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Symptoms of Dupuytren's
Is your Dupuytren's Contracture or Ledderhose disease painful?
Frequently suffers are told their disease is not painful, this is largely wrong with a certain population. Many of us who seek treatment do that because our disease is painful, interfering with our daily life and task. We have nodules and/or chords growing, we can no longer grip the tools or items we use to, etc. Dupuytren's Contracture and Ledderhose disease can be very painful. This pain might be caused because the nerves are squeezed by the fibromatosis or the tissue of the nodules.
Common Symptoms of Dupuytren's Disease
The very first thing to be said about Dupuytren's disease is that it is different in every person, to the extent that some researchers doubt that it is even a single disease. Descriptions of the disease are invariably peppered with words like “often”, “mostly” and “usually”; your symptoms may be puzzlingly different from any single description. Although no two hands with Dupuytren's disease look alike, most doctors in Europe or North America (where the disease is surprisingly common) will recognise it without difficulty.
The next thing to say about early symptoms is that almost everybody misses them. It has been shown again and again that most people who have Dupuytren's disease don’t realise that they have it. Most people have noticed nothing wrong, or if they have noticed changes in their hands, they have put them down to calluses or a natural and unremarkable consequence of getting older.
The first thing most people notice – if they notice anything – is one or more firm areas in the palm of a hand, little lumps under the skin, usually next to the crease in the palm closest to the fingers (and often in line with the third, or ring finger), which are usually completely painless though perhaps slightly tender to pressure. These firm areas gradually become harder, developing into nodules whose resilience gradually passes from that of a tomato to that of an orange, a tennis ball and finally, a coconut.
Dupuytren's disease is not always painless. Unfortunately, many doctors use “painless” as a diagnostic characteristic of the disease – which often leads to misdiagnosis when people present with painful hands.
Nor does the disease inevitably start with firm areas. You might instead notice dimpling in the palm or in the side of the phalange of a finger. These pits in the skin are often more or less V-shaped, as if something under the skin were pulling the skin to one side (which is exactly what is happening). You may find that the nodules become more distinct and easier to feel as the fat underlying the skin becomes thinner as the disease progresses. Pitting, dimpling and (often) V-shaped hollows of the skin may develop and increase near the nodules.
A fairly good diagnostic characteristic of Dupuytren's disease is that the mass of the nodule is fixed to skin (it won’t slide about under the skin) and deeper fascia (you can’t really move the nodule relative to the palm, though there may be some movement relative to the underlying tendons and bone).
Usually the disease starts – and may remain – in one hand, but almost half of those with Dupuytren's disease have it in both hands. Bilateral it may be, but it almost certainly won’t be symmetrical.
Some people feel tingling and itching in the palms and fingers, and may liken it to the feeling you get as your hands warm up after making snowballs with bare hands. This sensation, which can be maddening, seems to be an indication of active disease.
For some people the disease is very painful, and can make it nearly impossible to use the affected hand.
One final thing about early symptoms is the psychological reaction one may have to the discovery of Dupuytren's disease. While some people are alarmed and quickly seek professional advice, many – perhaps most – react with indifference or by avoiding thinking about the nature of what is developing in their palm. And for most people, this denial of reality has no practical consequence, since the disease does not develop much in most affected hands.