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Can I treat Dupuytren’s contracture naturally without surgery or drugs?

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New Dupuytren non-surgical and non-drug treatment

Natural Dupuytren contracture treatment

Anyone who has spoken to his family medical doctor, orthopedist or hand specialist about Dupuytren contracture treatment has been told the only options are some form of hand surgery and Xiaflex drug injections.  But this is not true.

There is another viable Dupuytren treatment option and that is the use of Alternative Medicine to attempt to increase the healing ability of the body.  This is explained that with a better supported healing response the body will have a greater capacity to reduce or eliminate the Dupuytren lumps or cords, as well as reduce the finger contractures that eventually develop.

Avoid hand surgery and drug injections with Alternative Medicine

Dupuytren Contracture Institute has worked since 2002 with those who have had one or more hand operations, and has seen it is possible to eliminate or greatly reduce the need for a second surgery. Many of the people who work with our ideas find their doctors no longer want to do a second surgery after they make significant progress with natural therapies for their Dupuytren hand problem.

For those who never have had a Dupuytren operation, DCI suggests following a conservative treatment  option that consists of a short therapeutic trial of Alternative Medicine remedies first – rather than last – in an effort to possibly avoid hand surgery.  For those who already have had one or more Dupuytren surgeries, DCI suggests it is still possible to follow the conservative option but with reduced expectation.   Either way it makes sense to consider natural Dupuytren treatment as a way to possibly postpone or avoid another hand surgery.

Bulstrod, Loos and Messina are well respected medical researchers who report successful Dupuytren treatment outcomes with exercise, massage and traction, all without surgery. In spite of good clinical results their work is not given much interest because research funding is always directed toward innovative surgery and high profit drugs.   There is almost no financial incentive to research or document the value of the combined use of low cost natural Alternative Medicine treatment for Dupuytren contracture with, minerals, herbs, traction, massage or exercise that a person use at home.

Only a short therapeutic trial of aggressive natural treatment is needed to learn if your body can reduce or even eliminate the palm lumps of Dupuytren contracture.  To learn about the wide variety of natural self-management ideas that DCI has been developing since 2002, visit Different Way of Looking at Dupuytren Contracture Treatment.

Three primary reasons to avoid surgery for Dupuytren contracture

DCI has never suggested anyone not have hand surgery when it is recommended by a treating doctor.  But, DCI always recommends a patient learns the pros and cons of any therapy.  There are three fundamental things about Dupuytren surgery in all its forms or the use of Xiaflex injections that should be of special interest to anyone thinking about using them.

  1. Recurrence of Dupuytren contracture does occur after surgery.  No surgery or drug stops this problem, but delays it.  Eventual return of the nodules, lumps and cords, with gradual flexion contracture of the involved finger, develops again at the rate of 50% of people five years after surgery.  In later years that percent of recurrence continues to rise over time.  It is commonly held that eventually any9one who has had Dupuytren surgery will experience a return of the problem.
  2. Dupuytren surgery removes both normal and abnormal tissue from the hand and forever changes the physical relationship of tissue that remains, therefore after surgery the hand cannot return to a fully normal state and sometimes worsens.  Pain, stiffness, numbness, tissue hypersensitivity, reduced blood flow can all start – or worsen – after the kind of surgery that is done to remove Dupuytren lumps, nodules, cords and joint contracture.  Common and simple activities of daily living (washing, dressing, shopping, typing) can continue to a problem after surgery because normal tissue must be removed along with abnormal tissue of the hand.  Very often people who have had Dupuytren surgery learn they have simply traded one kind of hand problem for another; sometimes the new problem is less than the original one and sometimes it is worse. Anyone who thinks the hand will be like new after having a Dupuytren hand surgery will be disappointed.  The hand is always compromised in some new way that can be large and small, even though the immediate problem of finger contracture is usually improved for a few years after surgery.

In conversation with hundreds of people over the years who have had Dupuytren hand surgery, the two most frequent comments are:  1. “My finger is straighter, but now I have new hand problems.”   2. “I was definitely better for a year or two, and then the hand  problem came back worse than before.  I think I would not have had the first surgery if I knew it would only lead to a second one so soon, and so little genuine improvement.”

No Dupuytren surgery can make the hand as good as new, although everyone I have ever spoken to about their hand surgery has told me this is what they expected as the outcome of their hand surgery.

It is true that needle aponeurotomy (fasciotomy) is less invasive than different types of open hand surgery (fasciectomy), however NA still carries the problem of a much faster recurrence rate and presents the possibility of surgical error since it is done blindly because the surgeon is not able to see the tissue he is slashing with the needle tip.   For this reason, in this type of surgery the skill of the surgeon is extremely important.

  1. With each hand surgery that is done, the next hand surgery will be more complicated and subsequent risks greater because there is less normal tissue remaining in the hand and the increased development of scar tissue. The younger a person is when the first Dupuytren surgery is done, the more likely that person will need a second, then third, hand surgery.  If enough surgeries are performed it could happen that eventually no additional surgery can be done – no matter how painful or useless the hand becomes.  When this point is reached sometimes patients opt for finger amputation.

The Dupuytren Contracture Institute estimates that at least 80 percent of the people experience a moderate to marked degree of improvement of their hand problem within the first two to three months of Alternative Medicine treatment, when they faithfully follow our treatment suggestions for use of an aggressive therapy plan, using the therapy products found within this website.   Substituting bargain brand or questionable products while trying to treat this kind of deep soft tissue problem is not wise, and usually leads to disappointing results.

 

Can Dupuytren contracture recur after I have hand surgery?

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Recurrence of Dupuytren contracture is common and impossible to predict

In general, Dupuytren contracture recurrence means that is spite of hand surgery, the shortened, thickened tissue appears to return to the area of previous surgery, but actually is a continuation of the extension or progression of the disease into tissue previously unaffected.  Many surgeons openly speculate that Dupuytren contracture surgery accelerates the rate and extent of the disease progression.

In broad terms, the rate of Dupuytren’s recurrence after needle aponeurotomy (palmar fasciotomy) is considerably higher than for traditional open hand surgery (palmar fasciectomy).

Avoid surgery if possible with natural Dupuytren treatment

Any type of hand surgery done to release the contractures of Dupuytren disease can eventually result in the return of more contractures.  This recurrence if followed by another hand surgery can result in the return of more contractures eventually.  While this cycle of surgery and reappearance of more contractures proceeds, the patient is exposed to the potential risks of hand surgery each time it is done: permanent numbness, reduced finger movement, reduced hand strength, reduced sensations and pain.

To avoid this cycle the patient should consider the use of a brief therapeutic trial of Alternative Medicine as a conservative and essentially risk free option that could make surgery unnecessary.

Dupuytren’s surgery, even when done well, can have bad unintended consequences as well as stimulate the recurrence of additional nodule and cord formation in the palm.  Since 2002 this website has suggested that anyone with Dupuytren contracture should first consider conservative treatment options before attempting irreversible surgery.  To learn about Alternative Medicine self-management, please see Different Way of Looking at Dupuytren Contracture Treatment

What is Dupuytren contracture recurrence?

The wide range of recurrence rates represent only gross estimates because there is no formally accepted definition of this term, so what characterizes a reappearance of Dupuytren contracture varies from one study or doctor to the next.  Recurrence of Dupuytren contracture can be:

  1. A finger or hand that received a prior Dupuytren surgery had to be operated on again for any one of a variety of reasons.
  2. The condition of a finger or hand worsened after hand surgery, without evidence of even initial improvement.  Sometimes the worsening is determined to be any degree of flexion deformity greater than prior to surgery, and sometimes must be a 5-10 degree increase.
  3. The condition of a finger or hand was initially good after Dupuytren surgery, but after time some degree of finger flexion returned to that finger or hand.  Sometimes the return is determined to be any degree of flexion deformity greater than the level of correction initially provided after surgery and sometimes it must be a 20-30 degree increase greater than the level of correction initially provided after surgery.

“The greatest French surgeon of the 19th century,” Guillaume Dupuytren, battled with the problem of reappearance of this disease after surgery. He experimented with a variety of tactics and methods to minimize the return but none were totally successful, just as it is today.

How often does Dupuytren contracture come back after hand surgery?

The general consensus is that after having conservative surgery by needle aponeurotomy, 50% of patients see a return of the same or worse contracture just three years later.  But after having more invasive open hand Dupuytren surgery, 50% of patients will notice a reappearance of the same or worse contracture five years later.  It seems that Dupuytren contracture will tend to come back over time to the same 50% group, but for needle aponeurotomy patients it happens much sooner.

In 2011 the partial fasciectomy is still the most common surgery for Dupuytren contracture.  In this operation the diseased tissue is completely removed and perhaps parts of the palmar aponeurosis might also be excised.  In 1990 McGrouther reported after this kind of surgery anywhere from 2 to 63% of surgery patients will have their Dupuytren tissue changes  reappear, while in 2007 Schwartz reported 44% recurrence after these same surgeries.

MedScape News Today reported in February of 2011 that contracture recurrence rates range from 27% to 80% after palmar fasciectomy (open hand surgery), and are highest  when this technique is used on  the PIP joints of the fingers. This same Medscape commentary reported 65% to 85% contracture problems recur after palmar fasciotomy (needle aponeurotomy).

Little information for laypeople about Dupuytrens returning after hand surgery

Many patients research on the web or elsewhere for information about Dupuytren contracture surgery.  Usually they find little information explaining that the palmar nodes and cords often   reappear a few years, sometimes as soon as one year, after surgery.  While attempting to learn about Dupuytren surgery from a medical website – and recurrence in particular – the reader will often encounter only a single sentence that mentions the word “return” or “recurrence,” with rarely any discussion or statistics to explain the scope or frequency of the problem.  A large medical website promoting palmar fasciectomy or needle aponeurotomy might only comment, “After surgery, a therapy program of massage, wound care, exercises and night time splinting is important to get the best possible result and prevent recurrence.”

While it can be said that such a website does inform people about the possible return of Dupuytren contracture after surgery, the usual mention is so vague and casually presented that a potential surgical patient will not understand the rather high rate at which the nodules and cords come back after being surgically removed.  With limited information being the norm it is difficult for anyone to develop a clear understanding of how often, how quickly, and how problematic is this return of the Dupuytren’s contracture problem after undergoing a surgical release of the constricted fingers.

It is almost as though the popular medical information sources are reluctant to reveal that while Dupuytren surgery can improve the palm and finger contractures for the short term, the results are somewhat temporary and have no beneficial effect on the eventual progression of the disease.

This would explain why over the years the majority of people I encounter through the Dupuytren Contracture Institute are completely surprised and unprepared when they have a reappearance of their hand contractures after surgery; most thought that once they had the  hand operation their problem was solved and would not come back again.  Over and over I learn these people were not told about Dupuytren’s recurrence by their surgeon, or that the idea of needing a second operation was presented as a genuine rarity.  It is a serious problem when patients cannot provide informed consent for their hand surgery because they have not been given adequate information about the post-surgical return of Dupuytren nodules and cords.

Final comment, Dupuytren reappearance after hand surgery

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, of course, that surgery for Dupuytren’s contracture does not stop the disease process or prevent its return, but only provides a temporary break from the contractures. This would not be too bad if the time between surgeries was longer or if side effects, or complications from surgery did not make the problem worse for some patients over time.

Better to avoid the first hand surgery if possible.

What is my recommendation for a confusing contracture of finger?

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Hello,

A recent diagnosis of this contracture is confusing. For a couple of years I have had what was treated as a ganglion on my middle finger–it wouldn’t break. Then that finger started to bend oddly. I purchased some herbs for the cyst and it really helped the lump but it seemed to go into the fatty pad in my ring finger which started to bend. now the the doctor says that the ring finger is the contracture–with no treatment recommended but the pain is severe and all this seems to be going into the other hand.

The doctor wants to remove the remaining ganglion, etc but it seems minor compared to the pain in the ring finger. I have been doing stretching exercises, etc. but it is getting so bad I need some help (and would like to avoid even the more minor surgery). I am familiar with real pain as I have bone on bone in my ankle–from injury. The hand pain is getting close.

I feel I am in early stages and would like your recommendation for treatment.

In addition I need to know if these treatments are safe to use as a mild diabetic.

Thank you.

Mrs. Lana Long

Greetings Lana,

Thank you for your inquiry.

You did not directly state in your email whether your current diagnosis is actually for Dupuytren contracture, nor did you directly state that you had a formal diagnosis of a ganglion cyst of the middle finger.  I get the impression from what you reported and did not report that much of what you have said about your finger and hand problem is self-diagnosed, and this concerns me.

Considering there are several elements of your description that causes me also to be uncertain of your problem (such as the severe pain you describe, and initial involvement of the middle finger), and that your description makes it appear that your condition is actually worsening under your doctor’s care, my recommendation is that you get a second opinion from a hand specialist in your area to confirm your current condition and appropriateness of your current care.

When you have done this and can confidently report back what is happening in your hands I would be happy to reply to your inquiry.

TRH

Why is Neprinol not in any Dupuytren treatment plan?

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Dear Dr. Herazy,

I have had Dupuytren contracture in both hands for almost six years and they are slowly worsening, maybe the right hand more than the left. It is getting difficult to dress and do other common daily activities that i used to take for granted. My doctor said I should have surgery but I am not ready to take the risks that I read about when I investigate all the bad things that can happen.

After reading your website I see that you have some good ideas that appeal to my logical way of thinking. But when I read about the three Dupuytren treatment plans I notice that Neprinol is not listed in any of them. I have read many good things about Neprinol and wonder why it is not included, but you do include Fibrozym and Nattokinase. I want to place an order for either the medium or large size plan but I want to get this explained before placing my first order. Can you please clear this up for me?

Thank you in advance,

Vanessa

Greetings Vanessa,

Neprinol is not included in the DCI Small, Medium or Large Plans for two reasons:

1.  Neprinol is more powerful than Fibrozym and Nattokinase 1500.  It contains the same enzymes as Fibrozym and Nattokinase 1500 – at perhaps 10-12 times greater bioactivity.  It also contains different kinds of enzymes that are not found in Fibrozym and Nattokinase 1500.  this makes Neprinol more concentrated and with a greater variety of enzymes than these other products.  Therefore, based on almost ten years experience working with Dupuytren contracture I learned it is better to start treatment with the less intense and concentrated enzymes of Fibrozym and Nattokinase 1500 to get accustomed to the action of these enzymes; it is easier on the body and people have less intestinal upset (diarrhea) this way.   When you re-order the 1st or 2nd time you can then slowly introduce Neprinol into your treatment plan.

2.  Cost.  Because the bottle of Neprinol contains 300 capsules of more powerful and concentrated enzymes, as compared to 100 capsules in the other products, Neprinol costs more.  Therefore, many of our customers appreciate this way of keeping costs down when getting started.  The first order is the most expensive, and this is appreciated by anyone who is just starting and wants to how the suggested Dupuytren treatment plans work.

I suggest after being on your plan for a few weeks or few months, or whenever you are comfortable adding Neprinol to your plan, that you do so.  Many people will later use Neprinol as the primary source of systemic enzymes in their plan, but also keep a few Nattokinase 1500 and Fibrozym in their plans as secondary or minor sources of systemic enzymes.

Dupuytrens is a tough and terrible thing.  It takes dedication and persistence to overcome it.   I have worked with many who have had their problem longer than yours, and have done quite well.  It is never easy to overcome, but always worthwhile.

The biggest advantage in ordering your therapy products from DCI is that we provide a high level of service and background information specific to Dupuytren contracture that you will not receive from anyone else.   Just try to call one of those internet vitamin sellers and ask a question, let alone get specific information about treating Dupuytren contracture.  It cannot be done.    Each product you order from PDI comes with all the information you will need to you it correctly to treat your DC.

Please let me know if I can assist your recovery in any way.  Good luck to you.

TRH