Treatment for Dupuytren's contracture depends on the severity of your condition. Over the course of Dupuytren's disease, fibrous tissue in the palm thickens and tightens. This causes one or more fingers to progressively stiffen, bend, and lose flexibility.
As the condition progresses, your doctor may suggest nonsurgical and surgical types of treatment for your Dupuytren's contracture.
The goal of treatment for Dupuytren’s is to reduce the symptoms and disability caused by the disease. At this time, however, there is no treatment to stop Dupuytren's contracture from getting worse.
In some people, the condition may progress slowly and it may never become worse than a bit of lumpiness in the palm of your hand. A simple wait and see approach may be all that is necessary if your Dupuytren’s is mild and does not affect your daily life.
For more progressive cases, your doctor will discuss the best treatment options for you. These will depend on the stage and pattern of your disease, the impact it is having in your daily activities, and your overall health.
Nonsurgical Treatment for Dupuytren's Contracture
Nonsurgical treatments are often recommended at early stages of Dupuytren's or in addition to surgery. While many nonsurgical treatments have been studied, only a small number have shown a benefit.
Experts may recommend stretching for the mildest forms of Dupuytren’s. In addition, stretching may be used along with other treatments. It’s important to work with your doctor on any stretching program.
These strong anti-inflammatory medications, when injected into a Dupuytren’s nodule, may be helpful. Often, however, multiple injections are necessary. Steroid injections may reduce the size of nodules early in the course of disease but are less effective in the later stages of Dupuytren’s when more thickened tissue has formed. Steroid injections may help slow progression of the condition but won't help straighten your finger if you already have a contracture.
If your finger is already bent, your doctor may recommend Xiaflex, a mixture of enzymes that is injected into the affected area to break up the tough tissue. The drug loosens the tissue. If the contracture is still present on the following day, your doctor will stretch your finger and try to straighten it. The injections are given in the doctor’s office and may be used as an alternative to surgery. Your doctor will also recommend certain stretching exercises after the injections.
Most people need one or two injections in the affected joint, but some people may need up to three injections to straighten or nearly straighten the finger. The most common side effects are swelling in the affected area or bleeding, bruising, and pain at the injection site. Rarely, more serious side effects, such as damage to a tendon, nerve injury, or allergic reaction may occur.
Splinting, vitamin E cream, and ultrasound are some of the other treatments that have been tried but generally have not been successful.