Bumps and bruises are part of life. But some bumps may signal a problem. If you’ve noticed hard bumps under the skin on the palm of your hand, it’s time to get them checked out. They could be a symptom of Dupuytren’s (pronounced (du-pwe-TRANZ) contracture.
What is Dupuytren’s Contracture?
This condition impacts a layer of tissue under the skin of your palm, called fascia. This tissue contains strands of fibers that run from the palm to the fingers. In those with Dupuytren’s disease, these cord-like fibers begin to tighten and contract – eventually causing the fingers to be pulled forward. While it’s possible for any fingers – or even the thumb – to be impacted, it mainly affects the pinky and ring fingers. In moderate to severe cases, this condition can lead to hand deformities that greatly impact daily activities.
The first signs of Dupuytren’s contracture are usually lumps of tissue on the palm. They may feel sore at first, but this can fade over time. You may also notice deep indentations in the skin surrounding the bumps or nodules.
The condition typically progresses slowly over several years. As it advances, the nodules can contract and thicken – forming dense cords of tissue under the skin that extend up to the fingers. As this worsens, the fingers will start to curl and may become impossible to straighten.
Though there is not a definitive cause, it’s thought that genetics could play a factor in who develops Dupuytren’s Contracture. Some of the risk factors include:
- Age: This condition most often occurs after the age of 50.
- Sex: Men are more likely to develop Dupuytren’s contracture.
- Ancestry: People of Northern European descent are at a higher risk of developing the condition.
- Family history: The condition tends to run in families.
- Alcohol and tobacco use: These are both associated with an increased risk of Dupuytren’s contracture.
- Medical conditions: People with seizure disorders and diabetes are more likely to have Dupuytren’s.
A doctor will just need to perform an examination of your hand to make a diagnosis. Your doctor will record the location of the knots and bands of tissue on your palm, measure your range of motion and test the feeling in your fingers. The measurements and notes taken will be used to monitor the condition’s progress over time.
There is currently no cure for Dupuytren’s contracture, but there are a number of treatment options:
- Enzyme injections: Injecting collagenase into cords can provide some relief and allow the hand to be in a more functional position.
- Needling: Using a needle to break and puncture the cord of tissue that’s contracting a finger has proven to be effective and can be done in the office.
- Surgery: This is an option for people whose condition has advanced and have limited function. Surgery can produce a longer lasting and more complete result.
Can Hand Therapy Help Dupuytren’s Contracture?
There are benefits to doing hand therapy after treatment or surgery.
Therapy may include stretching and heat treatments to control pain and slow the progression of symptoms. Some patients may also be advised to wear a brace or splint to keep the fingers straight. After surgery, PT can help improve function and strength in the fingers, as well as reduce swelling and help with healing.
Countryside Orthopaedics hand specialist, Dr. Imran Khan, or one of our other highly qualified providers can properly diagnose your condition and determine the next steps that may be needed. If you have been diagnosed with Dupuytren’s Contracture, or have arthritis or other hand conditions, one of our hand therapy experts at Countryside Orthopaedics, Physical & Hand Therapy will work with your physician to develop a therapy plan that best addresses your individual needs.