UKC

Anyone suffer from, or had experience of Dupuytren’s Disease?

I'm beginning to suffer a thickening of the tendons in the right hand, meaning I cant lay my palm flat on, also finding it sore to use flat palm to open doors etc.

Whilst it is only an inconvenient problem at present I'm worried longer term - will my tendons contract further so that I struggle to open my hand - will I be able to grip things - will I be able to mantleshelf?

Anyone ever suffered from this?

In reply to subtle:

See Pete O'Donovan's article on here.

In reply to subtle:

Sorry to hear that. Discussed here quite a lot, unfortunately:

https://www.ukclimbing.com/forums/info/search.php?forum=0&dates=1&n...

In reply to subtle:

There's a load of stuff on here if you search - it's very common in rock climbers.

I was diagnosed with it last year, much to the surprise of myself and my GP as it's very uncommon in women in their mid-thirties with no family history. I've only got tendon thickening, no contracture yet, so have been advised just to leave it. Apparently not all cases progress to the point of needing treatment so I'm just going to wait and see. It goes through active phases and is intermittently painful but most of the time it doesn't hurt or get in the way of climbing. But yes, if it gets bad it cam stop you from mantling, jamming or anything that requires you to be able to flex your hand properly.

In terms of treatment I was advised that nowadays they tend to do needle aponeurotomy instead of hand surgery as it's less risky and has a shorter recovery time. Unfortunately DC is a chronic condition so there's a pretty high chance that it'll come back after treatment anyway, but this is more likely after NA than surgery.

In reply to subtle:

Cheers, lots of (sobering) reading and information on this then.

I seem to already fail the passing a ball point pen under my flattened palm so that's not a good sign, perhaps I should shuffle along and see the doctor to get it properly diagnosed

Oh well, seems not much I can do about it so will just have to get on with it.

Hi subtle

Lots of advice and experience on several previous threads. Below is my experience which I've posted before but hopefully worth retelling again.

I've had a Dupuytren's nodule on the palm of my hand for at least ten years. So far it has not advanced to contracture although it has changed size and shape over the years. It's now more widespread but flatter than it was.

All I have done about it is to keep stretching regularly. Sometimes it feels tighter when I stretch and I get a sharp pain either in the nodule or down in the wrist. But if I gently but firmly stretch through the pain, it dies away.

Whether this has prevented contracture, I can't say - I'm a sample of one with no control. But it does seem sensible to keep stretching regularly and, for me, so far so good. It has not impacted on my climbing at all.

One thing to note, I was taking glucosamine supplements at the time my dupuytrens appeared. On an internet search I did come across a speculative link between glucosamine and dupuytrens so I stopped taking it. Again, I don't think there is scientific evidence for a link at the moment.

In reply to subtle:


I saw my GP last year about this and other issues affecting one of my hands. She passed me along to a hand specialist; he said that he wouldn't be doing anything about the Dupytren's unless there was a marked contraction rather greater than that needed for the pen test. So go to your GP by all means, but don't get your hopes up about someone doing something about it anytime soon. Of course in this our wonderfully funded modern NHS, procedures in one area can differ markedly from those in another; so you might just drop into a treatment queue. Good luck!

T.

In reply to El Greyo:


I was in a similar position, and also read something about a link between the two. I stopped taking the glucosamine and the nodule seems to have diminished, or at least not developed any further. But then it might just have been an unrelated cyst

In reply to subtle:

I have had the problem in my L hand for some time and hand-jamming is getting very difficult if not impossible. My small finger is now at 90 degrees to a flat palm, but the doctor say it not serious enough to operate. Some signs now in my R hand too such as hard lumps. I can still type though...

In reply to subtle:

I had my RH operated on 7 years ago, when the little finger got to about 45 degrees, before that the specialist wouldn't consider it. Gripping was never a problem, mantleshelfing or anything requiring weight on the flat hand became a problem. Up to a point getting a handjam in was OK, but getting it out again became difficult.
Since the op it's stayed straight and my hand strength came back fairly quickly.

I now have quite pronounced thickening in my LH. Before it contracts to a similar point I might explore NA instead of the full hand op.

In reply to subtle:
Had the condition for a number of years now and received poor input from specialists.
Interestingly, last week my GP said that applying heat to hand regularly may soften the hardening. Probably too late for me, but it may have more impact at an earlier stage.
GP advice was apply as much heat as bearable for 15 mins 3 times a day. Bit of an effort, but might be worth trying.
I have never seen any reference to this in the literature I have read, so GP could be talking nonsense.

In reply to John Postlethwaite:

I am having surgery on my LH in a few weeks. My specialist said that nothing works apart from surgery so obviously there are differing opinions.

In reply to subtle:

Some of my experiences of suffering with a dupuytren contracture.

I have suffered for about 7 years. Though never debilitating it was slowly getting worse, and could be painful limiting on a couple of types of moves such as mantles, and palming in corners/grooves.

I never found climbing made it ache or tight, but using DIY tools for just a couple of hours could be painful. In this case I found massage and stretching helped relive pain. I also found hangovers made it feel worse - maybe due to dehydration?

Finally, I have never had any treatment, but last year I fell and landed in a way which forced my hand flat. I felt like I ripped the contracture. It was very painful but resulted in my finger being straight and able to put my palm flat. I don't advocate this self-treatment, but I think it is interesting as straightening the finger does not seem to be offered by Drs, but has had good results.

In reply to subtle:

My experience of this and what the specialists have told me during my consultations is that once it develops and pulls the finger to an angle so you cannot release the tension then operation is the method to overcome it (possibly not 100% successful and possibly only short term)

I have had two operations on my right hand over the last 6 years, the 2nd operations was two years ago and included a skin graft to ensure elasticity back to the skin, this 2nd operation has been a success.
However, I’m waiting to see a specialist now to be referred for an operation on my left hand as this has rapidly developed contracture.
In all three instances the contracture has hindered climbing and daily function.

Good luck and ask for specialist advice

In reply to WB: very interesting re the accidental tear/apparent release. I've had what was diagnosed as Dupuytren's for over 30 years. I am sceptical as to it really being that but the nodules and an element of the contraction is there in my left pinkie and ring finger. I've generally managed it by daily(and now habitual) stretching. Late last year it was getting worse and this coincided with taking glucosamine and chrondroitin for an extended period of time. Fast forward to a trip to Spain in February where a damp pocket led to an excruciating hand injury. It felt like the ring finger to start with and there was def some damage but the tearing sensation in the hand at the base of the ring and pinkie was the worst bit. Awake in the night sore. The finger sorted and the hand took months but didn't limit climbing strangely though it was sore after. After reading various articles I binned the glucosamine. So upshot, the ring finger is straighter, the pinkie is back to where it was but doesn't feel nearly as tight. There may be something in the accidental tear bit but like you I wouldn't recommend it as treatment. I'll be staying off the glucosamine and chrondroitin just in case though I believe it did help repair other damage.

In reply to Neil Morrison:


This is basically what the collagenase treatment aims to do but in a much more controlled way! Sounded a bit grisly to me and I'm glad the needle aponeurotomy seems to have done the trick. I had mine about 4 years ago and despite the advertised 50% recurrence rate it's still fine.

In reply to Dave Garnett:


I had the collagenase (Xiaflex) treatment about 3 years ago on one finger. It helped but didn't straighten it completely and it has recurred. I needed the treatment twice as it didn't work the first time. I find narrow cracks difficult with a bent finger.

In reply to subtle:

Diagnosed a few months back. Apparently it's called the Viking disease because it's most common in people of Nordic ancestry. As mentioned, it's fairly common among climbers. As a Swedish climber, I clearly had it coming.

I haven't done much research yet, but Xiaflex seems to be a common treatment in Sweden. I don't think NICE have taken a position on it yet, so I don't know if you can get it on the NHS.

In reply to subtle:

Early stages here. It's rare in women so it definitely has a gender aspect. I have asked doctors whether there are any hormone-based treatments or perhaps like the anti-androgens used for hair loss but the reaction from the one's I have asked has been very negative. I suspect that work on this aspect has not found its way into the english-speaking academic mainstream yet and then there are the extra steps of finding approval amongst bureaucrats and practitioners.

Has anyone got experience of Dupruytrens and then been on treatments for other conditions involving hormones or hormone antagonists?

In reply to Jim Fraser:

I think you're making a number of questionable assumptions here.

What if the key factor is the amount of stress and damage, and this is weight-related? Do we have comparable female cohort who have been climbing long enough? (I'm perfectly aware, indeed have personal experience, of women who have been climbing hard for decades, but it's fair to say that it's a small sample. There will certainly a suitable cohort in a decade or so)

Even if there's a clear sex bias, is it hormonally based? And even if it is, would the disease, once started, be treatable by hormonal interventions? Given the side effects, could this justified for such a relatively benign condition, usually treatable in other ways?

Apart from that, it's an interesting idea!

Edit: It occurred to me that the interesting question would be the pre- and post-menopausal incidence. A quick google suggests it is more common in postmenopausal women but then it's also related to age generally, so that would take some careful study design to sort out.

I thought it was more common in fishwives but maybe I'm thinking of Raynaud's...

In reply to Dave Garnett:


Noted fishwife Mary Berry is a sufferer

In reply to nufkin: I had what i thought was a cyst removed which turned out to be the beginnings of dupuytren's. The hand surgeon says the latest thinking is that there is an auto-immune element. The Germans treat with radiotherapy, but then they seem to treat everything with readiotherapy!

In reply to El Greyo:

I've had a slightly 'bowstring' tendon with a lump on it for a few years. I stretch it regularly and it doesn't appear to be worsening. A friendly GP was not concerned in the slightest.

How that helps or not I have no idea

In reply to WB:




I've had the same experience, both my hands are affected the right more so. After slipping backwards on a ramp, entering a swimming pool; I planted both hands to avoid landing on my backside. The result was severe pain across the palm of my right hand where the thickening is at its worse. Agony for a short time but eventually resulting in more flexibility and a flatter palm.

In reply to nniff:

My partner has had some success reversing hers by taking N acetyl cysteine (NAC) regularly. She was also told by her consultant that oestrogen HRT was bad for it.

Margaret Thatcher and Ronald Reagan both had it. I liked to call it "Politician's Claw".

In reply to Šljiva:

The Germans treat with radiotherapy, but then they seem to treat everything with readiotherapy!

I work in the radiotherapy department at the Christie in manchester. We treat dupuytrens here too. I can't personally comment on the effectiveness, but we don't irradiate unless there's a benefit, so must be evidence that it works.

In reply to The Norris: at least I won't have to go to Germany for that one then! I've let them lose on my swollen knuckles, hard to tell if it's doing anything yet!