If you have a family history of Dupuytren's contracture then the " wait and see " GP's advice will be of little comfort.
Starting treatment early when nodules and cords are not yet contracting or are only pulling a few degrees may offer several advantages.
1/ The cords/nodules will be less dense, therefore easier to treat.
2/ The cells involved will be less fibrous, increasing the possibility of resuming normality.
3/ The skin will not be so densely ( puckered ) hardened or fixated.
4/ The finger joints (PIP Joints and MCP joints) will be more mobile.
5/ Less spread of fibromatosis into other fascial structures or ligaments, therefore less likely to involve tethering to the neurovascular or lymphatic systems.
7/ Avoidance of surgery, needles, radiation etc.
8/ Less likely to promote scar tissue formation.
See discussion on Dupuytrens forum =
Q/ What specific massage techniques are used ?
Three different types of massage techniques are used:
Cross fibre friction softens the fibrous bands, helping the effectiveness of the compression technique.
Compression technique inhibits the local contractile forces produced by myofibroblast activity, thereby inducing a relaxed (elasticising) normalization of the treated tissue.
Effleurage technique is used before and after each of the above techniques. Initially to increase local circulatory function and lymphatic activity by vasolidisation, then to flush the tissues through by bringing in fresh oxygenated blood.
Q/ Will it hurt ?
Please do not think of this treatment as a more pain more gain exercise! Throughout your treatment you will be asked for feedback about the depth of pressure.This ensures the pressure used is kept within your comfort range.
Q/ How many treatments will be required and how far apart ?
Initially 4 treatments should be planned 1 week apart each taking between 40 to 50 mins at a cost of £45. Improvement should be noted after the FIRST treatment.
Q/ What research has been done related to Dupuytrens and massage?
The research was done in September 2011 and reported in the journal of hand surgeons July 2012 it is titled Nonoperative treatment of PIPJ flexion contractures associated with Dupuytren's disease. It covers the use of massage therapy combined with night splinting. Please see pubmed http://www.ncbi.nlm.nih.gov/pubmed/21965179
The full text article is available here.
Written text from the book "massage therapy and remedial exercises" (in print from 1932 till 1984) advises cross fiber frictions and deep massage for early stage Dupuytren's contracture.
The most comprehensive text is covered over 9 pages in Ratray and Ludwigs clinical massage therapy =
This book is the bible of some of the most advanced Massage therapists in the world. They are working within the Canadian health system in Ontario and British Columbia.
My research found anecdotal evidence from therapists in the USA and Canada. Two Massage therapists from within the Canadian health system were particularly helpful, they were very positive about treating the condition and especially, treating EARLY. We consulted my client's GP who thought it definitely worth trying. Now 5 years on, his cord is much thinner, and have stopped contracting (15 degrees down to 0 degrees). 1 nodule has disappeared the other is reduced 50% and much softer.
Q/ Will you still treat me if my fingers are in late stage contracture and I have already had surgery ?
Yes, provided you understand the potential to achieve good results may need more treatments.
I'm sure you will have many more questions for me, please feel free to ask as many as you like. 07956 - 664285
13/2/13 Wonderful feedback from a recent client on the international dupuytrens forum. :-
After unsuccessful RT last year, I have been having massage therapy for DD with Stephen Jeffrey. After only three very relaxing and holistic treatments I am already feeling the benefits. The nodules on both hands have softened and flattened and there is no sign of progression and no new nodules. The aching and stiffness which I think were side effects from RT is also getting better.
I am feeling really encouraged and for the first time in months I have stopped obsessing so much about my hands! I only wish I had opted for massage therapy as my first line of treatment when I was initially diagnosed.
Wouldn't it be wonderful if massage therapy, the most non-invasive and benign of treatments, could stop the progress of DD and minimise nodules?
I will report my progress.
Allisun o'connel. 27/9/13 Dupuytrens Contracture facebook page.
Stephen Jeffrey has developed a protocol for massage therapists to treat Dup's. I shared this protocol with my local massage therapist who also did her own research online and in her medical books. Not all massage therapists are created equal and I learned the required education varies greatly. Fortunately I had already found a great one due to a hip injury, who has lots of education due to my state's stricter licensing requirements, & a passion for learning more and working on this disease. Stephen is incredibly helpful for anyone wanting to try this with a local practitioner. He personally treated Anthea Ryan.
If you would like details of my protocol for your massage therapist please email me at [email protected]
If you are not sure how to find a massage therapist in your area
please contact me on the above email address stating your hometown, district/county and country.
Massage Today Magazine.
Dupuytren's Sufferers information and forum's.
A Dupuytren's sufferers guide to why he favours Dermofasciectomy.
On page 553, Canty et al. show how cells use finger-like projections to lay down parallel arrays of collagen fibers that are many times the lengths of the cells.
13/ The 3 phases of cellular action. http://www.bjj.boneandjoint.org.uk/content/85-B/3/448.full.pdf
Alterations in the extracellular matrix proteoglycan profile in Dupuytren's contracture affect the palmar fascia.
Extracellular Matrix and Dermal Fibroblast Function in the Healing Wound