With Dupuytren’s contracture, knots form underneath the skin of your fingers and palms. You may treat this condition with needling, surgery, enzyme injections, or certain at-home treatments.

Dupuytren’s contracture is a condition that causes nodules, or knots, to form underneath the skin of your fingers and palms. It can cause your fingers to become stuck in place.

It most commonly affects the ring and little fingers, but it can involve any finger. It causes the proximal and middle joints—those closest to your palms—to become bent and difficult to straighten. Treatment varies depending on the severity of the nodules.

Dupuytren’s contracture usually progresses slowly. Often, the first symptom is a thickened area on the palm of your hand. You could describe it as a lump or nodule that includes small pits on your palm. The lump is often firm to the touch, but it’s not painful.

Over time, thick cords of tissue extend from the lump. They usually connect to your ring or pinky fingers, but they can extend to any finger. These cords eventually tighten, and your fingers can become pulled into your palm.

The condition can occur in both hands, but usually, one hand is more affected than the other. Dupuytren’s contracture makes it difficult to grasp large objects, wash hands, or shake hands.

The cause of this disease is unknown. You may be more likely to develop Dupuytren’s contracture if you:

Some people are more likely to develop Dupuytren’s contracture than others, including people:

  • assigned male at birth
  • 40 to 60 years of age
  • of Northern European descent
  • with a family history of the condition
  • who smoke or drink alcohol
  • living with diabetes

Overuse of your hands, such as from doing a job that requires repetitive hand motions, and hand injuries don’t increase your risk of developing this condition.

A doctor or other healthcare professional will examine your hands for lumps or nodules. They will also test your grip, your ability to pinch, and the feeling in your thumb and fingers.

Your healthcare professional will also perform the tabletop test, which requires you to put the palm of your hand flat on a table. If you can do this, it’s unlikely you have the condition.

Your healthcare professional may take measurements and record the location and amount of contracture. They will refer to these measurements at future appointments to see how quickly the condition is progressing.

There is no cure for Dupuytren’s contracture, but it can be treated and managed over time. You may not need to begin treatment until you can no longer use your hands for everyday tasks.

Nonsurgical treatments are available. However, in more severe or progressed cases, your doctor may recommend surgery.

Treatment options include:

Needling

Needling involves using a needle to break the cords apart. This procedure can also be repeated if the contracture often comes back.

Needling has several advantages, including the ability to be done multiple times and a very short recovery period. However, it can’t be used on every contracture because the needle could damage nearby nerves.

Enzyme injections

Xiaflex is an injectable collagenase injection that weakens the cords. Your healthcare professional will manipulate your hand to try to break up the cord the day after you get the injections.

This is an outpatient procedure with a short recovery time.

The disadvantages are that it can be used on only one joint each time and that the treatments must be at least one month apart. The fibrous bands also recur frequently.

Surgery

Surgery removes the cord tissue. You may not need surgery until a later stage when the cord tissue can be identified.

Sometimes, removing the cord without removing the attached skin may be difficult. However, a healthcare professional can usually prevent this with careful surgical dissection.

Surgery is a permanent solution. The disadvantages are that it has a longer recovery time and often requires physical therapy to regain the full function of your hand.

If your healthcare professional removes tissue during the surgery, you will need a skin graft to cover the area, but this is rare.

At-home treatments

Some things you can do at home to ease your pain and other symptoms include:

  • stretching your fingers away from your palm
  • relaxing the contracture using massage and heat
  • protecting your hands by using gloves
  • avoiding gripping tightly when handling equipment

Dupuytren’s contracture isn’t life threatening. You can work with your doctor to determine which treatment options will work best. Learning how to incorporate treatment can help you manage your contracture.