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By Brittany Ferri January 12, 2021

Based on the information we've already provided you with, you know that Dupuytren's is very manageable in its earlier stages. Mild or new cases often cause one simple lump (also called a nodule). However, over time, this lump gets hard and can cause other symptoms to develop. The skin on the hands may start to appear dimpled. The lump may become sensitive to touch, but usually does not cause pain.

During the later stages of Dupuytren's contracture, there are chances of more severe effects. The knotted tissue cords under the skin start to extend to the fingers. When this happens, one or more affected fingers will involuntarily start to curl or pull towards the palm. This is when the condition does become more serious, since it is very difficult for someone to use their hand in this position.

Humans rely on equal parts of extension and flexion in the fingers to get through their days. Extension (when the fingers are fully straightened) is a position that can be useful, since people may be able to use their entire hand as a hook. However, when the fingers are fully flexed in the shape of a fist, people cannot place things inside them or use them to maneuver throughout their environment. At this point, people begin to have difficulty when performing a number of daily functions. It will also be hard to lay the hand flat down to give yourself support, balance, or stability.

Will I Be Able to Care for Myself?

With increasing severity, Dupuytren's may make it impossible to use the hands to perform certain tasks. At this point, the fingers may get permanently stuck in the bent position. This condition has even more of an impact on daily functions when it impacts both hands. In most cases that involve both hands, one hand usually demonstrates more severe symptoms than the other does. It is more common for the pinky and the ring finger to be impacted, since they are farthest away from the complex structures of the thumb. Sometimes, the middle finger is also impacted.

Thankfully, it is extremely rare for the index finger and thumb to see the effects of Dupuytren's contracture. This means most symptoms won't cause major issues during tasks such as writing, since most of the fingers curl in toward the palm to wrap around a writing utensil. By the time the condition gets very severe, a person will have issues opening the hand fully, grasping objects, and bending fingers to complete more delicate tasks.

How Severe is Dupuytren's Contracture Pain?

The pain associated with Dupuytren's contracture can vary from person to person. According to a majority of Dupuytren's patients, symptoms do not cause them pain. For this reason, pain is one topic that doesn't often come up during conversations about Dupuytren's.

In fact, this hand deformity can be extremely painful for some patients. The disease can often coexist with other painful hand diseases like arthritis, which makes it difficult to pinpoint the condition that is causing the discomfort.

Relief for Dupuytren's

Unfortunately, Dupuytren's cannot be cured. As the condition is not dangerous or life-threatening, many patients make the decision to leave it untreated. However, it is possible to find a treatment that helps slow down its progression and eases some of the uncomfortable symptoms. Once you opt for treatment, your doctor will devise a health plan based on your:

  • Age
  • Overall health status (including medical history and past procedures)
  • Severity of symptoms
  • Reaction to certain medications, therapies, or treatment
  • Prognosis, also known as the likelihood your condition will worsen over time
  • Personal preference 

Some of the following treatments are advised for many people:

  • Stretching: This is a good option for all cases, but it's usually most helpful for the mild ones. Stretching is usually recommended in combination with other treatments.
  • Steroid injections: This anti-inflammatory medication is injected into the lumps or nodules that have formed in the hand. You usually need multiple injections to effectively reduce the size of lumps. This is another option that is less effective in the later stages of the disease. If your fingers have already contracted, the steroid injection will not help straighten them.
  • Radiation therapy:  Radiation directs low-energy x-rays towards nodules to break them down and soften the thickening tissue. This is best when done in the early stages of the condition because it helps prevent contractures from developing.
  • Needle aponeurotomy: This is another non-invasive treatment that surgeons perform after numbing the area. They use a needle to divide the affected tissue without making any incision in the skin. 
  • Open surgery: This is performed by a surgeon who makes an incision to divide or remove the thickened tissue bands. Some surgeries will involve full removal, while others are only partially taken out.
  • All-Natural Dupuytren's Contracture Cream: For patients who want to avoid injections, needles, or surgery, this is a simple and effective option that cuts down inflammation. The lotion is applied directly to the skin on the hand twice per day. Noticeable results are generally seen after 30-45 days of use. There are no known side effects of this treatment option, so it is a safe solution for everyone.

When should you call your healthcare provider?

If you feel your symptoms have gotten much worse in a short time or your symptoms are causing you severe discomfort, you should immediately visit your doctor for an evaluation.

Brittany Ferri
Brittany Ferri

Brittany is a registered and licensed occupational therapist who has 6 years of clinical experience treating conditions such as Dupuytren's, arthritis, carpal tunnel, and more. She is passionate about educating others about their health.