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Knuckle pad and pain in palm
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05/02/2014 08:25
Rachel 
05/02/2014 08:25
Rachel 
Knuckle pad and pain in palm

Hello

I am new to the site. In January I was told by a hand specialist that I have a knuckle or garrod pad on my right ring finger. I had, until then, assumed it was a ganglion. The only sympton (apart from the lump) was stiffness in the finger in hot weather and at the morning. To alleviate the stiffness the hand specialist recommended a steroid injection. The consultant was very kind and gave me two pain killing injections, so I felt nothing. However, for a week after I was unable to bend the finger at all and had numbness and pins and needles in the hand and even up to my neck. Eventually, I regained movement (had hand therapy), but have had pain in the palm ever since (sometimes a dull ache, sometimes more of a burning feeling). I have also now started to get tenderness in the skin on my thumb and can feel a slight formation under the skin which I suspect is another knuckle pad. Yesterday, I also found a small hard lump (literally tiny and relatively painless) on the side of the finger that was injected below the knuckle. I still have pain in my palm, sometimes up into my wrist.

The consultant was great. In the months following the injection I have ultra sound and MRI scans and they were unable to find anything. I have not yet been back with the latest developments. In the meantme though, I have got terribly down about the whole thing. Have become frightened about the future. My GP has put me on anti-depressents as I was badly low.

I just wondered if anyone has heard of a steroid injection triggering dupuytren? Also, does it sound as though I am certain to get the full blow disease. I have had the garrod pad that was injected for two years and am cross at myself for having the injection when it was no trouble compared to the constant pain I am in now. My dad was diagnosed with dupuytren in January too. He is 70. I am 42.

Thank you so much for taking the time to read this - sorry my post is so long. It feels sort of cathartic writing it.

Best wishes

Rachel

05/02/2014 11:17
spanishbuddha 

Administrator

05/02/2014 11:17
spanishbuddha 

Administrator

Re: Knuckle pad and pain in palm

Hi Rachel

Welcome to our forum. I've had knuckle pads most of my life, but didn't realise what they are until about 3 years ago. I'm a male, and assumed they were just knocks and scrapes from DIY and generally not looking after my hands well. A bit unsightly but no real bother. Occasionally one swells and gets quite big, but a few days/weeks later it's back to normal size.

Now in my 60's I have confirmed Dupuytren's, and when first diagnosed was also a bit depressed at the possible outcome. I play tennis and piano, bad news. But the disease usually progresses slowly, and for the majority, even with nodules and cords, does not lead onto contracture.

I would start looking after your hands, if not already, and with DD that often means leave well alone if the symptoms are not bothering you. Stay under the guidance of your consultant, but no more interventions unless really necessary. Get help with pain and inflammation, and do some yourself at home with ice and heat. People rave about Vitamin E oil, I don't think there is any scientific proof this helps, but it may make you, and your hands feel good. Keep a record of your hands with photos so you can track changes.

Maybe you have DD, maybe not. Maybe you will get a contracture, maybe not. As we get older we get 'things', some are disabling, terminal, unpleasant, and in context DD is not so bad. In the meantime live your life to its potential, but baby the hands. If you do need to come back here one day, with a confirmed diagnosis and signs of progression with nodules, cords, stiffening, more pain and weakness, there are choices we can help you with, stories to share.

Best wishes
SB

Edited 05/02/14 14:18

05/02/2014 14:11
Rachel 
05/02/2014 14:11
Rachel 
Re: Knuckle pad and pain in palm

Hi SB

Thank you so much for your kind response and for taking the time to come back to me. You have really helped and it is hugely appreciated.

I really feel for you with your tennis and piano. I play guitar so I am a little concerned I might not be able to continue this (I think my neighbours are slightly less concerned).

I will definitely invest in some vitamin E oil and have read that guave juice might help. My consultant also recommends vitamin D. I also read something about DMSO but have not quite got to the bottom of what this is. In addition, I started hypnotherapy, which I know sounds completely mad, but it really helped my anxiety levels for a little while. I am having another session tonight as I have got quite badly low again. Anything is worth a try.

Going forward I will definitely stay away from the steroid injections! One lady has recommended ultra-sound for the treatment of garrod pads. Did you have the knuckle pads and nothing else for a long period of time before any other symptoms started? Also, did you ever have paid in your palm - the consultant thought I had tendonitis from the symptoms I was describing but an MRI scan showed that my tendons were fine.

I do hope that all goes well with you with your DD trearment and thank you again for your kind response.

Best wishes

Rachel

05/02/2014 15:21
spanishbuddha 

Administrator

05/02/2014 15:21
spanishbuddha 

Administrator

Re: Knuckle pad and pain in palm

Rachel

Well I still play tennis, now with a glove, and also piano. So although I have nodules and cords, and some perpetual soreness, I carry on.

Nothing wrong with improving diet, spending small amounts on things that make you feel good, but be aware that the treatments shown on this website under the treatments tab are the only ones with evidence of results. So where does this leave DMSO (with SSKI), and many other suggestions including ultrasound. Be careful before spending money. Lots of people on this forum have tried them all, none have come back with claims of success (just one who claims success with Chinese medicine). Ultrasound and verapamil are proven to help other related conditions, and may have a role with DD treatment for relief. But just like the injection you had there's a possibility that something like ultrasound may stir things up.
There is also on this site a list of risk factors, see if any apply to you and can be modified via lifestyle.

There is an interesting claim of success for several people, with a special type of massage, let me know if you want the link and reference.

I think for now you should listen to your consultant. If he has plenty of experience of DD he should be able to confirm a diagnosis, even early stages. Remember if it is DD it usually progresses oh so slowly, and for the majority not to a contracture. Regular 3 months checks with him, with your photo log/symptom diary, will take you down the right path for a diagnosis and treatment. Ask him his experience and research his standing in the field. What country are you in?

SB

05/05/2014 21:40
Rachel 
05/05/2014 21:40
Rachel 
Re: Knuckle pad and pain in palm

SB
Thank you so much again for your kind message.

I am in London and my consultant is Mr Jonathan Compson.

I think I have found the massage link for West London. Thank you for alerting me to that. I will also mention it to my dad - he has cords, nodules and some puckering. He is convinced this started after a dental implant, although this would seem strange.

I have been getting some itching and pain in my palm. I am trying not to focus on it too much as I just start worrying. The list of risk factors is helpful as I am sure I have high cholesterol. I also like a glass of wine with my dinner, although I guess giving up all alcohol may not improve things.

The knuckle pads are a pain - mine seem to cover the entire knuckle and they hate cold weather and hot weather. I really notice them if someone shakes my hand or if I have to look for something in a bag. I read on this site that bromelain is good and also a cream - lanolin something I think it was called. Are you aware of the benefits of either of these?

Thank you again for taking the time to reply to me.

Best wishes

Rachel

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dupuytren   injection   consultant   hypnotherapy   progresses   Knuckle   ultra-sound   treatment   ultrasound   experience   suggestions   sometimes   recommended   inflammation   Occasionally   interventions   developments   something   contracture   anti-depressents