sometimes happens that Garrod’s knuckles develop without any physical explanation.

Knuckle pads can look like calluses on the skin, where the skin thickens and loses its elasticity. The cause of Garrod’s pads is excess fibrous tissue (collagen and fibrin) in or under the skin. Because this problem is a fibromatosis of the fingers, it usually runs in families, but can also appear as a sporadic occurrence.

Garrod’s pads can appear in one or both hands, at any or all fingers, one joint or many.

They mainly affect the PIP finger joint (joint closest to the hand). Less often they appear at a knuckle (MCP or metacarpophalangeal/first joint) or distal interphalangeal (DIP/third) joint of a finger. In severe cases, this dark, raised and rough tissue can also appear away from the knuckles, on the sides of the hand or elsewhere on the upper extremity. Some clinicians even apply the name to other parts of the body. Although the hands are by far most commonly affected, other areas and joints, such as the feet and knees, may be involved.

When appearing along with Dupuytren’s contracture, Garrod pads usually suggests a more aggressive form of the Dupuytren disease problem.

In the U.S and the rest of the world knuckle pads are a common occurrence. The prevalence of knuckle pads is difficult to determine because this problem often does not cause physical symptoms. Thus, people do not often seek medical care 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.

Pain associated with knuckle pads

Pain associated with Garrod’s pads is greatly variable. For some people there is no pain. Most, and for others the pain is intense and constant. Further, for some, pain is only when touched or when the finger moves. This suggests a connection between the Garrod’s pad and the tendon sheath of the finger.

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.

Treatment for Garrod’s pads

Treatment for Garrod’s pad makes sense when knuckle pads cause pair or otherwise affect the use of the hand. Surgery can be considered after safer conservative natural DCI treatment has not been successful. Please read about the DCI treatment protocol.

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Dupuytren contracture recurrence after hand surgery

Posted on March 23, 2023March 23, 2023 by Dr. Herazy

Recurrence of Dupuytren contracture is common

Dupuytren contracture recurrence means that the abnormal palm and finger tissue comes back after surgical removal. For example, after surgically removing the palm lump, it grows back again. And, after surgically straightening the bent finger to some degree, the finger cord grows back, pulling the finger down toward the palm again. This happens because this is the nature of Dupuytren disease. Excessive and spontaneous collagen production in the palm of the hand continues because surgery cannot stop it.

Recurrence of Dupuytren contracture after surgery is common and frequent. This return of the Dupuytren contracture tissue is exactly why some people have 2-4, or more, hand surgeries. They always think the next surgery will solve their problem.

Surgeons admit that “sometimes the Dupuytren contracture returns within a few months after surgery. Other times, it can return many years – even decades – later.” It has been written, if a person lives long enough after hand surgery, the Dupuytren tissue will eventually return.

No Dupuytren contracture recurrence with natural treatment

Good news! Based on reports from customers using the DCI large treatment plan, 8-10 people have moderate to marked reduction of palm lumps and finger cords, for every one who reports no change. Since 2002, no one has ever reported a recurrence or worsening or side effect after improving their DC with the DCI treatment method.

The purpose of using natural Alternative Medicine treatment is to get that DC tissue healing, thus avoiding the need for any hand surgery. If you can get better on your own, there is no need to worry about Dupuytren contracture recurrence.

The DCI treatment system has saved countless people from needing hand surgery. Their fingers and palms improved enough with the DCI method that they, and their doctors, did not think surgery was still necessary.

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An old and common surgical problem

The greatest French surgeon of the 19^th century was Guillaume Dupuytren. Even so, he also had patients whose palm lumps and finger contractures returned after hand surgery. He experimented with a variety of tactics and methods to minimize the return, but none were totally successful. Some things never change.

So, if Dupuytren contracture continues to be a problem during 300 years of surgery, what does that mean? That they were all bad surgeons? No, of course not. Actually, even fantastic surgeons must deal with recurrence of Dupuytren contracture. Fundamentally, the real problem is that Dupuytren disease is a nasty problem. After surgery the patient still has Dupuytren disease. And, of course, this means the patient still has the tendency to produce too much collagen and fibrin – even after surgical removal of the palm lump and finger cord.

Here is the nasty truth about Dupuytren contracture: There is no way to get rid of it by cutting it out or dissolving it with Xiaflex (collagenase enzyme). It just keeps coming back.

Hand surgery to remove the palm lump and finger cord is like hitting a skunk with a stick to get it out of your garage. Forcing the skunk out just creates more trouble, and you get more of what you are trying to get rid of.

DCI thinks it is smarter and safer to get the skunk to leave quietly, naturally, so it does not cause any more stink.

People tell us about their Dupuytren contracture recurrence

At DCI, we talk to many people about their Dupuytren problems. As you might suspect, the subject of Dupuytren contracture recurrence is a popular topic. Based on these conversations, we learn the average persons’ Dupuytren recurrence returns 2-3 years after surgery. It is not uncommon for recurrence to start in less than a year; some just a few months after hand surgery. At the other extreme, other people say their DC took 5-10 years or more to return.

In addition, we discuss the actual condition of the hand when the DC returns. Do not assume that after returning, the Dupuytren problem will be the same as before surgery. Perhaps it might feel good for a few months, or even or year or so. Eventually, the hand contracture will return. How good or bad the hand becomes depends ultimately on many different factors that are beyond the control of the doctor:

Amount of normal and abnormal superficial and deep tissue that must be removed.
Size of the palm lump and finger removed.
How deeply the palm lump and finger cord has grown into the surrounding normal tissue.
Where the palm lump and finger cord are located in relation to important blood vessels, muscles and nerves.
If skin grafts are necessary to close the incisions, and if they heal well or get infected.

What happens after hand surgery?

After hand surgery, the patient still has Dupuytren disease. Surgery only removes the thick contracted tissue; the disease remains. Therefore, the patient’s hand can still produce an excessive amount of collagen and fibrin in that same area of the hand. When it does, it is called Dupuytren contracture recurrence.

Removal of a large percent of tissue from the palm of the hand has consequences. It often results in a worse situation than before the hand surgery, for several reasons:

Continued scar formation causes the palm to become even thicker and less flexible.
Pain due to scar development after the removal of normal and abnormal tissue during surgery. It can be mild to severe, and occasional to constant.
Numbness and tingling of the fingers and hand due to that same scar development.
Permanence of some degree of finger joint stiffness. Seldom are fingers completely straightened after surgery. And over time they stay flexed even more than before.
Loss of muscle and valuable connective tissue with each surgery, causes weakness and awkwardness of finger and hand movement.

What is the possibility of recurrence

First of all, there is no way to accurately predict anything about Dupuytren recurrence after surgery. No one can say when recurrence will happen; how severe it might be; or what symptoms might develop.

However, a few statistical indicators suggest recurrence of Dupuytren contracture could happen sooner if one or more of the following is true:

Finger joint flexion fixed at 30 degrees or more.
One or more immediate family members also have DC.
One or more ancestors are from northern Europe or Scandinavia.
Younger than 60 years of age at onset of DC.
Palm lump and finger cord are developing rapidly.
History of diabetes or liver disease.

Final comment

In 1964 Weckesser stated, “In general, the longer the follow-up period [after Dupuytren’s disease surgery], the lower the percentage of good results.” This means that shortly after surgery the hand can feel and look pretty good. However, as weeks and months pass, it is very common for the hand to tighten up again. The results and benefits that looked so promising at first, fade and worsen. This return of the contracture ultimately causes more pain, numbness, weakness and other related problems.

Surgery for Dupuytren’s contracture only provides a temporary break from the contractures and other related complaints. The recurrence of Dupuytren contracture might not be too bad if the time of relief was long enough. But this is not the case.

People usually say that the short period of relief they got from hand surgery is not worth what they went through. They felt the risk of surgery, the pain, hours of rehab, cost, complications and side effects related to the surgery and subsequent complications related to Dupuytren contracture recurrence did not justify what they got out of it.

It is reasonable to first be conservative. Try a simple natural approach to help your body heal the DC tissue, and so naturally remove the Dupuytren tissue. Better to work hard to avoid needing hand surgery if possible. You can always have surgery later if it is still necessary.

Learn about Dupuytren’s natural treatment