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Physical therapy after NA
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06/06/2010 19:49
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06/06/2010 19:49
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Physical therapy after NA

I've had NA, RT and Xiaflex. I wore a splint for 4-5 months after Xiaflex but my finger returned to previous contracture in less than a year. I had NA after that, a different splint and physical therapy--didn't make a difference and was back to previous contracture in 3 months. Both of my splints were radically different--and seemingly contraindicated as compared to photos on Dr. Eaton's website.

I'm curious as to exactly what kinds of things folks who had PT experienced and hope folks will share their esxperience My sessions consisted of 10 minutes of "contrast" baths--a series of hot and cold soaks, ultrasound and a few minutes of massage. I had a few home exercises assigned after 6 treatments and received some hand putty to help with them but overall I was not impressed at all with the PT and the folks supposedly had lots of experience with Dupuytrens.

After this, I had NA with Dr. Eaton on 6 fingers/both hands and he did not recommend any splinting. Currently I seem to have the most success with daily "passive" stretching--pushing the joints inward. Does anyone here use "direct pressure massage" with a wooden dowel as described on Dr. Eaton's website?
http://www.handcenter.org/newfile39.htm

06/07/2010 14:28
LubaM. 
06/07/2010 14:28
LubaM. 
Re: Physical therapy after NA

I have had NA twice on same finger (PIP joint small finger). First time the finger was at about 50 degrees at PIP joint. NA was successful, had alot of swelling for a long time at PIP joint and I did therapy for a couple of months. I was given a night brace which I only wore about three months. The therapy consisted of hot parafin bath, followed by ultrasound, massage and all sorts of exercises like stretching and making a fist, also hand putty. The contracture returned after about three months.

Over a period of 4-5 yrs. the contracture continued to increase and was now at 90 degrees at PIP joint, I also developed a boutonierre deformity at DIP joint. In March of this year I had a repeat NA, this time with Dr. Eaton. My PIP joint is at about 15-20 degrees and I can totally move it (great improvement since it was locked before in a 90 degree angle)..... and my DIP joint is totally straight but locked.

My PIP joint still swells a bit and the swelling goes down when I wrap it in a coban elastic wrap. My therapist made me a night brace which I plan to use for a very long time. I believe that the contracture came back so soon after first NA because I didn't wear the brace after three months. She also made me a brace to help exercise the DIP joint, but its not helping. I think the putty is good to keep making a closed fist and easy stretching is also good. I have not tried the wooden dowel exercise from Dr. Eaton's website. The palm of the hand that has had two NA's is now free of nodules and cords...so far so good.

I think Dupuytrens is such a "weird" disease, so different from person to person and from method to method. What helps one person doesn't help another. I believe radiotherapy is good for early stages of Dupuytrens (I had RT on my other hand and on Ledderhose of left foot). I will try everything before I do surgery.

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therapy   esxperience   different--and   different   boutonierre   exercises   improvement   stretching--pushing   Physical   experience   supposedly   Dupuytrens   experienced   stretching   ultrasound   radiotherapy   contracture   therapy--didn   treatments   contraindicated