Search
Close this search box.
500+ Google Reviews
4.9/5
4.9 out of 5

Dupuytren’s Contracture and Shockwave Therapy: A Useful Adjunct to Non-Invasive Treatment

Contents

Dupuytren's contracture and shockwave therapy

Dupuytren’s contracture, also known as Viking disease, is a debilitating condition affecting the hands. It causes one or more fingers to bend towards the palm, reducing the range of motion and severely impacting daily activities. This article explores the innovative use of extracorporeal shock wave therapy (ESWT), a non-invasive treatment option for Dupuytren’s contracture. By understanding the benefits and mechanisms of this therapy, readers can appreciate its potential to improve hand function and quality of life.

Outline

  1. What is Dupuytren’s Contracture?
  2. Understanding Shockwave Therapy
  3. How Does Shockwave Therapy Work for Dupuytren’s Contracture?
  4. Can Dupuytren’s Contracture Benefit from Shockwave Therapy?
  5. The Procedure: What to Expect
  6. Effectiveness of Shockwave Therapy
  7. Shockwave Therapy in Wimbledon: A Local Perspective
  8. Comparing Shockwave Therapy to Other Treatments
  9. Limitations and Considerations of Shockwave Therapy
  10. Future Directions in Treating Dupuytren’s Contracture

What is Dupuytren’s Contracture?

You can see our comprehensive review of Dupuytren’s contracture for more information, but essentially Dupuytren Contracture is a condition characterised by the thickening and tightening of the tissue under the skin of the palm and fingers, known as the fascia. This results in the formation of nodules and cords, leading to flexion contracture where the fingers cannot fully straighten. The condition progresses over time, severely limiting hand function.

The exact cause of Dupuytren’s contracture remains unclear, but it is more common in men, particularly those of European descent. Factors like age, family history, alcohol consumption, and certain medical conditions are associated with its development.

Understanding Shockwave Therapy

Shockwave therapy, specifically extracorporeal shockwave therapy (ESWT), is a non-invasive treatment method that uses sound waves to stimulate healing in targeted tissues. Originally used for kidney stone disintegration, ESWT has been adapted for various musculoskeletal conditions, including Dupuytren’s contracture.

ESWT involves the delivery of focused shockwaves to the affected area. These waves promote tissue regeneration, reduce inflammation, and can help break down the thickened cords in Dupuytren’s disease, improving hand function without the need for surgical interventions.

How Does Shockwave Therapy Work for Dupuytren’s Contracture?

Shockwave therapy for Dupuytren’s contracture involves using a device to emit shock waves directly to the affected tissue. The focused shock wave therapy stimulates the body’s natural healing processes, promoting the breakdown of scar tissue and improving blood flow.

This treatment method aims to soften and break down the collagen-rich cords that cause the contracture, thereby improving pain and, in combination with splinting, stretches and exercises, improving the range of motion in the fingers. The non-invasive nature of ESWT makes it an attractive option for patients seeking to delay the progression of the disease to a point of needing surgery.

Can Dupuytren’s Contracture Benefit from Shockwave Therapy?

Patients with early-stage Dupuytren’s contracture are ideal candidates for shockwave therapy. The treatment is particularly beneficial for those who experience pain or functional limitations due to the condition but are not yet ready for surgical interventions.

Shockwave therapy is also suitable for patients who have experienced recurrence after surgery or other treatments. It provides a viable option for managing symptoms and preventing further progression of the disease.

The Procedure: What to Expect

During a shockwave therapy session, patients can expect a thorough assessment by a one of our team to determine the suitability and treatment protocol. Our advanced hand specialist team will complete a clinical assessment helping you to define your current issues, such as contractures, pain, or loss of function. 

Our team feels clinical education about your condition and its natural progression is vital, so this will be included in your session. Your therapist will provide you with a splint if it is assessed as appropriate. The splint design will be specific to you and the hand therapist will make it based on your contracture and tightness. You will also be given active and passive range of movement exercises. If pain is an issue, then we can assess you for the suitability for shockwave therapy. 

The procedure itself involves the following steps:

  1. Preparation: The treatment area is cleaned, and a coupling gel is applied to ensure effective transmission of shock waves.
  2. Application: The shockwave device is positioned over the affected area, and focused shockwaves are delivered in a controlled manner.
  3. Duration: Each session typically lasts between 15 to 30 minutes, depending on the severity of the condition.

Patients may experience mild discomfort during the procedure, but it is generally well-tolerated. Multiple sessions are often required for optimal results, and we offer an exclusive, all-inclusive package price for your complete peace of mind in treatment.

The package includes a splint and five sessions of shockwave therapy and a review appointment at 3 months time. 

Effectiveness of Shockwave Therapy

Studies have shown that shockwave therapy can be an effective treatment for Dupuytren’s contracture. It helps reduce the thickness of the cords and improve hand function, with minimal side effects. Patients often report decreased pain and increased flexibility following treatment.

One of the key studies that investigated the efficacy of shockwave therapy for Dupuytren’s contracture was a systematic review and meta-analysis published in 2024 by Yazdani et al. (1). This study aimed to evaluate the effectiveness of shockwave therapy in reducing contracture and improving hand function in patients with Dupuytren’s contracture. The results of the meta-analyses suggested that shockwave therapy could lead to a significant improvement in contracture reduction, hand function and patient satisfaction compared to control groups.

Furthermore, a randomised controlled trial (RCT) by Knobloch et al. in 2021 (2) also examined the effects of shockwave therapy on Dupuytren’s contracture. The study compared the outcomes of shockwave therapy with a placebo intervention in patients with Dupuytren’s contracture. The results of this RCT indicated that shockwave therapy was associated with a significant reduction in pain and improved hand function compared to the placebo group.

The success of shockwave therapy varies depending on factors such as the stage of the disease, the patient’s overall health, and adherence to the treatment protocol. However, many patients experience significant improvement, making it a promising option for managing Dupuytren’s contracture.

Shockwave Therapy in Central London: A Local Perspective

Shockwave therapy is becoming increasingly popular in Central London, as a treatment for Dupuytren’s contracture. Our 4 local, centrally located clinics in Chancery Lane, St John’s Wood, Kensington and Chelsea offer advanced ESWT services, providing patients access to cutting-edge non-invasive treatment modalities.

In Central London, shockwave therapy is performed by our experienced advanced hand therapy practitioners who specialise in musculoskeletal conditions. This local availability ensures that patients can receive timely and effective treatment without the need to travel long distances.

Comparing Shockwave Therapy to Other Treatments

Traditional Dupuytren’s contracture treatments include collagenase injections, needle aponeurotomy, and surgical interventions. While these methods can be effective, they come with certain risks and limitations, such as infection, scarring, and long recovery times.

Shockwave therapy offers several advantages over these treatments:

  • Non-invasive: No incisions or injections are required, reducing the risk of complications.
  • Minimal recovery time: Patients can resume normal activities shortly after treatment.
  • Effective for early stages: It can, when combined with splinting, stretching and exercises, help prevent disease progression without the need for more invasive procedures.

The clinical evidence for the treatment of dupuytren’s without surgical care is

  1. Early evidence that shockwave can be beneficial for pain relief  – research has shown an improvement in pain and DASH scores
  2. Splinting, stretching and exercises may be beneficial for improving or maintaining ROM and function. 

However, while we may use shock wave therapy for grades 1-2, it may not be suitable for advanced cases of Dupuytren’s contracture, where surgical intervention might be necessary.

Shock Wave Therapy Limitations and Considerations

Despite its benefits, shockwave therapy has certain limitations. It may not be effective for all patients, particularly those with severe or long-standing contractures. Additionally, the success of the treatment can vary, and some patients may experience a recurrence of symptoms over time.

Patients considering shockwave therapy should discuss their medical history and treatment goals with a healthcare provider to determine if it is the best option for their condition. Understanding the potential benefits and limitations can help in making an informed decision.

Future Directions in Treating Dupuytren’s Contracture

The future of treating Dupuytren’s contracture lies in continued research and innovation. While the core non-surgical treatment approach will always remain to be splinting, exercises, and stretches, any advances in shockwave therapy, including the development of more precise and powerful devices, hold promise for improving treatment outcomes.

Additionally, combining shockwave therapy with other modalities, such as magneto-transduction therapy or laser therapy, could enhance its effectiveness. However, more research is needed to refine treatment protocols and expand the indications for ESWT in musculoskeletal conditions.

Summary

  • Dupuytren’s Contracture: A condition causing the fingers to bend towards the palm, limiting hand function.
  • Shockwave Therapy: A non-invasive treatment using sound waves to stimulate healing and break down thickened tissue.
  • Effectiveness: Shockwave therapy can reduce pain, improve flexibility, and delay disease progression.
  • Procedure: Involves delivering focused shockwave treatment to the affected area in multiple sessions.
  • Candidates: Ideal for early-stage Dupuytren’s contracture and patients with recurrence after other treatments.
  • Comparison: Offers advantages over traditional treatments, including being non-invasive and having minimal recovery time.
  • Limitations: May not be suitable for advanced cases and success can vary.
  • Future Directions: Continued research and innovation are key to improving treatment outcomes.

Shockwave therapy represents a promising advancement in the treatment of Dupuytren’s contracture, offering hope to those seeking non-invasive solutions to this challenging condition.

References

  1. Yazdani, A., Nasri, P., & Mahdavi, S. B. (2024) The Effects of Shock Wave Therapy on the Symptoms and Function of Individuals With Dupuytren Disease: A Systematic Review. Archives of Physical Medicine and Rehabilitation. https://www.archives-pmr.org/article/S0003-9993(24)01050-5/abstract
  2. Knobloch, K., Hellweg, M., Sorg, H. et al. Focused electromagnetic high-energetic extracorporeal shockwave (ESWT) reduces pain levels in the nodular state of Dupuytren’s disease—a randomised controlled trial (DupuyShock). Lasers Med Sci 37, 323–333 (2022). https://doi.org/10.1007/s10103-021-03254-9

Contact Us

Discuss your needs with our friendly team and find out how we can help you return to fitness!

Comments

Request a Callback

We usually call you back within the hour during normal working hours

For appointments & advice

Contact Us Now!

We usually respond within the hour during normal working hours