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Tuesday, March 11, 2014
Arthritis and Rheumatism
What Could Cause Tendons in Palm To Knot Up?
An elderly friend of mine has the tendons (according to him) that stretch across the palm of his hand knotting up. You can feel his palm and feel where they are feel nearly solid like there are pebbles beneath his skin. You can feel two places where it`s happening, and you can feel them leading up to his middle and ring fingers, which he can only bend a very small distance before intense pain in his palms where the knots are. Is there any information on what might be causing it and what might be done to relieve pain and/or overcome the symptoms? Thank you.
Your friend may be experiencing a condition known as Dupuytren's Contracture. This condition is marked by the toughening and contracting of the tissue beneath the skin of the palm. The tissue changes may lead to an inability to extend fingers or straighten the palm. Nodules may form within the affected tissue. It is typically a slowly progressive, painless process. However, occasionally the nodules may be irritating or painful.
Tobacco use, alcohol use, and diabetes mellitus are recognized risk factors. Less invasive treatment options include local corticosteroid injections, radiation therapy, or disruption of the affected tissue with a needle. However, if treatment is needed, it is more likely that surgical intervention will be required where the involved fascia/tissue is released or removed. Surgical intervention is then followed by hand rehabilitation therapy. Consultation with an orthopedist who specializes in hand care would help confirmation of the diagnosis and a treatment plan.
Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University