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My fourth and fifth fingers are slowly becoming bent inwards towards the palm of my hand. On the advice of a physiotherapist, I have been doing daily stretching exercises, but over the past year the fingers have become much worse, and it is now impossible to straighten them. Is there any other treatment that will work?

My fourth and fifth fingers are slowly becoming bent inwards towards the palm of my hand. On the advice of a physiotherapist, I have been doing daily stretching exercises, but over the past year the fingers have become much worse, and it is now impossible to straighten them. Is there any other treatment that will work?

This condition is called Dupuytren's contracture. It is named after the French surgeon Baron Guillaume Dupuytren who first described it 200 years ago. It is caused by thickening and shortening of the tendons in the palm of the hand that pull the fingers into a clenched fist. As you have discovered, exercises don't make much difference to the progress of the disease. The only successful solution is an operation on the palm to release and lengthen the tendons. Men get the problem more often than women, and there is sometimes a link with drinking too much alcohol, although teetotallers can also suffer from Dupuytren's contracture.

I was diagnosed as having cervical spondylosis and 20 years ago had my neck manipulated after being a given a Valium injection to put me to sleep. It worked marvellously. However for the last five years I have had neck ache again and cannot sleep on my left side as this results in awful pains in the neck and right up behind my ear. When I mentioned this to my doctor he sent me to a physiotherapist who gave me exercises for my neck. These have helped, but I still suffer with my neck, especially at nights. Is there any way of finding out the extent of my spondylosis?

Spondylosis and spondylitis and two terms that are used to describe inflammation and wear of the small joints between the bones of the vertebral column. The only practical way of looking at the condition of these joints is with an X-ray, though a doctor or physiotherapist might be able to tell quite a lot with a thorough examination of your neck. Unfortunately, X-rays are an unreliable way of knowing how bad (or how good) things are. People with terrible symptoms sometimes have normal X-rays, and people with no symptoms sometimes have disastrous-looking X-rays. The Arthritis Research Campaign publishes a leaflet called Pain in the Neck. You can see it at its website (www.arc.org.uk), or order it by writing to ARC Publications, PO Box 31, Newark NG24 2BS.

Please send your questions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions

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