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Dupuytren and nerve problems?

Does Dupuytren cause nerve problems?

A common topic of discussion on Dupuytren forums such The Dupuytren’s Disease Support Group DDSG is whether or not Dupuytren causes numbness and tingling in the hands and arms. As with everything Dupuytren related, the answer is …it depends. A few small studies suggesting that local tenderness in Dupuytren cords, nodules, or scar tissue may be due to tiny nerve endings getting caught up in the local tissue anatomy. There are also a few reports that areas at risk for Dupuytren have more than the normal amount of nerve endings. This may explain why some people have spots of tenderness, tingling numbness or sensitivity right in a Dupuytren nodule or cord. But – this doesn’t explain how Dupuytren might cause wider areas of numbness or tingling in the hands and arms.

Numbness and tingling in the hands and arms is very common. There are several categories of diagnoses. One category is “pinched nerve” diagnoses. This includes carpal tunnel syndrome, cubital tunnel syndrome, cervical radiculopathy and other less common diagnoses. Another category is the common “not a pinched nerve” peripheral neuropathy diagnosis which can be associated with diabetes (common), vitamin deficiencies (not common), unexplained (common), and a long list of rare diseases. The last category is central nervous system problems that affect the brain and spinal cord. These include stroke, multiple sclerosis, Guillain Barre, and another long list of rare disorders.

But – there’s is no data to suggest that Dupuytren causes any of these nerve problems. And although the tiny nerve endings in the palm issue may turn out to be something, there’s no data to suggest that pinched nerves, peripheral neuropathy or central nervous problems cause Dupuytren disease.

So why do so many Dupuytren sufferers also have numbness and tingling in their fingers? Demographic overlap. Carpal tunnel, cubital tunnel, cervical radiculopathy, and cubital tunnel are all very common – overall, more common than Dupuytren – and increasingly common from midlife on. Common things happen with other common things – because they are common.

On the other hand, it’s also common for someone with Dupuytren who also has a rare disease to assume that the two are somehow connected. Unless it’s a Dupuytren spectrum disease (Dupuytren, Ledderhose, knuckle pads, Peyronie), that assumption is most likely wrong. The likely explanation is that someone with a rare disorder also has Dupuytren – a common disorder. As my veterinarian says: “It’s possible to have both ticks and fleas”.

Finally, “no data” doesn’t mean “no relationship”. It just means that there’s not enough information to draw a solid conclusion. How can we change this? By collecting more information on Dupuytren disease through the International Dupuytren Data Bank IDDB Enroll. If you haven’t enrolled, now is the time. If you have, thanks! Now encourage others to do the same.

Charles Eaton MD