Pain in Dupuytren’s disease

Abstract

To investigate pain in patients with Dupuytren disease, we analyzed the literature on pre- and post-interventional pain and complex regional pain syndrome. The pre-interventional pain intensity score of primary Dupuytren ranged from 0.3/10 to 2.0/10. One year after surgery or needle fasciotomy, no significant change of pain could be found. Collagenase therapy significantly reduced the mean pain intensity score from 1.3/10 [SD 2.2] to 0.5/10 [1.5] (p<0.01) after one year. The prevalence of complex regional pain syndrome after fasciectomy ranged from 0% to 12.8%, after needle fasciotomy from 0% to 6.3%, and after collagenase therapy from 0% to 3.0%. We conclude that for most Dupuytren patients, pain is not an issue. A minority seems to suffer pain and collagenase treatment appears to reduce this complaint significantly. However, complex regional pain syndrome is a known complication of Dupuytren treatment, with a low incidence after minimal invasive treatment.