I have been diagnosed with Dupuytren disease because my fingers stopped straightening all the way. But the reason I went to the doctor was because of the pain. Then I found out that most people with this problem don't have pain. How come I'm so lucky?
Dupuytren's contracture is a fairly common disorder of the fingers. It most often affects the ring or little finger, sometimes both, and often in both hands. The condition is noted to be secondary to an increase in fibroblast density, a complex biochemical and cellular interaction. The disorder may occur suddenly but more commonly progresses slowly over a period of years. The disease usually doesn't cause symptoms until after the age of 40.
What you have discovered is correct -- most people with Dupuytren disease don't complain of pain. They are bothered much more by the loss of finger motion, especially extension (straightening the affected fingers). But sometimes the nodules that form are painful.
We can answer your question by referring to a study done in Switzerland. Surgeons there were wondering why this condition becomes painful for some patients. So they decided to investigate further. They also evaluated whether surgery would help (or make worse) painful symptoms in 10 patients.
Cords and nodules present as part of the condition were dissected (cut apart and removed) and then examined under a microscope. The tissue samples all contained some type of nerve tissue. Some had tiny nerve branches in or across the fibrous tissue. Other patients had nerve fibers embedded inside the nodules. Three patients had actual neuromas (bundle of nerves grown together where they don't belong).
Based on these findings, the surgeons suggested that nerve compression is the cause of painful Dupuytren disease. The fact that all patients were painfree after surgical removal of the tissue supports this theory. remains a mystery. More studies are needed to find out the exact cause why these 10 patients (and you) developed nerve branches inside the nodules and cords. Clearly, it is a problem that affects some, but not all, people with Dupuytren disease.
A. von Campe, MD, et al. Painful Nodules and Cords in Dupuytren Disease. In The Journal of Hand Surgery. July 2012. Vol.37A. No. 7. Pp. 1313-1318.
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