Dupuytren's Disease - Treatment Overview
The goal of treatment for Dupuytren's disease is to keep or restore hand function. Dupuytren's disease often is a progressive disease, and recurrence is common. As you review your treatment options, consider the following:
- In the early stages of the disease, you may be able to keep hand function by doing range-of-motion exercises. In some cases, splints are used to try to slow the progress of the disease. But there is not much evidence that stretches or splints help.
- If you have increasing disability or pain in your hand(s), your doctor may give you an injection. Lidocaine or corticosteroid has usually been used. But even though medicines may be used to treat symptoms, they do not cure or stop the progression of the disease. A medicine called collagenase is now available. When it is injected, it appears to dissolve some of the tight tissue in the hand.
- If disability continues to progress, you may choose to have surgery to release the contracture of your fingers. A sustained program of physical therapy and hand exercises may help you regain mobility after surgery. Dupuytren's disease recurs after surgery nearly half of the time, so reoperation may be necessary to keep hand function.
- Alternative treatments, such as traction devices or exercises, may be used along with surgery to treat Dupuytren's disease.
Initial treatment
Dupuytren's disease often develops slowly. If the tissue between your skin and tendons (palmar fascia) does not thicken to the point that your fingers are bent and cannot be straightened (contracture), you may only need to have your palms checked regularly.
Medicines are not generally used as part of treatment for Dupuytren's disease. But long-acting corticosteroid medicine is sometimes injected directly into the affected area to help manage symptoms of the disease in its early stages, before one or more fingers develop contracture. This medicine may also temporarily help improve hand function.
Ongoing treatment
Treatment for Dupuytren's disease depends on how bad the disease is. You may notice the characteristic nodules in your palms years before your condition interferes with daily activities, or you may never have a reduction in your range of motion.
A long-acting corticosteroid medicine is sometimes injected directly into the affected area to help manage symptoms of the disease in its early stages, before one or more fingers bends toward the palm (contracture).
Collagenase (Xiaflex) injected into the tight cord can help reduce the contracture and improve the range of motion.2
Another medicine under study for relief of Dupuytren's disease is interferon.3
Treatment if the condition gets worse
In severe Dupuytren's disease, the tissue between your skin and tendons (palmar fascia) thickens to the point that your fingers are bent and cannot be straightened (contracture). If you lose the ability to wear gloves or hold objects, or if your hands become painful, a procedure may be done to relieve the contracture. Surgery is most common, but some doctors are now doing needle aponeurotomy.
WebMD Medical Reference from Healthwise
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