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Is combining therapies (RT and Steroids) beneficial? When do you decide 1 hasn't worked?
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03/21/20 17:38
BRIANB 
03/21/20 17:38
BRIANB 
Re: Is combining therapies (RT and Steroids) beneficial? When do you decide 1 hasn't worked?

Jamba90:
BTW, I now also wear gloves religiously and also bought these: Weight Lifting Hooks - with Lifting Wrist Straps for Pull-ups, deadlifts, pull downs https://www.amazon.com/dp/B07KY6KY1C/ref...i_wsgBEbRJECPG7

They take some pressure off the hands, but I’m still kind of iffy and just got them last week. I used to do about 50 pullups 3x / week on weeks I got a full workout in. Some with a weight belt and 45 lbs hanging off. the weight belt is gone now both b/c of concern and atrophy.

I’m thinking I’ll only do pullups once a week from here and move to swimming, which I’m terrible at, but will provide the added benefit of cardio. The joy of dups!
Swimming is great for everything..and studies show swimmers live longer than other athletes.
Begin very slowly..develope a good stroke...because a poor stroke habit is hard to break..

03/24/20 06:51
Jamba90 
03/24/20 06:51
Jamba90 
Re: Is combining therapies (RT and Steroids) beneficial? When do you decide 1 hasn't worked?

BRIANB:
Jamba90:
BTW, I now also wear gloves religiously and also bought these: Weight Lifting Hooks - with Lifting Wrist Straps for Pull-ups, deadlifts, pull downs https://www.amazon.com/dp/B07KY6KY1C/ref...i_wsgBEbRJECPG7

They take some pressure off the hands, but I’m still kind of iffy and just got them last week. I used to do about 50 pullups 3x / week on weeks I got a full workout in. Some with a weight belt and 45 lbs hanging off. the weight belt is gone now both b/c of concern and atrophy.

I’m thinking I’ll only do pullups once a week from here and move to swimming, which I’m terrible at, but will provide the added benefit of cardio. The joy of dups!
Swimming is great for everything..and studies show swimmers live longer than other athletes.
Begin very slowly..develope a good stroke...because a poor stroke habit is hard to break..

Sound advice. Of course with the whole COVID thing going on, first i have to find an open pool. Ha!

04/05/20 01:25
Prof.Seegenschmiedt 
04/05/20 01:25
Prof.Seegenschmiedt 

Re: Is combining therapies (RT and Steroids) beneficial? When do you decide 1 hasn't worked?

Dear Jamba & all others having answered so far:

There is ONE MEANINGFUL CLINICAL STUDY available by Ketchum et al from 2000/2014:

In this study intralesional triamcinolone acetonide (Kenalog-40) injections of 40 mg/mL have yielded some subjective improvement in the down-sizing of Dupuytren nodules in some patients. In this study, patients received a mean of three injections of 60-120 mg triamcinolone acetonide directly into the progressive or symptomatic nodule(s), resulting in a remarkable nodule regression in 97% of the hands after an average of 3 injections.

However, 50% of patients experienced recurrence of nodules 1 to 3 years after their last injection, and those with mild MCP contractures (< 15º) did not have any functional improvement in their extent of contractracture.

Ketchum's conclusion was, that early treatment of a nodule with an intra-lesional steroid injection, before the development of joint contracture (particularly PIP joint involvement), can interrupt the inflammatory process and thus the progression of disease.

Nevertheless, there are possible risks and complications involved, including fat atrophy and skin discoloration / depigmentation by 6 months after the last injection and possibly tendon rupture

Sources:

(1) Ketchum LD, Donahue TK. The injection of nodules of Dupuytren's disease with triamcinolone acetonide. J Hand Surg Am. 2000 Nov. 25(6):1157-62. [Medline].

(2) Ketchum LD. The Rationale for Treating the Nodule in Dupuytren's Disease. Plast Reconstr Surg Glob Open. 2014 Dec. 2 (12):e278. [Medline].



With gratitude for all affected patients & medical colleagues who help to advance patient care ...

Edited 04/05/20 01:27

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depigmentation   Steroids   effectiveness   injections   Triamcinolone   wsgBEbRJECPG7   steroid   Lifting   pullups   dupuytren-online   Significantly   combining   contractracture   disease   beneficial   intra-lesional   discoloration   Fibroblasts   religiously   therapies