I’m wondering whether or not to do NA and would very much appreciate the thoughts and advice of others who are more knowledgeable and experienced. I’ve had DD in both hands for 8 years. In both hands there is about a 20-25 degree MCP contracture from the palmar cords under the ring fingers. There has been no further contraction in the last 3 and a half years—everything seems quiet/inactive. I have no real disability and no limitations on the use of my hands and no pain—just the feeling of tightness that comes with not being able to fully open the hands.

I understand that NA will not prevent any future contracture—or any part of the disorder. It will just release the present contracture—therefore, it is just for comfort’s sake. In one of his postings, the much respected Dr. Keith Denkler, mentioned that scar tissue from NA could “morph” into DD tissue and then begin the process again. Also, although the reported chance of side effects with NA are miniscule, still they exist as with any surgical procedure, and thus one always pauses to make sure a procedure is really necessary. It also seems to me that it might be good if I try to limit the number of NA’s, because I may need several during my lifetime if the DD becomes active again, which I know is possible (maybe even probable). I’m “only” 63.

I’ve lived in east Africa while all this has gone on but will now return to Canada for a brief visit and thus can have NA there or in the US—or even in France or Germany on the way back. Or, I can just continue watchful waiting and live with the deficit I have which is possible to live with without difficulty.

Any thoughts or opinions or advice would be most welcome.

Raymond

Agreed - if it's not bothering you, don't do anything. NA is safe but there is always the very slight possibility of nerve damage.

I agree, if it starts to be active again, then do NA. There is evidence that you can "wake the sleeping giant" by any trauma to the hand.

Something to keep in mind - As I understand it, the longer fingers are contracted and the greater the degree of contracture, the harder it is for the tendons to stretch back out.

Raymond,

From my own experience and from what I've read through the years on this forum..... I know its not so much the degree of contracture, that matters, but it also depends which joint is contracted and on which finger...

I believe that the hardest joint to correct is the PIP (the middle joint) on the small finger... no matter what the contracture is... so keep a close eye on the development of your disease.

Raymond,

In your post of 4/10 you said 20-15 degrees...now you mention 50-60 degrees in the MCP joint...if it really is around 50 degrees, keep a close watch. I don't have much experience in MCP joints, since my only contracture is a PIP pinkie finger, but you don't want to let it go much further ...

If you are on a trip to Canada and can stop in Florida on the way back, please consider consulting with Dr. Eaton for an easy MCP joint correction with NA.

Luba

Edited 04/13/10 17:27