Hi - I'm a 55 year old male. I was just diagnosed today with Dupuytren. I have a lump in the middle of my palm. I can't straighten my fingers on that hand (without help from my other hand), and my ring finger is definitely more crooked than the others. My very conservative thinking GP, thought it wasn't bad enough to risk treatment, but he didn't actually measure the curvature. He just pressed on the lump and asked if it hurt much, which it doesn't. It hurts mainly when I have to try and stretch my fingers.

I had been aware of the lump for months, but only recently realized that it was affecting the functioning of my hand. After pushing my GP, he gave me a referral to the in house orthopedic dept (I work at a university that has their own medical dept, so it require several steps to obtain a referral to an outside specialist).

I have several questions. First, what constitutes the severity that would cause a specialist to recommend treatment? I read that one doctor requires at least a 30 degree curvature. Another hospital web page said not being able to flatten one's hand on a table. The latter I definitely can't do, and I'm pretty close to the 30 degree measurement

Secondly, what doctor is the best person in the greater Boston area to go to?

While I'm waiting for a decision on treatment, is there anything I should be doing (or not doing) to avoid the problem from getting any worse? Is stretching the hand good or bad for it?

Complicating the problem, is that my job status after 6 months from now is unknown. So it would be nice to be able to deal with the problem now, rather than later, when I would have to be looking for, or starting a new job. I can take a significant time off now, because I have vacation time. I also already have voice recognition software on my computer, due to previous RSI problems, and I have a private office, so I could deal with having to just use my left hand and my voice, where I presently work. A future job might not be so easy to deal with a long recovery period.

I know that I'm freaking out about this issue. I have a lot of other problems that I've had to deal with (fibromyalgia being one of them). I don't NEED yet another problem to deal with, so I am tending to want to aggressively treat the problem. If surgery is necessary, so be it. I'm used to long recovery periods for problems. And I already have scars on my other hand, from slicing my hand open as a teenager. Permanent damage to a tendon or nerve, would of course definitely not be fun, so I understand from a logical view point that I should go slow. Any advice would be greatly appreciated! Thanks. - Mark

Callie - Thanks for the info. I realize now that it's my ring finger that prevents me from straightening out my fingers. I can straighten out my 1st and 2nd fingers if I keep my ring finger bent down. But if I try to straighten all my fingers, I can get them up to about 30 degrees from being straight up and down. FWIW, if I push down hard on the lump in my palm, I can then straighten all my fingers. I don't know whether the latter experiment affects whether radiation would help or not, but I thought I would mention it. :) - Mark

Your experiencing something that I would consider unusual (at least from my experience). I did not have "good times or bad times". My fingers, once they started contracting, never got better, or less contracted.

Radiation will not decrease contraction. It will influence the nodules which produce the cell structure that causes the contraction. The contraction can be "fixed" by surgery, NA or Xiaflex. The Dupuytren's isn't cured (you will still have it). It may, or may not, be a problem after it is "fixed".

From what you are describing doesn't sound like Dupuytren's really. Maybe you should get a second opinion. You might eb suffering from something else and then strating with Dupuytren's treatments might be thewrong thing to do.

Wolfgang

mrl:

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This is weird, but tonight I'm able to stretch my fingers pretty good. It's as if my hand was cramping earlier, but not now. I had been trying to stretch my hands earlier. Could that have helped, or was I having the nocebo effect? :) Very puzzled.

With Dupuytren's there is usually a pronounced cord that develops with the contraction. This cord is often mistaken as being a tendon, but it isn't a tendon. Do you have something like that?