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One of the more unusual conditions affecting the hands and fingers is Dupuytren's contracture (also called Dupuytren's disease). Here, one or more fingers become curled, which can make it difficult to pick up or hold objects or perform everyday activities.

Legend says the condition originated with the Vikings of Northern Europe, although this is debated. It was later named after the 19th-century French surgeon Guillaume Dupuytren, who did the first successful operation on the condition. Fast-forward to the 21st century, and Dupuytren's contracture now affects about one in 20 Americans.

What is Dupuytren's contracture?

Fascia is a sheet of fibrous tissue beneath the skin of the fingers and the palm. Dupuytren's contracture is a thickening and shortening of this tissue.

This thickened area begins as a hard lump called a nodule. Over years to decades, it may progress to a thick band called a cord that causes one or more fingers to curl toward the palm and become stuck in a bent position. This can make it difficult to grasp objects, button clothes, use a computer, or perform other daily tasks.

The condition does not always get progressively worse. It may be stable for years or even improve in some people.

Which fingers are most likely to be affected?

The ring and pinky fingers are most often affected. But the condition can strike all fingers and the thumb.

"In about half of cases, the condition can affect both hands," says Dr. Phillip Blazar, an orthopedic surgeon and Division Chief of Hand and Upper Extremity at Harvard-affiliated Brigham and Women's Hospital. Fortunately, it rarely causes pain.

What causes Dupuytren's contracture?

Currently, the cause is unclear. Still, several factors can increase a person's risk, such as

People with diabetes and seizure disorders are also more likely to have Dupuytren's. The condition may appear and/or worsen after trauma to the hand.

How is Dupuytren's contracture treated?

Although there is no cure, treatments and occupational or physical therapy can help address symptoms and improve finger mobility. "Many people who have mild cases of Dupuytren's find it has little impact on their ability to use their hands," says Dr. Blazar.

However, moderate or severe cases can interfere with hand function. It's possible to restore normal finger motion with nonsurgical treatments, such as:

"Your hand surgeon will discuss both treatment options to determine which is best for your situation," says Dr. Blazar. "There are also some variations in the anatomy of the disease which may make one treatment or the other less favorable for a particular person or finger." Both of these treatments don't remove the cords, and the condition can return and require additional treatment.

What about surgical treatment?

If nonsurgical treatment does not relieve symptoms or you have a severe condition, surgery may be recommended. Surgical approaches include:

You wear a splint on the repaired hand during recovery. People should expect some pain, stiffness, and swelling afterward. The length of recovery varies for each individual, and also with how many fingers were operated on and which ones.

"Most people largely recover by three months, but some may not feel fully recovered for quite a bit longer," says Dr. Blazar. Hand therapists can also help with strength and flexibility exercises to speed recovery.

Most people's fingers move better after surgery. However, as with nonsurgical treatments, the contracture can come back, so some people may need additional surgery later on.

Source: Harvard Health Publishing

Source: Harvard Health Publishing

In parts of the United States and Canada, warming temperatures driven by climate change may be contributing to a rise in tick-borne illnesses. Ticks are now thriving in a wider geographic range, and appearing earlier and sticking around later in the shoulder seasons of spring and fall. That means we need to stay vigilant about protecting ourselves against ticks that cause Lyme disease and other illnesses — even during winter months in many warmer states and provinces.

Here's a timely reminder about why preventing Lyme disease is important, and a refresher on steps you can take to avoid tick bites.

What are the symptoms of Lyme disease?

Lyme disease is best known for its classic symptom, a bull's-eye red rash that appears after a bite from an infected tick (scroll down to see photos of classic and non-classic rashes). However, 20% to 30% of people do not develop a rash. And a rash can be easy to miss because ticks tend to bite in dark body folds such as the groin, armpit, behind the ears, or on the scalp. Some people have flulike symptoms such as a headache, fever, chills, fatigue, and aching joints. So if you notice a rash or have these symptoms, call your doctor for advice. At this stage, prompt antibiotic treatment can wipe out the bacterial infection.

When people don't receive treatment because they didn't see the rash or didn't have other early symptoms, the bacteria can spread to different parts of the body. Not only can the bacteria itself cause problems, but the body's immune system can over-respond to the infection. Either process, or sometimes both, may harm joints, the heart, and/or the nervous system. And some people treated for any stage of Lyme disease develop post-Lyme disease syndrome, which can cause a range of debilitating symptoms that include fatigue, brain fog, and depression.

How to avoid getting Lyme disease

Preventing tick bites is the best way to avoid Lyme disease and other tick-borne illnesses. Blacklegged ticks (also called deer ticks) may be infected with the bacteria that causes Lyme disease. If you live in one of the areas where the incidence of Lyme disease is high, these steps can help.

Know where ticks are likely lurking. Ticks usually crawl up from leaves or blades of grass on the ground to the legs. So be extra careful when walking through fields or meadows and on hikes where you may brush up against bushes, leaves, or trees. Try to walk on well-cleared paths.

Wear protective clothing. Long pants tucked into socks is the best way to keep ticks from crawling up under the pant leg. Lighter-colored clothing can make ticks easier to see.

Use repellents. You can buy clothing that's pretreated with the insecticide permethrin (which repels ticks). Or you can spray your own clothes and shoes; just be sure to follow the directions carefully. On all exposed skin, use a product that contains DEET, picaridin, oil of lemon eucalyptus (OLE), IR3535, para-menthane-diol (PMD), or 2-undecanone. This search tool from the EPA can help you find a product best suited for your needs. Pay attention to the concentration of active ingredients: for example, at least 20% but not more than 50% with DEET; between 5% to 20% with picaridin; and 10% to 30% with oil of lemon eucalyptus. Many products come in pump spray bottles or as sticks or wipes, which may make them easier to apply where needed.

Get a tick check. After spending time in tick-infested areas, ask a partner to check you for ticks in areas on your body that you can't see very well. The common bite areas are the back of the knee, the groin, under the arms, under the breasts in women, behind the ears, and at the back of the neck. The tick species that transmits Lyme disease is about the size of a sesame seed. Note that a tick has to be attached to your skin for 24 to 36 hours for it to transmit enough bacteria to give you the disease.

For more information about preventing Lyme disease or living with it, visit the Harvard Health Publishing Lyme Wellness Initiative.

Source: Harvard Health Publishing

We all have habits we'd like to get rid of, and every night we give ourselves the same pep talk: I'll go to bed earlier. I will resist that cookie. I will stop biting my nails. And then tomorrow comes, we cave, and feel worse than bad. We feel defeated and guilty because we know better and still can't resist.

The cycle is understandable, because the brain doesn't make changes easily. But breaking an unhealthy habit can be done. It takes intent, a little white-knuckling, and some effective behavior modification techniques. But even before that, it helps to understand what's happening in our brains, with our motivations, and with our self-talk.

We feel rewarded for certain habits

Good or bad habits are routines, and routines, like showering or driving to work, are automatic and make our lives easier. "The brain doesn't have to think too much," say Dr. Stephanie Collier, director of education in the division of geriatric psychology at McLean Hospital, and instructor of psychiatry at Harvard Medical School.

Bad habits are slightly different, but when we try to break a bad one we create dissonance, and the brain doesn't like that, says Dr. Luana Marques, associate professor of psychology at Harvard Medical School. The limbic system in the brain activates the fight-flight-or-freeze responses, and our reaction is to avoid this "threat" and go back to the old behavior, even though we know it's not good for us.

Often, habits that don't benefit us still feel good, since the brain releases dopamine. It does this with anything that helps us as a species to survive, like eating or sex. Avoiding change qualifies as survival, and we get rewarded (albeit temporarily), so we keep reverting every time. "That's why it's so hard," Collier says.

Finding the reason why you want to change

But before you try to change a habit, it's fundamental to identify why you want to change. When the reason is more personal — you want to be around for your kids; you want to travel more — you have a stronger motivation and a reminder to refer back to during struggles.

After that, you want to figure out your internal and external triggers, and that takes some detective work. When the bad-habit urge hits, ask when, where, and with whom it happens, and how you are feeling, be it sad, lonely, depressed, nervous. It's a mixing and matching process and different for every person, but if you notice a clue beforehand, you might be able to catch yourself, Collier says.

The next part — and sometimes the harder part — is modifying your behavior. If your weakness is a morning muffin on the way to work, the solution might be to change your route. But environments can't always be altered, so you want to find a replacement, such as having almonds instead of candy or frozen yogurt in lieu of ice cream. "You don't have to aim for perfect, but just a little bit healthier," Collier says.

You also want to avoid the all-or-nothing mindset, which leads to quick burnout, and instead take micro-steps toward your goal, Marques says. If you stay up until midnight but want to be in bed at 10, the reasonable progression is: start with 11:45; the next night 11:30; the next 11:15 … It builds success and minimizes avoiding the new habit.

It also helps to remember that urges follow a cycle. They're initially intense, then wane, and usually go away in about 20 minutes. Collier suggests to set a timer and focus on "just getting through that."

In that waiting period, seeking new sensations can provide useful distraction. You can go outside and feel the wind and smell the air. You can do something physical. Collier also likes using hot and cold. In the extreme, it's submerging your face into a bowl of water, which can slow down your heart rate. But it could also be holding an ice cube or taking a hot shower. "You're focused on the sensation and not the urge," she says.

Accept that success isn't a straight line

As you try to change, there will be bumps and setbacks, which are part of the process of lasting change. The problem is that we're our own worst critics, and some people view anything except total success as complete failure.

Marques says to try to take a third-person perspective and think about how you'd react to a friend who said that having one bag of chips had ruined their whole diet. You'd be kind and reassuring, not critical, so give yourself the same treatment. A lot of the struggle with self-criticism is not seeing thoughts as facts, but merely thoughts. It takes practice, but it's the same idea as with meditation. You treat what comes into your head as clouds, acknowledging them and letting them roll on through. "Everyone has distorted thoughts all the time," Marques says. "It's what you do with them."

It also helps to reduce stress and minimize that sense of failure to know that the goal isn't to make the old habit disappear, because it won't. You're just trying to strengthen the new routine so eventually it takes over, and the old habit isn't even a thought. But it's a constant process, made easier with self-compassion, because there's no way to prepare for every situation or be able to predict when and where a trigger might happen.

"You can't prepare for life," Collier says. "Life is going to throw things at you."

Source: Harvard Health Publishing