[SA Chris]

Come on Bonjoy, clearly it's all very <obvious>.

[Bonjoy]

Obviously

[tregiffian]

Saw the senior hand man in Cornwall today. Wouldn`t put the needle into my pinkie lumps saying I would likely be back  with the fingers crooking in after a matter of months. No sympathy with the Glucosamine link and blamed the Celts while admitting that their gene pool could have been muddied by Viking pillagers.

[Bonjoy]

Best say that again, didn't hear you the first two times.

[tregiffian]

As the bishop said "Once never enough."

[Paul B]

After 3 weeks of pocket pulling my contractures seem to be the most aggravated they've been for about 3 years. Coincidentally I bumped into a friend who has just had surgery performed on one of his hands and supposedly the practitioner was saying that the injection treatment was due to be licensed in the UK within the next 6 months.

This involves an injection, 24 hr wait and then the hand is clamped in a stretched position and the scar tissue is broken-down through massage. Can anyone shed any light on whether this is accurate or your hearsay?

[Bonjoy]

The doc whole performed my needle op offered this treatment as his first choice for me but I chose to go with the needle op for various reasons. Google Xiapex if you want to know more about it. Basically you are injected with an enzyme which breaks down collagen, left for a bit and then manipulated to break the weakened cords. The upside is that the enzyme does not attack nerve tissue so the risk of nerve damage is low. I chose not to have it for several reasons. It is very much in the early stages of use in the UK and I was not confident practitioners would have had enough practice to be fully competent. Tendons are made of collagen and very close to DC cords, you do the math. In most people I doubt this would be a problem as mild damage to tendons would not be noticed, for a climber it could be a very different matter, I'd rather some other climber was the guinea pig. Testimonials on US websites (where the procedure has been used for years) were very mixed, with quite a lot of folk reporting some pretty distressing side effects. The recovery time is a lot longer than for NA. Only one hand can be treated at a time (I had both hands NA'd on same day). From what I read it didn't seem to last a whole lot longer than NA. All in all I'm not totally convinced the whole treatment isn't just a clever way for drug companies to make some money (apparently it's very expensive stuff to manufacture). I don't think the risks outway the benefits for climbers, at least not until I hear otherwise from a few climbers who've had it done.

P.S. My hands are still totally flat and free of 'activity' 9 months on from NA.

[Paul B]

ta yoot! Mine seemed to have stabilised but obviously don't like being loaded in sets of two-fingers.

[petarar]

I spoke to Dr Schoffl (world expert on climbing injuries) at the latest BMC medical conference about dupytrens in climbers and he confirmed what i have found in clinical practice. There does seem to be a link between dupytrens and climbing but no scientific evidence to support  this. However in climbers the condition often does not progress and is best left alone. The reason young non climbers with dupytrens go for aggressive invasive treatment is it tends to progress quickly to a stage where they can not open their hand

[tregiffian]

This chimes with my experience.

[Bonjoy]

Most of the climbers I've met with DC have only had it for a relatively few years (less than 10), i.e. it is too early to say that the DC does not progress. DC takes a long time to become problematic.

[nik at work]

I haven't got DC, and haven't read this thread. But yesterday I was listening to Radio 4 and there was a little obit piece for Dave Brubeck, jazz popularizing pianist, who has just died. (Stick with me here this will become relevant soon...)
Anyway as part of the obit they played an interview from a few years ago where he was discussing his DC. He was considering the surgical option but was not massively keen then he spoke to some non-surgical specialist and he was advised to take B6 in MASSIVE doses.
From what I remember of the interview he was saying that the specialist said that a normal dose of B6 would be about 200mg a day but he gave his patients 40,000mg!!! Anyway apparently Brubeck tried this and he's had no problems since.
Now from what I hazzily remember about vitamin dosing 200mg of B6 sounds a bit high to me so maybe the guy was a bit confused about the actual numbers of the dosing?? But he seemed quite convinced by the principle. Might be worth a bit of research??
Like I say I don't have DC, and I was only half listening to the radio, and I haven't read this thread through (this may well be old news that you all covered on page one). But when I heard his comments I immediately thought of this thread and thought I'd mention it here. I'm not suggesting everyone should start mainlining B6, but it might be worth seeing if there is any evidence base (beyond second hand annecdotal) about this strategy if you're wary of surgery.

[SA Chris]

So we need to find the old Rockfax bouldering guide, and get a massive dose of B6s?

[Stewart]

Recently been diagnosed with this as well 

Hadn't been causing too much trouble over the summer, been outside a lot and it's never quite as intense. However, after a full-on indoor session yesterday my hand is really aching, particularly around the affected area on the palm. Is this normal?

Don't suppose anyone has any good news stories or suggestions since it was last discussed on here 10 months ago?

[Bonjoy]

That sounds normal from my experience. It comes and goes. Sometimes it wont change for months, other times it seems to change rapidly. Overall it's a very slow process though. I suspect there are things which trigger bad episodes but I can never pin down what they are for me, though I do think cutting out all dietary supplements may have helped (used to take Glucosamine for joints and high does of vit C for colds) in the past.
As for good news, i had the needle op on both hands in Feb 2012, at which point my hands were both really bad. I was climbing again in less than a week. My hands are still flat and the rate of DC development has been notably slow since having the op, I think this is because once you have contracture you end up overstretching the tissue every time you climb, hence a feedback effect - contracture causes more contracture. Once the op releases the tension in the area you don't get major agravation every time you climb. I've had next to no pain from my DC since op either.

[SA Chris]

Mine hurts a bit when climbing on steep jugs (there's a moral there!) otherwise I've learned to climb so as not to load the affected area with the edge of a hold.

It's not had any development since the sudden rapid growth i noticed while taking Glucosamine regularly. I still take multivitamins (when i remember).

[Stewart]

Chris, you're probably right. Outdoors there are hardly any holds that really dig into your palms, while every other problem indoors has a dyno to a jug for the last move so that probably explains why it's particularly bad today.

Bonjoy, glad to hear you've got a way of coping with it. I found the link on one of your earlier posts which is probably the best source of info I've seen, especially for NA which I'll repost here

http://www.dupuytrens.co.uk/styled-4/

I can still nearly straighten my fingers so don't know if it's too early to go down this route. Probably. Might see if i can find a hand specialist north of the border that can advise.

At least it's a good excuse 'i probably would have flashed that but my dupuytrens is acting up today' or 'sorry dear, i would love to go and get you a cup of tea but my dupuytrens is really sore today'

[Paul B]

I suspect there are things which trigger bad episodes but I can never pin down what they are for me

I've noticed recently that time spent using ascenders and hauling (pulling the slack rope through a 2:1) really aggravates mine to the point where after a few days my left palm (visible contracture) was very sore. Frustratingly this behaviour has led to pains in the same position in my right palm which as of yet has no visible signs of contracture (I guess it's inevitable).

[SA Chris]

see if i can find a hand specialist north of the border that can advise.

Be surprised if there is, might need to travel for that one, should it come to it.

[Oldmanmatt]

And I have to say, mine hasn't advanced since I posted on this thread last.

I think I must be luck to have it primarily in my left (non-writing) hand; so it's rarely agrivated.

Does anyone know if it is guaranteed to progress or does it sometime stabilise?

[Fiend]

Hi! Can I join the club? I now have a small lump on my left palm beneath the little finger. Slightly tender to touch but not to climb on and no contracture at all (yet?).

Is there anything I can do at this stage to slow further progression?

I did read through most of this thread but half the links were broken and then slackline started waffling on about statistics and proof and I lost the will to live after that. I take sporadic vitamin supplements, not glucosamine tho, and living in Glasgow I get fuck all vitamin D of course...

[SA Chris]

Don't think there's much you can do to slow progress. Mine was just a lump for about 10 years, gre while I was taking GSS, not grown since. Stay off the jugs, don't irritate it.

[slackline]

Hi! Can I join the club? I now have a small lump on my left palm beneath the little finger. Slightly tender to touch but not to climb on and no contracture at all (yet?).

Is there anything I can do at this stage to slow further progression?

I did read through most of this thread but half the links were broken and then slackline started waffling on about statistics and proof and I lost the will to live after that. I take sporadic vitamin supplements, not glucosamine tho, and living in Glasgow I get fuck all vitamin D of course...

Get it diagnosed by a professional.

Read what you can be bothered to on the  evidence of its aetiology and effective treatments.



As a quick straw poll, how many of those who have been clinically diagnosed as having a contracture have a relative with Dupuytren's and what sort of relative (NB only include those who you actually share genetics with)?

[Stewart]

No genetic connection for me.

As aside, mine has been pretty sore, the lump seems to have been pressing into something which is causing the pain rather than being sore itself. Seen a specialist in glasgow who is not keen on the aponeurosis technique but gave me a steroid injection to reduce swelling and pain in the short term. It's not really had any effect though.

[Bonjoy]

Hi! Can I join the club? I now have a small lump on my left palm beneath the little finger. Slightly tender to touch but not to climb on and no contracture at all (yet?).

Is there anything I can do at this stage to slow further progression?

I did read through most of this thread but half the links were broken and then slackline started waffling on about statistics and proof and I lost the will to live after that. I take sporadic vitamin supplements, not glucosamine tho, and living in Glasgow I get fuck all vitamin D of course...

Radiotherapy is supposed to be effective at stopping early signs from progressing