Carpal Tunnel or Dupuytrens Disease?

So here I am, keyboarding away, writing this article, when all of a sudden I notice that my wrist is beginning to ache, my fingers and thumb are tingling and there is an increasing numbness in my hand.  Unbelievably, I’ve just finished reading all my resources pertaining to this very subject and, wait for it…yes, there it is: a pain that feels like a live electric wire is travelling up my arm to my shoulder. How ironic. I never thought about it before when it happened but, I think I may have developed Carpal Tunnel Syndrome.

Nothing is physically obvious on the outside, but from the inside…OUCH!

There are very specific symptoms to “Carpal Tunnel”, but if noticeable swelling or a deformed appearance to your palm is also in evidence, a more serious condition called “Dupuytrens Contracture“…aka: Dupuytren’s Disease… may be present. Either way, you should visit your doctor or an orthopaedic surgeon to rule out Dupuytren’s Contracture (“doh-pwee-trenz”), which can actually start out with much the same early symptoms.

Although neither Carpal Tunnel Syndrome nor Dupuytren’s Disease can be found amongst the standard labels of ‘Invisible Illnesses’, sometimes the symptoms of either condition may not be immediately visible. And because carpal tunnel is more common and successfully treated, people might “pooh pooh” complaints about the unique pain and disabilities that are part and parcel of the similar early symptoms of Dupuytren’s Disease.

Carpal Tunnel Syndrome

CarpalTunnel_A00005F02Just as general background information, Carpal Tunnel Syndrome (CTS) centers around the median nerve. This nerve originates in a network of nerve fibers called the brachial plexis, around the spine. Sometimes hand and/or arm vibrations (such as those experienced by motorcycle/scooter drivers or power tool operators) or repetitive movement, such as typing or keyboarding, can cause the tissues which surround the tendons in your wrist to swell. In turn, those swollen tissues press against the median nerve, thus causing pain.

In some instances, CTS may simply be genetic in nature (run in families) as the size of the “tunnels” in the carpal bones of the wrist are often an hereditary condition. Another common occurance that may lead to CTS is fluid retention during pregnancy or menopause. If you have problems with obesity, smoking, alcohol abuse, or mental stress, you may also be at risk to develop CTS. And if all of those risks weren’t enough to think about, women are three times more likely to suffer CTS than men because, as a rule, womens’ bones are simply smaller than mens’!

“But wait! There’s more!”

Certain medical conditions, if present, can increase the tendency to carpal tunnel problems. These biologic conditions can include:

  •  trauma or injury to the wrist
  • overactive pituitary gland
  • hypothyroidism
  • rheumatoid arthritis
  • the development of a cyst or tumor in the canal

On the Northside Hospital website (located in St. Petersburg, Florida), there is a video explaining Carpal Tunnel Syndrome and the surgery performed to correct the condition. This video, produced by Nucleus Medical Media, is highly recommended for its in-depth information on the subject.

Dupuytren’s Disease/Dupuytrens Contracture

Dupuytren’s Disease or Dupuytren’s Contracture was actually “discovered” in 1831 by a French surgeon, Baron Guillaume Dupuytren. Although the disease has been monitored in great detail, to this day its causes are still the subject of ongoing studies. Whether this condition may be an autoimmune dysfuntion or a biochemical reaction in the hand’s fascia (the tissue just underneath the skin, where lumps and pits in the palm may develop), the question still remains a puzzle.

CT  CTH 031710-HEALTH sc-health-0317-hand-drug MJWIf you develop this disease, you may notice thick cords which appear to be tendons (although they are not tendons), running from the palm of your hand to your fingers, usually the ring and little fingers (you’re looking at your hands, aren’t you!). Eventually, in the later stages of this condition, these cords will act like drawstrings in your hand, causing your fingers to bend inward toward the palm or even at an odd angle. This is called ‘contracture’. Either one or both hands can be affected, however, usually the condition affects one hand more seriously than the other.

As opposed to CTS, Dupuytren’s Disease is more likely to occur in men over the age of 40 and is usually found in those of Northern European descent (Caucasian), with the highest percentage of sufferers carrying Scandinavian heritage. Also, whereas Carpal Tunnel Syndrome can be brought on by injury, continuous repetitive motion or vibration, no evidence exists to indicate that these kinds of conditions will lead to Dupuytren’s Contracture.

Again, initial symptoms of Dupuytren’s Disease may be quite similar to Carpal Tunnel Syndrome, but as a rule it isn’t as painful as it is inconvenient…unless, of course, you attempt to force your digits to straighten out! And the progression of this disease isn’t always predictable, either. Sometimes only lumps and noticeable cording may be all that occurs, while others may suffer the severely bent fingers. Fortunately (sort of), if the disease is going to be one of the more severe cases, it will usually be evident early on.

One study in London showed that Dupuytren’s Contracture/Disease will normally present in women, aged 60-70, while the incidence in men is closer to those aged 70 or older. It is a sad fact that if onset occurs around age 30, there is a greater likelihood that the condition will lead to a more severe case and also increases recurrences if corrective surgery was performed.

Alleopathic or Homeopathic Treatments?

(Click the picture link for informative video about homeopathy)

(Click the picture link for informative video about homeopathy)

With both CTS and Dupuytren’s Constricture, if you catch it before it becomes too problematic, you can ease the pain, discomfort and inconvenience you will initially have to deal with.

Severe Carpal Tunnel Syndrome might be avoided by simply identifying the activities you perform which seem to trigger the pain or restriction of movement. Using a mouse pad with gel wrist support, taking more frequent breaks from the aggravating activity, using a wrist brace made specifically for CTS sufferers and/or purchasing one of the re-freezable wrist packs designed for wrist stress can delay, or even halt, the onset of a severe case of this condition. However, if it recurs often enough, or you’re unable to get relief, high-tail it to your doctor and hope that surgery can be avoided.

The increasing symptoms of Dupuytren’s are not so easily dismissed. Generally this is a progressive disease which has, historically, been treated by the surgeon, although the same supports, rest and manipulation of the hand may help the discomfort and inconvenience…in the beginning…if the disease is recognized for what it is.

There is good news, though: Surgery may not be your only option, as newer treatments have been discovered. In 2010, FDA (Food and Drug Administration) approved a more homeopathic sort of treatment by way of enzyme therapy (sic), by which the nodules and ‘cording’ can be diminished or even returned to normal (see reference to the Chicago Tribune article, below).

Bottom Line…

So Carpal Tunnel Syndrome and Dupuytren’s Disease aren’t officially “Invisible Illnesses”, but because we don’t tend to stare at peoples’ hands, the fact that our co-workers, family members or friends may be suffering will not be immediately evident. But if the conditions are brought to our attention, don’t dismiss their complaints as “hypochondria in action.” Instead, be supportive. Direct them to the many support groups who will be able to explain the options about which, perhaps, their doctors may have neglected to tell them.

Many people with Carpal Tunnel Syndrome or Dupuytren’s Disease suffer in silence. That doesn’t mean it doesn’t hurt.

Citations:

(1)  The Mayo Clinic Staff. (n.d.). Dupuytren’s Contracture. In The Mayo Clinic. Retrieved 4 December 2013, from http://www.mayoclinic.com/health/dupuytrens-contracture/DS00732.

(2)  ASSH. (n.d.). Dupuytren’s Disease. In American Society for Surgery of the Hand. Retrieved 4 December 2013, from http://www.assh.org/Public/HandConditions/Pages/DupuytrensDisease.aspx.

(3) PDLabs. (n.d.). What is Dupuytren’s Disease?. In PDLabs.net. Retrieved 4 December 2013, from http://www.pdlabs.net/dupuytrens/whatisdupuytrens.html.

(4) SCOI. (n.d.). Dupuytren’s Disease. In Southern California Orthopedic Institute. Retrieved 4 December 2013, from http://www.scoi.com/dupuytrens-disease.php.

(5)  Clay, R MD. (1944). Dupuytren’s Contracture: Fibroma of the Palmar Fascia. In Dupuytren Foundation.org. Retrieved 4 December 2013, from http://dupuytrenfoundation.org/DupPDFs/1944_Clay_1188.pdf.

(6)   Johns Hopkins Staff. (n.d.). Dupuytren’s Contracture. In Johns Hopkins Medicine. Retrieved 4 December 2013, from http://www.hopkinsmedicine.org/healthlibrary/conditions/plastic_surgery/dupuytrens_contracture_85,P01110/.

(7)  Northside Hospital Staff. (n.d.). Carpal Tunnel Syndrome Related Media: Carpal Tunnel Release. In Northside Hospital (St. Petersburg FL). Retrieved 5 December 2013, from http://northsidehospital.reachlocal.com/?scid=3050457&kw=7472251&pub_cr_id=34057645591.

(8)  National Institute of Health Staff. (n.d.). Carpal Tunnel Syndrome Fact Sheet. In NIH National Institute of Neurological Disorders and Stroke. Retrieved 5 December 2013, from http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm.

(9)  University of Maryland School of Medicine Staff. (n.d.). Carpal Tunnel Syndrome. In University of Maryland Medical Center. Retrieved 5 December 2013, from http://umm.edu/health/medical/reports/articles/carpal-tunnel-syndrome.

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