I saw the Dr. yesterday. She said it was Dupuytren's. She is sending me back to the orthopedic surgeon that treated the trigger finger. She said he is pretty conservative and that surgery probably wouldn't be his first choice. We'll see. I am in Syracuse NY. If anyone has any feedback on drs - good or bad I would really, really appreciate it.

I don't what to do next. I saw the physician's assistant about two weeks ago. He was the first to use the D word. I saw the surgeon yesterday, and the visit was a disaster. He wants me to go back to physical therapy, although I told him I've actually had slightly better range of motion and significantly less pain over the two weeks I haven't gone. He suggested that the therapist was incompetent and that I hadn't bothered to do what they asked me to. His only other suggestion is cortisone injections. The first time I tried that, 9 months ago, they caused severe pain once the Novocaine wore off- at least as bad as broken bones or childbirth- and the benefit only lasted about three or four months. After that, the original problem was back, worse than before. I'm having a hard time convincing myself that cortisone is a viable option. (I'm also having a hard time convincing myself that ever darkening this doctor's doorway again is a viable option.) He suggested I consult with a rheumatologist, as I "have a lot of problems" but said that the rheumatologist wouldn't have any help for my hand.

I have a call into the hand therapist. First, there's the question of whether my insurance co. will authorize any more treatment. If they will, I want to go at least TALK to her. I don't know how much she knows about Dupuytren's, as I get the impression PT isn't usually used, except maybe after surgery or another treatment.

I don't know how many of my problems are from the surgery and how much is the Dupuytren's. I don't feel like any of this is my fault, and I've been conscientious about doing what the doctor and therapist have told me to do. I think I have a surgeon who gets really ratty and defensive when surgery doesn't get good results. I'm not looking for a lawyer, I don't blame him for what has happened, I just want to know what's going on and what we can do about it!

Who has given you good advice?

Cricket,

I can understand your confusion, and it does sound more like trigger finger. I worked for many years as a certified hand therapist. The symptoms you describe are typical of trigger finger, and it tends to be a very chronic, painful problem which will eventually cause contracture without surgery, splinting. With trigger finger, the nodule is on the actual tendon, not allowing it to easily slide trough the 'pulley system' of the hand. As you know by now, Dupuytren's effects the fascia, not the tendon.
Having said all of that, I was experiencing what felt like triggering in my hands for a couple of months. It was confusing, because it was involving all fingers, both hands. I knew it couldn't be trigger finger. Since I didn't fit the profile (except that I am of German heritage) I never suspected D.D.
After having severe foot pain, MRI diagnosis of L.D., I realized what the situation was with my hands.

All that to say, that even though there are 'typical presentations' which we read about, there are atypical presentations of every disease. My MRI said 'atypical presentation of plantar fibromatosis', my DD is the same. I have rapidly forming cords, but barely noticeable nodules.

Only an experienced MD, or therapist would recognize this. You need to make sure you are seeing a hand specialist, and if you aren't happy with him, find another. This isn't necessarily an orthopedic surgeon, many excellent hand surgeons are plastic surgeons. You should also be seeing a Certified Hand Therapist, which may be a Physical Therapist or Occupational Therapist (of which I am the latter). Don't be afraid to ask whether they have experience with trigger finger/D.D.. Any professional worth their weight won't be offended by being questioned.

Best wishes with all of this. Please message me, if you feel I can answer any other questions.
Beth