Dupuytren's Contracture

Every day, we take for granted the functional use of our hands. From the moment we wake up and brush our teeth, button our shirt, hold a coffee cup, or open the door, we are interacting with the world around us using our hands as both tools and guides. However, when a condition such as Dupuytren's Contracture occurs, it can become much more difficult for us to engage in the world we live in.

What is Dupuytren’s contracture?

Dupuytren's contracture (otherwise known as Dupuytren's disease) is a condition that affects the connective tissue in the hand, forcing the fingers to bend towards the palm and limiting their movement and mobility. This is commonly seen as a bending of the ring and pinky fingers; however, other fingers may be affected as well.

What causes Dupuytren’s contracture?

The exact cause of Dupuytren's contracture is not yet fully understood, but it is believed to be related to a combination of genetic and environmental factors. People who have a family history of the condition, as well as those who smoke, drink heavily, or have diabetes, are at increased risk of developing Dupuytren's contracture.

What are symptoms of Dupuytren’s contracture?

The symptoms of Dupuytren's contracture usually begin with the formation of small nodules or lumps in the palm of the hand. These nodules typically aren’t painful and may go unnoticed for some time. As the condition progresses over the period of years, these nodules can become thicker and harder, eventually leading to the formation of cords of tissue that pull the fingers towards the palm. With time and in some cases, the condition can become quite painful, especially if the affected fingers are forced to extend or straighten.

Limitations caused by Dupuytren’s contracture?

Limitations include performing everyday tasks, such as opening a jar, opening your house/car door or writing with a pen. This condition can also have a significant impact on a person's ability to perform everyday tasks, such as holding onto a leash when walking the dog or shaking someone’s hand. The limitations are almost too difficult to fathom with this contracture- except all aspects of your daily routine that cause you to use your hand or hands.

How can occupational therapists help?

Fortunately, there are a number of treatment options available for Dupuytren's contracture, depending on the severity of the condition. For mild cases, non-surgical approaches such as hand therapy, splinting, and steroid injections may be effective in relieving pain and improving mobility. For more advanced cases, surgery may be necessary to remove the affected tissue and restore normal finger function.

Occupational therapists are trained healthcare professionals that can help address the functional implications of Dupuytren's Contracture. Occupational therapists focus on enabling individuals to continue engaging in daily activities that are meaningful and enjoyable. Occupational therapists can work closely with individuals experiencing Dupuytren's Contracture in order to develop personalized treatment plans, which may include options such as splinting, exercises, stretching, providing education about joint protection, and other treatment interventions with the goal of decreasing pain and improving hand function.

Occupational therapists can work with you in addressing Dupuytren's Contracture either pre- or post-surgery. After surgery occurs, occupational therapists can provide skilled interventions to manage wound care, scar management, and the gradual restoration of hand function through guided exercises and stretches. They may also help assist you in learning new ways of completing functional tasks with adaptive equipment or learned strategies to ease function and maintain your independence in daily life.

In summary, Dupuytren's contracture is a condition that can have a significant impact on a person's hand function and quality of life. While the cause of the condition is not fully understood, there are a variety of treatment options available to manage the symptoms and prevent further complications.

If you or someone you know is experiencing symptoms of Dupuytren's contracture, it is important to speak with a healthcare provider to understand your options and the best course of action.

Don’t let a condition keep you from living the life you want to live!