A current patient of mine, Roz, a 71 year old professor, presented to my office on September 19, 2013 seeking treatment for her left hand which was suffering from Dupuytren’s contracture. Dupuytren’s contracture is a condition that results in contracture of the soft tissues of the hands and fingers (most commonly the ring and pinky fingers). The cause of this condition remains unknown, although commonly affects men over the age of 50 and progresses slowly affecting hand function. The condition runs in Roz’s family, but she is the only one in her family that seeks out treatment for the condition.
Although I always try to treat the cause of a condition, for Dupuytren’s contracture this is impossible. So, my treatment approach aims to reduce the effects – muscular, tendinous, and fascial restrictions. I do this using a combination of three techniques:
- Low Level (“Cold”) Laser Therapy
- Myofascial Release
- Graston Technique
Roz actually sought me out specifically because I offer Graston Technique. Graston is a certified “Instrument Assisted Soft Tissue Mobilization (IASTM)” technique. IASTM is an increasingly popular method of treating soft tissue adhesions, whether those adhesions are present in muscle, tendons, fascia, ligaments, or joint capsules. Graston Technique uses stainless steel instruments to help break down the adhesions by running the instruments along the soft tissue areas in need. As it might sound, the instruments physically break down the adhesions, ala ironing a wrinkled pair of pants.
In addition to using the Graston tools, I also use my own hands-on myofascial release to assist the contractured adhesions to release.
I have also been incorporating “Cold Laser” therapy into Roz’s treatment. Laser stimulates tissue repair and promotes proper soft tissue alignment as it heals. Pairing the physical tissue breakdown techniques of IASTM and myofascial release with the technology of “cold laser” makes perfect sense for the treatment of Dupuytren’s contracture, as well as so many other musculoskeletal ailments.
After Roz’s second treatment, we each noticed a considerable improvement in her hand’s contractures, function, and form. We continue to use these techniques to further the recovery. And, driven by the success of her left hand, we have begun to use similar approaches for her recently fractured right wrist.
In addition to laser and Graston Technique, Roz will perform therapeutic exercises, and receive osteopathic manual manipulation with our Osteopath Katherine to maximize her wrist fracture recovery.
Mar 17, 2017 at 3:40 PM
Hello i am going to get a laser to get me some help with my dupuytren's could you give me some idea which laser low watt i should consider as i can not afford to get professional help Thank you John
Mar 17, 2017 at 11:43 AM
Hi John, Thanks for your comment/question. Unfortunately, I do not have a good answer for you. Scientifically speaking, I do not believe there is an established an answer to your question. I use a Low Level Laser Therapy device made by Theralase. It incorporates two wavelengths of laser: 660nm and 905nm, and is delivered via a patented super-pulsed method. It is arguably one of the best devices in the world. With that said, I incorporate the laser device into my physical therapy approach for Duputyren's Contracture, including manual therapy, Functional Release and Graston Technique. I would not only use Laser for this condition. But, even if you were determined to try Laser Therapy alone, purchasing a device for yourself is extremely expensive. Laser devices today cost between $20,000 to $40,000. Your better bet is a conservative trial of therapy incorporating both Laser & manual therapy techniques. Feel free to email or call me to discuss further. And, good luck!
Jul 06, 2020 at 8:04 PM
Hi, I have recently developed thickening of tendons in left hand, and a nodule on the tendon. I am reading about the Graston technique. It appears to be similar to the Chinese "spooning" technique where a ceramic spoon is scraped along the fibrous tissue to break it up (accompanies acupuncture treatment for Dupuytren's) I live in Bogotá, Colombia, and it would be impossible for me to see you. Can you possibly lead me in the right direction to a provider who is experienced in the Graston technique, anywhere in Colombia? Sincerely, Rachael
Jul 09, 2020 at 8:26 AM
Hi Rachael, The best place to look for a graston technique provider is https://grastontechnique.com/ Good luck with your hand!
Apr 16, 2021 at 11:59 AM
Hi, I have recently developed a nodule on my right palm. I see you published the article on Roz in October 2013. I'm wondering what success you've seen over the past 7-1/2 years using this technique, treating nodules only. 1.Low Level (âColdâ) Laser Therapy 2.Myofascial Release 3.Graston Technique I've found a chiropractor in my area that provides these services after reading your article. I have an upcoming appoint, and would like to know what kind of results you have seen when starting treatment prior to contractures. And any advice you might be able to give me. Thank you -Mary
Apr 20, 2021 at 7:26 PM
Hi Mary, Thanks for your comments and question regarding the blog I had written regarding hand contractures. I wish I could give you some solid statistics and evidence of what works and what doesn't. Unfortunately, these statistics for this condition simply do not exist. I have not seen enough patients (only a handful) with this condition to even formulate an opinion of whether my approach works or doesn't. A few of my patients responded well with approximately 5 to 10 visits of FR, Graston & Laser with home exercises based on the FRC protocols. However, some of the more advanced contractures did not respond favourably, and, one patient in particular did eventually require some medical involvement to dissolve the contractures and help him regain some range of motion. The treatment I recommend has no risks, potential for moderate improvement. It's worth a shot. Good luck!
Dec 19, 2021 at 12:07 AM
Where can I find someone who does the laser treatment for Dupuytrens in Cronulla NSW Australia 2230
Dec 21, 2021 at 3:54 PM
Hi Julie, I hope this reply finds you well. Unfortunately, I cannot direct you to anyone in Australia that uses Laser Therapy for the contractures. This is a technique I've had moderate success with, but it is not a proven method. I suggest you call your local physiotherapist or chiropractor to inquire on their strategies for treating hand contractures. Good luck!
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