Former Olympic rower Sir Steve Redgrave has spoken about how a condition affecting his hands could impact his performance on Dancing On Ice, which returns to ITV1 on Sunday. The 62-year-old, a five-time Olympic gold medallist, has shared his worries that his Dupuytren’s contracture (a condition also experienced by the actor Bill Nighy) and diabetes might pose challenges during the competition.
“I’ve been diabetic for almost 30 years so the sensation in my feet isn’t as good as what it used to be, so navigating my footing on the ice could be a problem,” said the former athlete. “I also have Dupuytren’s contracture which affects my hands, meaning I can’t make them flat. So if I do fall over, although I’m planning not to, it means I may have trouble getting up.”
But what is Dupuytren’s contracture? And can it be treated?
What is Dupuytren’s contracture?
“The first thing I tell people is that it is a condition that can cause lumps in your hand, those lumps will form cords and the cords can pull your fingers in,” explains Anna Schurer, chair of British Dupuytren’s Society.
The overall prevalence of the disease in the UK is about 4%, rising to about 20% in those aged over 65 years, according to NICE.
“It is more common in older people and people of northern European descendent,” adds Shurer.
What causes it?
“Research suggests that for 80% of patients it is hereditary and that for 20% it is environmental – so people can develop it if you don’t have family members who have the condition, but they’re far more likely to develop it if somebody in the family already has it,” says Schurer.
“Inflammation and trauma can also set it off. For example, if patients break their wrist or have surgery for carpal tunnel, a few months later they sometimes start noticing changes in their hands.”
How is it diagnosed?
“Most GPs will be able to diagnose the typical cases and if you need treatment, if you already have a contracture, then you would be referred to a hand specialist, a hand surgeon,” informs Schurer.
What are the symptoms?
“Usually it starts in the hands,” highlights Schurer. “And it starts, in most cases, with a lump in the palm of the hands.
“Some patients first notice what is called dipping, where the skin seems to be pulled in towards the bones. And that can also be a sign of Dupuytren, because that can be a sign of tissue already starting to contract.”
When should people seek medical advice about this?
“I wish people would go to a doctor sooner and get seen,” stresses Schurer. “A lot of patients still think it’s a bit of arthritis, or, you know, just getting older and your fingers curl. But, if you leave it too long, then treatment is going to be far less effective.
“Any lumps in your body should be checked out by a doctor.”
Can it be treated? What are the treatment options?
“For early disease, so that’s when there’s only lumps in the hand, radiotherapy is an option,” says Schurer. “NICE has some guidance on that and in most cases it can either slow it down or stop the disease, at least for a while.
“The radiotherapy option is comparable to radiotherapy for cancer, except it is a lower dose. You can have it every day for a week, you get a break for a few months and then come back for another week.”
According to the NHS website, there are also three surgery options: surgery to remove the affected tissue in the hand (fasciectomy), using a needle to make small cuts in the affected tissue (needle fasciotomy) or surgery to remove the affected tissue and skin (dermofasciectomy).
“Some surgeons will be able to puncture the cord with a needle, that’s called needle fasciotomy, and can be done under local anesthetic, when they keep puncturing the cord until it’s weak enough that they snap it,” explains Schurer. “It can only be done for cords that are thin enough and in the palm of the hand. Not many surgeons will do it for cords in the finger.
“The main surgery that is available on the NHS, which is considered gold standard, is surgery where they cut open the palm of your hand and remove all the disease tissue, and then you’re talking about a few months recovery.”
What do you wish more people knew about the disease?
“The condition is not strictly hands only, it can happen in other parts of the body as well,” points out Schurer.
If you are diagnosed with Dupuytren’s disease you may also get disorders affecting tissue elsewhere in the body, according to NHS England. These can affect the feet (called Ledderhose disease) or the penis (called Peyronie’s disease).