Home treatment for Dupuytren’s contracture involves measures to accelerate the absorption of scars, which increases the range of motion in the affected joint. This can include rubbing, ointments, baths with essential oils, massage, and applications.
MEDICAL TREATMENT UNDER SUPERVISION OF A DOCTOR AND AN EXAMPLE
In cases where there is a replacement of part of the tendon by coarse fibrous tissue, surgery is usually performed. However, if the patient notices the first symptoms of Dupuytren’s contracture early enough, treatment can be carried out using conservative methods. The use of pharmacological drugs is not practiced, although occasionally non-steroidal anti-inflammatory drugs such as Ibuprofen, Nise, and Ketorol may be prescribed to relieve pain. Sometimes injectable solutions of corticosteroids (dexamethasone, Diprosan) are also administered into the tendons. Dupuytren’s contracture, or palmar fibromatosis, is not an inflammatory condition. Therefore, hormonal medications are used only for persistent pain that cannot be relieved by NSAIDs.
Applications containing proteolytic enzymes have proven effective:
- Lydase.
- Trypsin.
- Ronidase.
These drugs, which are available in powder form, are mixed with a physiological solution of sodium chloride. Then, a sterile gauze is moistened with the mixture and applied to the affected tendon. The dressing is covered with a polyethylene film and secured with a bandage. The duration of the treatment procedure can vary from 1 to 3 hours. Proteolytic enzymes soften fibrous tissues, improving finger flexion and extension.
Recently, a medication called Xiaflex has appeared on the market, which is considered a worthy alternative to surgery. Its active ingredient is collagenase, an enzyme that breaks down the peptide bonds of pathological collagen. Xiaflex is intended for direct injection into the tendons.
MASSAGE AND THERAPEUTIC EXERCISES AT HOME
Massage and regular performance of special exercises help increase tendon elasticity and improve finger flexion. Traumatologists and orthopedists recommend combining these therapeutic procedures. Cosmetic or vegetable oils such as olive, flaxseed, almond, wheat germ, and apricot kernel oils are used for massage. Occasionally, concentrated sea buckthorn oil is also used, but its staining effect on the skin should be considered. Natural remedies are applied thinly over the entire palm and gently rubbed into the skin with circular motions. After improving blood circulation, attention is turned to the area of the affected tendon. The procedure may cause slight discomfort, but if severe pain occurs, massage should be stopped. Proper execution of all manipulations contributes to the improvement of finger flexion function. Therefore, it is time to perform therapeutic exercises. Physiotherapists recommend paying attention to the sensations that arise during the exercises. If rotating the palms leads to increased joint mobility, such exercises should be repeated daily, 50-80 times in several approaches. This also applies to finger flexion and extension exercises.
Very useful devices—soft expanders, rubber or plastic spiked balls—are sold in pharmacies and medical equipment stores. They are designed to strengthen the ligament-muscle apparatus of the hand. Expanding and contracting the expanders or balls can be done while watching TV, reading a book, or working on a computer.
PHYSIOTHERAPEUTIC PROCEDURES AT HOME
Physiotherapy procedures such as shock wave therapy, electrophoresis, magnetotherapy, and laser therapy are actively used in the treatment of Dupuytren’s contracture. These procedures improve blood supply to the tendons with nutrients and biologically active substances, promoting softening of fibrous formations. Home applications further enhance therapeutic activity. The following substances can be applied to the affected tendon:
- Clay—blue, green, or red. The substance is produced in powder form, to which liquid is gradually added to form a viscous, thick mixture. It is evenly distributed over the affected area, covered with a plastic film, fixed with a bandage, and left for 1-2 hours. Clay is mixed with vegetable or cosmetic oils, non-fat kefir, or mineral water. To provide a warming and analgesic effect, 2-3 drops of fir or pine essential oil are added during mixing.
- Ozokerite or paraffin. Applications with these compounds have a powerful warming effect, which positively affects joint mobility and microcirculation. Ozokerite and paraffin are sold as dry mixtures, which are melted in a water bath. Then, cooled to a comfortable temperature, applied in 5-10 layers with a wide brush to the tendons, and left for 1-3 hours.
Applications with bischofite, a natural mineral consisting of a sodium-magnesium-chloride complex, accelerate metabolism and increase tendon elasticity. It also contains bromine, iodine, iron, and other microelements necessary for joints. Bischofite is sold in liquid form ready for use in pharmacies. A sterile gauze is moistened with it and applied to the affected tendon until completely dry. Bischofite is added to warm water in a 1:5 ratio, and hands are soaked in it for 30-45 minutes. Such baths are suitable for daily use.
HOMEMADE RUBS AND OINTMENTS
One of the most effective methods of treating Dupuytren’s contracture with folk remedies is through rubbing and ointments. Their therapeutic effect is based on warming and softening the tendons, improving finger flexion and extension. Folk healers recommend preparing rubs according to the following recipes:
Peel and chop 10-15 horse chestnuts. Place the pieces in a dark glass container with a volume of 0.5 liters and cover them with vodka or 96% ethyl alcohol. Store the container in a dark place for 1-2 months, shaking it thoroughly every day. Rub onto affected tendons 2-3 times a day. For those with dry and sensitive skin, it’s better to dilute the tincture with water before use.
Peel and chop 3-4 young fresh horseradish roots and place them in an opaque container with a volume of 1 liter. Add a couple of large horseradish leaves, sliced into strips 1-2 cm wide. Pack it down, pour in alcohol or vodka so that the liquid just covers the plant material. Keep the container in a dark place at room temperature for 1-2 months, shaking it frequently for better extraction of beneficial substances. Rub onto affected tendons 1-2 times a day.
In spring or early summer, gather young large leaves of stinging nettle. Fill an opaque container of any size, tamping down the leaves, and pour vegetable oil along the walls. For musculoskeletal therapy, flaxseed and olive oil are considered the most beneficial, but regular sunflower oil will also work. Let it infuse in a dark place for a couple of months, then rub onto tendons and joints several times a day. The longer the nettle stays in the oil, the more healing the rub will be.
Homemade ointments are also used in the treatment of Dupuytren’s contracture. The most effective remedy is a mixture with pine resin. In a mortar, combine 50g of thick honey, natural cream butter, and medical vaseline. Mix thoroughly, adding 3 drops each of essential oils of rosemary, fir, pine, 1 tablespoon of pine resin, and almond oil. Transfer the aromatic mixture to a jar and store it in the refrigerator. Rub onto tendons 2 to 5 times a day.
HEALING COMPRESSES
Compresses are actively used in folk medicine to alleviate symptoms of Dupuytren’s contracture. Prepared mixtures are soaked into several layers of sterile gauze and applied to the area of the affected tendons. Cover with a polyethylene film and secure with a tight bandage. The duration of the procedure is from 2 to 5 hours. Folk healers advise keeping the compress overnight if it doesn’t negatively affect sleep quality. For the treatment of palmar fibromatosis (often called “chicken paw”), the following mixtures are used:
In a mortar, mix 30g of thick honey and vodka, adding a drop each of juniper, rosemary, and mint oil.
Brew 3 tablespoons of dried sage with a glass of boiling water, infuse for an hour. Strain and dissolve a tablespoon of sea salt.
Brew a tablespoon of chamomile in half a glass of boiling water, leave for a couple of hours. Strain, add 3 tablespoons of wheat germ oil. Before use, shake the emulsion thoroughly.
Horseradish warms and improves blood circulation in tendons, making compresses with fresh plant material effective. Cut pieces of horseradish leaves, cabbage, or plantain to fit the size and slightly crush them. Apply thick honey, apply to the affected tendon, cover with plastic wrap, and secure with an elastic bandage or adhesive tape. The duration of the therapeutic procedure is 1-3 hours. Dry heat treatments are also used for contracture treatment. They help alleviate painful sensations, enhance the action of pharmaceuticals and other folk remedies. Fill a cloth bag with warmed sea salt or flax seeds and apply it to the tendons and joints of the fingers for 30-40 minutes.
