What Is Dupuytren's Contracture? Signs You Have It and How to Treat It

If you’ve been told you have Dupuytren’s contracture, it’s okay if you’re feeling a bit alarmed. The telltale lumps and cords in your hands and the curled fingers you can’t seem to straighten can be worrisome, especially if you’ve never heard of this condition before.

The good news: Dupuytren’s contracture isn’t dangerous or life-threatening, says Laura Reising, PT, DPT, a physical therapist at Hinge Health. In many cases, it isn’t even painful. But you shouldn’t ignore it, either. Physical therapy and hand and wrist exercises can help you maintain hand function.

Here, learn more about Dupuytren’s contracture — what it is, what causes it, and what you can do about it, including exercises recommended by Hinge Health physical therapists. 

What Is Dupuytren's Contracture?

Dupuytren’s contracture refers to the thickening of the fascia in the palm of the hand. Fascia is a sheath of connective tissue that supports every part of your body including muscles, tendons, ligaments, nerves, and organs.

As the fascia thickens and shortens, it can cause one or more fingers to curl in toward the palm (this is “contracture”). It’s difficult to predict how Dupuytren’s disease will progress. 

Some people may experience only a nodule or cord of thickened tissue in their hand without any contraction of their fingers. It may never worsen and actually get better. For others, straightening the fingers can become difficult or even impossible and fingers may become so bent that performing everyday tasks like washing dishes, buttoning shirts, picking things up, and opening doors becomes difficult. 

Dupuytren's Contracture Symptoms

Symptoms will vary depending on the progression and severity of the condition. Dupuytren’s contracture can be painful for some people, but the pain may go away over time. Others may never experience any pain with the condition. Other common symptoms of Dupuytren’s contracture include:

• A nodule or cord of thickened tissue in the palm of the hand.

• Pitting or dents in the skin near the nodule or cord.

• Contracture in the ring or pinky finger, but it can happen in any finger or multiple fingers across both hands.

• Inability to straighten one or more fingers.

• Inability to flatten the palm on a surface or fully open the hand.

• Difficulty grasping or picking things up.

Dupuytren's Contracture vs. Trigger Finger

The conditions can look very similar, so it’s easy to confuse them. Both Dupuytren’s contracture and trigger finger (a condition that results in the finger or thumb getting stuck in a curled position) can cause one or more fingers to curl toward the palm, making it hard to open your hand or lay it flat. Both can occur in any finger. However, Dupuytren’s contracture is less likely to happen in the thumb, while this digit is a common site for trigger finger. 

Despite appearances, the conditions are quite different when it comes to their contributing factors. 

• Dupuytren’s contracture involves the fascia in the palm and develops slowly over time.

• Trigger finger tends to occur more rapidly and results from inflammation in a tendon in the hand or finger, sometimes due to an injury. 

• Even though Dupuytren’s contracture cords may look like tendons, tendons aren’t irritated as a result of this condition.

Trigger finger is usually painful, while Dupuytren’s contracture can often be painless. With both conditions, your finger may be unable to straighten on its own, but with trigger finger, you can usually straighten it with some assistance. If left untreated, Dupuytren’s contracture may cause your finger to become locked in place.

Causes of Dupuytren’s Contracture

The cause of Dupuytren’s contracture is unknown, but there appears to be a genetic component, and it may be related to other diseases. Dupuytren’s contracture is the most common genetic disorder of connective tissue, which means it runs in families. The highest prevalence of the condition is in people with type 1 diabetes (34%) and type 2 diabetes (25%), compared to 8% in the general population, according to one study, but researchers don’t yet know why.

Other possible risk factors for Dupuytren’s contracture:

• Over the age of 50

• Male

• Smoking or drinking alcohol frequently

• Northern European descent

• Regular manual work with your hands

• Using vibrating tools, like drills, regularly

While you can’t control many of these possible causes or risk factors, not everyone who has them develops Dupuytren’s contracture. But knowing you may be at risk can mean earlier detection and treatment, which help with symptoms.

Treatment Options for Dupuytren’s Contracture

Dupuytren’s contracture treatment depends upon the severity of the condition. Some treatment options include:

Heat. “Heat can help loosen things up and increase blood flow to the area,” says Dr. Reising. “I like to do heat before stretching the fingers and hand.” Aim for about 10 minutes when you notice tightness or other symptoms. You can use a heating pad or put your hands in warm water. Washing dishes is a great way to warm the tissue and stretch it.

Movement. Stretching or any kind of hand movement is essential for maintaining mobility and the ability to perform tasks with your hands. Anytime your hands will be inactive or holding a position for a long time, like while driving or reading a book, take frequent breaks. You can do the exercises below or simply move your hands and fingers.

Physical therapy. “Physical therapy is beneficial during the early phases of Dupuytren’s contracture,” says Dr. Reising. “A physical therapist can do an assessment and customize treatment to help you manage your symptoms, so you can keep doing your daily activities.”

Splinting. Wearing a splint, especially at night, may help stretch the affected fascia and keep the fingers straight. Splinting may be best in early-stage Dupuytren’s contracture.

Injections. Cortisone injections are sometimes used, but a collagen-type injection followed by manual manipulation may offer better results, according to research. 

Surgery. Sometimes surgery is necessary if the contracture is severe and interfering with your ability to perform daily tasks.

When an area of the body becomes tight, the surrounding muscles and tissue can weaken. That’s why doing both stretching and strengthening exercises is a vital part of Dupuytren’s contracture treatment. Stretches will help to maintain flexibility and mobility, while strengthening exercises will help to increase grip strength. You can do the above exercises as often as you like. For best results, do them at least once a day and warm up your hands first to improve your range of motion.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Be Consistent

“Consistency matters,” says Dr. Reising. “Stretching is key to maintaining the mobility in your hands, but doing it once a week is not going to be enough. Try making it a habit and a part of your daily routine like brushing your teeth. It only takes a few minutes.” Aim to do the exercises at least once a day, says Dr. Reising.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Pidgeon, T.S. and Clinkscales, C.M. (2023, May). Dupuytren's Disease. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/dupuytrens-disease/   

2. Walthall, J., Anand, P., and Rehman, U.H. (2023, February 26). Dupuytren Contracture. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK526074/ 

3. Salari, N., Heydari, M., Hassanabadi, M. Kazemninia, M., Farshchian, N., Niaparast, M., Solaymaninasab, Y., Mohammadi, M.,Shohaimi, S., and Daneshkhah, A. (2020). The worldwide prevalence of the Dupuytren disease: a comprehensive systematic review and meta-analysis. Journal Orthopaedic Surgery and Research, 15:495. doi:10.1186/s13018-020-01999-7 

4. Nordenskjöld, J., Lauritzson, A., Åkesson, A., and Atroshi, I. (2019). Collagenase injections for Dupuytren disease: 3-year treatment outcomes and predictors of recurrence in 89 hands. Acta Orthopaedica, 90(6):517-522. doi:10.1080/17453674.2019.1663472 

5. Nanchahal, J., Ball, C., Rombach, I., Williams, L., Kenealy, N., Dakin, H., O’Connor, H., Davidson, D., Werker, P., Dutton, S.J., Feldmann, M., and Lamb, S.E. (2022). Anti-tumour necrosis factor therapy for early-stage Dupuytren’s disease (RIDD): a phase 2b, randomised, double-blind, placebo-controlled trial. The Lancet Rheumatology, 4: e407–16. doi:10.1016/S2665-9913(22)00093-5