How is epilepsy a factor in Dupuytren contracture?

Dear Dr. Herazy,

Thank you for offering natural solutions! I’ve not been formally diagnosed with Dupuytren and have not seen progression pictures to conceptually know for sure if this is my diagnosis.   I have the nodules in both palms and both feet. Oddly enough, it affects my left hand more than my right. Middle, ring and now the pinky is starting to show pain. I can no longer make a fist and I have arthritis like conditions in the joints of the fingers that are affected. The right hand has only the middle finger affected. This has been going on for about 6-8 months.

From what I have read about this issue, epilepsy is a factor. Could you please explain how this is a factor? I received my epilepsy DX at 15 and I’m now 47 yrs. old.

I’m also a massage therapist and have learned to use forearms much more than hands. I sparely use my hands and use them more for swedish massage with little to no gripping. Could you please give instruction on how to massage the affected areas? I haven’t found that in your website other than not to do deep tissue or stretching.

Since I am self-employed and have a $7500 deductible on my insurance, I’m not anxious about adding yet another DX and underwriting nightmare to my life. Can using the products you mention do any harm and how hard is it to diagnose this? I would certainly like to think this is an overuse issue and that some PT would fix the problem but there are too many things that point to this DX.

Thank you in advance for your time and any help you provide!


Greetings Angela,

First of all, it is important that you show your hands and feet to your family doctor, or the physician who is treating your epilepsy so he/she can diagnose your condition.   Diagnosis is usually a relatively simple matter made on simple observation and history alone.  Given your situation I would almost guarantee the doctor who has been prescribing your anti-convulsion medication is very much aware of DC.

You see, as with most topics related to Dupuytren contracture, there is controversy regarding the causal relationship between epilepsy and collagen nodular formation of the hands and feet that appear in a disproportionately high percent of epileptics.

There are several studies of chronic epilepsy in which Dupuytren contracture has been found in 45-60% of epilepsy patients.  It is speculated that the Dupuytren development stems not from a genetic or neurological causation but from long term use of the anti-epilepsy drug, phenobarbitone.  The cause of the epilepsy is not an issue in regard to the Dupuytren development, nor is the neurological category or related symptoms.  these studies conclude that the most significant correlation is the duration of treatment with phenobarbitone; the longer you take it, the more likely you will develop Dupuytren contracture and Ledderhose disease (nodules and contractures of the soles of the feet.

Other studies do not find the same correlation between DC and phenobarbitone.   Instead they conclude that given the evidence of a genetic component of both Dupuytren contracture and idiopathic (without a medical cause) epilepsy, that the correlation is based on inherited defects of adjacent genes that cause Dupuytrens and epilepsy in the same individual.

I tend to believe that Dupuytrens is a side effect of phenobarbitone simply because there was no known pattern of high incidence of DC in epileptic patients until the use phenobarbitone for convulsions. The fact that many of these people have it not only in both hands but also both feet – as you do – points to a systemic drug reaction.

Unfortunately your massage therapy occupation must have previously placed a considerable amount of physical stress on your hands, and hand trauma is another of those causes that is often mentioned for Dupuytrens.

Use of massage to help Dupuytren contracture is a complex and detailed discussion.  I am more than half way through writing a book on this subject.   There is no way I can provide the kind of answer you deserve in the limited space available.

In doing this work since 2002 and communicating with thousands of people who use this form of  Alternative Medicine treatment for Dupuytren contracture and Peyronie’s  disease,  I have never been told of any adverse reaction to our therapy concept.  I suggest that you go to our testimonial page to learn how many people have helped themselves naturally.  TRH

Dupuytren’s Contracture and Cirrhosis: Chronic Liver Disease

Cirrhosis and liver disease as a cause of Dupuytren contracture

The predisposition and causation of Dupuytren contracture as a result of cirrhosis of the liver is not clear; more clearly established correlations exist:

  • People of Northern European (UK) and Scandinavian descent
  • Men rather than women; men are 10 times more likely to develop Dupuytren contracture between the ages of 40 and 60 years, after which the incidence rate increases for women later in life to become equal by 80-85 years
  • Workers who sustain constant micro-traumatic stress to the tendons of the hands (carpenters, bricklayers, rock climbers, jackhammer operators, etc.)
  • People over the age of 40; age as a factor increases as age increases
  • People with a family history (grandparents, parents, uncles, aunts, cousins)

Currently, unproven but interesting causes of Dupuytren’s hand contracture include diabetes, alcoholism, epilepsy therapy with phenythoin and liver disease.

A higher rate of Dupuytren contracture occurs in those with cirrhosis and related liver disease caused by alcohol abuse, as compared with those with cirrhosis and liver disease not associated with alcohol consumption.  It is important to note it is not alcohol consumption, per se, that appears to be a contributory factor for Dupuytren contracture but the abuse of alcohol intake, especially over an extended time.  Further, to keep contributory factors in perspective and rightfully appreciated, it is important to note that age and genetic predisposition to Dupuytren’s disease, as revealed by family history, are of greater contributory importance than alcohol abuse and resultant liver cirrhosis.

Dupuytren contracture and cirrhosis, liver disease and alcoholism

Perusal of recent studies that investigate the correlation of Dupuytren contracture and cirrhosis, liver disease and alcoholism reveals variable results and inconsistent conclusions.   The general trend of findings points toward the higher prevalence of Dupuytren contracture in chronic alcoholics and absence of correlation between Dupuytren contracture and chronic liver disease.  Alcoholics tend to have a higher rate of Dupuytren’s disease, and this is thought to primarily due liver disease caused by alcohol abuse.  Age, male incidence and genetic factors are of greater causation and predisposing factors than cirrhosis and liver disease.

If you male, and over 50 years of age, with a history of Dupuytren contracture in your family and heavy alcohol consumption, it would be wise to do all you can to reduce your chance of cirrhosis and liver disease.  You cannot do much about your gender, age and family genetics, but you can eliminate liver disease risk factors that might favor development of Dupuytren contracture.

Once Dupuytren contracture is present and someone learns that there is no known medical treatment available other than risky surgery, consider using Alternative Medicine as a Dupuytren contracture treatment option.  This is an option that the Dupuytren Contracture Institute has researched and developed since 2002, with considerable treatment success. To learn more, click Dupuytren treatment success.