As many of you know, I had NA performed on the PIP joint of my RH index finger and LH middle finger last January. Unfortunately, the joints contracted again in less than two months. But the worst part was that I also had pain and decreased range of motion, which I didn't experience before NA. So here we are, almost a year later and loss of flexion and pain are getting so bad that I'm losing function in both hands. It's very discouraging.

What can one do to correct this problem? I've had two doctors tell me that I'm not a candidate for Xiaflex because I don't have easily palpable cords in my fingers. I also feel like the nodules in my fingers are all wrapped around my tendons and nerves. I can't straighten them and trying to bend them past 90 degrees is very painful. In addition, I have recently developed severe pain in the adjacent fingers (RH middle finger and LH ring finger) even though there are no visible signs of disease in those fingers.

Is it worth it to try NA again? Can that help with loss of flexion? Is surgery my only alternative? My hands and fingers are getting so weak that I can barely open a zip locked bag. I really don't know what to do. I'm not even sure that surgery can fix this. Has anyone else had symptoms like mine?

Thanks for listening.

Is it worth it to try NA again? Can that help with loss of flexion? Is surgery my only alternative? My hands and fingers are getting so weak that I can barely open a zip locked bag. I really don't know what to do. I'm not even sure that surgery can fix this. Has anyone else had symptoms like mine?


I did not have the pain you have, but I had NA on the PIP on my little finger and within 3 months it was contracted to 90' again. A year or so later, I tried NA again on the same finger, but the DR was unable to release it and said I would need to have surgery. That was done in October, with skin grafts, and I am now in the PT process, trying to get my finger to bend again. Passive flexion is better than active flexion but I am still only a little over 2 months out from the first surgery and 6 weeks from the second one. Stitches have been out a month and I had cortisone injected about 2-3 weeks ago. Still doing PT twice a week but will go to once a week soon. I am assuming my DIP may never have full range of motion but I think I can get more improvement in the PIP. I am planning on doing the little finger on my left hand in April, hoping it will be an easier procedure if I get to it sooner. It is at about 50' right now. Waiting too long just makes it much more complicated as not only does the tendon contract, but so do the nerves and blood vessels and all the other structures of the hand.

Glad your finger has stabilized as far as the contraction goes. Mine was at 35' in May and at 50' in November, so is actively contracting. As a result, I don't want to wait. I don't have the pain you do. You don't have arthritis as well?