If you've ever had even one disabled finger, you are suddenly very aware of how much we need the cooperation of all fingers to get so much done. Tying ties, closing buttons, putting on make up, not to mention writing and typing.
Karen Mercado is playing her piano again, but it wasn't too long ago that her fingers were literally stiffened into her hand.
Many people may think its arthritis but it isn't. The condition is called Dupuytren's disease or Dupuytren's contracture.
Doctor's aren't sure why it happens, but they do know how.
For possibly genetic reasons the ligaments in the hands begin to change.
"It starts out usually as a small lump in the hand, then forms thickened bands and then finally pulls the fingers down, said Lawrence Hurst of the Stony Brook medical center. He adds, "And, in the majority of people, once it gets to about 30 degrees in this joint, it will progress to get worse."
And that can lead to discomfort, pain and dysfunction.
Karen remembers her father had the condition and had surgery for it.
"I can remember as a child hearing him say that he would never go through that surgery again," she said.
But painful surgery is only one option, a newer one is an injection of collagen approved this week by the FDA.
It's a medicine called xiaflex, developed by these doctors at Stony Brook Medical Center. After fifteen years of research, the collagen injection offers patients a new option.
"It is injected in a discrete area depending on where the bend of the finger is, the patient goes home, we see them the next day, the finger is manipulated in extension and the cord is ruptured," said Dr. Maria Badalamente, with Stony Brook Medical Center.
The studies showed most patients got some relief and 6 out of 10 got total relief.
Karen, who was part of the clinical studies, is thrilled she has her hands back, and she has another bonus.
"One of the best parts is now I can wear my wedding ring again," she said.
Unfortunately, Dupreytens disease does return, even with surgery.
There are risks to xiaflex, allergy reactions, nerve damage, and physicians need to be well trained before they can administer it.
Interestingly, Irish, English and northern Europeans are more prone to this condition than people in other parts of the world.
And men get it more often than women.