Dupuytren's contracture is a medical condition that affects the hand's connective tissue, causing 1 or more fingers to bend toward the palm, making it difficult or impossible to straighten them.1 Usually, the disease begins as a palpable nodule and then evolves to form cords with progressive contracture in flexion of a finger.2 Early disease is commonly classified as a contraction of digits 0°–45° or as nodules and cords present without contracture. Progression of the contracture is typically slow and happens over the course of multiple years, with some patients having very few symptoms for many years.3 When the fingers do flex into the palm, the patient's daily life is impaired severely.4 Patients with this condition are predominantly male and typically in their fifth decade of life or later. A family history of hand contractures is common, although not universal, and presentations may vary. Asymptomatic patients may present with Dupuytren's nodules during visits for unrelated issues, whereas patients with more-advanced disease may present with severe contractures and functional limitations.5
Generally, conventional treatment options for Dupuytren's contracture include surgery, radiation therapy, physical therapy, and collagenase injections.6 The limitations of conventional treatments for Dupuytren's contracture include the potential for complications and side-effects, the need for repeated treatments, and the risk of recurrence. Some patients may also find that these treatments do not restore finger function completely or do not prevent the progression of the disease.7,8
Acupuncture is a Traditional Chinese Medicine (TCM) technique that involves the insertion of thin needles into specific points on the body to stimulate healing.9 Here is a case report of a patient with Dupuytren's contracture who received acupuncture and moxibustion treatment.
Case
The patient was a 63-year-old male professor with a history of Dupuytren's contracture affecting his right hand for the past 8 months that was diagnosed by an orthopedic specialist. Due to the limited range of mooring in his fingers, this patient complained that he had difficulty performing daily activities, such as writing, using a computer to work, and grasping objects.
Acupuncture and Moxibustion Treatment
The patient received 12 weekly acupuncture treatments at a TCM Skill Training Centre, of Xiamen University Malaysia. The acupuncture focused on points along the affected hand and arm, including LI-4, SJ-5, LI-10, HT-7, and PC-7. The needles were left in place for 30 minutes during each session. Additionally, for indirect moxibustion, a moxa stick was applied to PC-8 for 30 minutes.
Clinical Outcome
After the first few sessions, this patient reported a decrease in pain and improved range of motion (ROM) in his fingers, but was still limited in ability to grasp objects, and perform work on his computer. By the end of the 12-week treatment time, the patient had full ROM in his fingers and reported having pain at times but this did not affect his daily activities or cause him discomfort. The patient also reported having improved grip strength and that he was able to perform daily activities with ease. During his acupuncture and moxibustion treatment, there were no adverse side-effects.
Follow-Up
This patient was followed-up 6 months after the end of his treatment. He did not have any recurrence of his Dupuytren's contracture. He reported continued improvement in finger movement and remained satisfied with the results of his treatment.
Conclusions
This case report illustrates that acupuncture + moxibustion may be a promising complementary and alternative treatment option for patients with Dupuytren's contracture instead of surgery or corticosteroid injections. However, further research is needed to confirm the treatment's effectiveness and optimal treatment protocols. It is recommended that acupuncture + moxibustion may be an appropriate treatment option for this specific condition.
Address correspondence to:
Yun Jin Kim, PhD
School of Traditional Chinese Medicine
Xiamen University Malaysia
Jalan Sunsuria, Bandar Sunsuria
Sepang, Selangor 43900
Malaysia
E-mail: yjkim@xmu.edu.my
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