Often, it starts subtly. You might notice a small lump in the palm of your hand. It isn’t painful, but it's firm and a little odd. Then you start to notice you're struggling to lay your hand flat on a table, or your fingers don’t extend like they used to when you stretch. Gripping a steering wheel, shaking hands, or even putting gloves on begins to feel different. Over time, one or more of your fingers start to curl inward toward the palm. This is often how Dupuytren's Contracture begins. A subtle, creeping change that slowly starts to change your hand function and your daily routine.
What Is Dupuytren's Contracture?
Dupuytren's Contracture is a hand condition where the tissue beneath the skin of your palm thickens and tightens over time. This fibrous tissue, known as fascia, can form cords that pull one or more of your fingers into a bent position. Once a finger is bent, it may not straighten fully, limiting your ability to perform daily activities.
Dupuytren's Contracture most commonly effects the ring and little fingers and usually progresses slowly over months or even years. Though not typically painful, it can significantly impact your hand function and quality of life.
Symptoms of Dupuytren's Contracture
Symptoms of Dupuytren's Contracture tend to develop gradually. Many people don’t notice anything is wrong until the condition has significantly progressed.
Nodules: Small, firm lumps in the palm that may feel tender early on.
Cords: Thickened tissue under the skin that may appear like a rope or string pulling the finger down.
Difficulty with daily tasks: Trouble placing the hand flat on surfaces, putting on gloves, or shaking hands.
Contracture: Fingers, especially the ring and little fingers, begin to bend toward the palm and can’t be fully straightened.
Causes of Dupuytren's Contracture
The exact cause of Dupuytren's Contracture is still not fully understood, but several contributing factors are known. It seems to be a combination of genetic and environmental triggers that lead to the thickening of connective tissue in the hand.
Contributing factors for developing Dupuytren's Contracture:
Genetics: A strong family history suggests a hereditary link.
Age: Most common in people over 50.
Gender: Men are more likely to develop it than women.
Ancestry: People of Northern European descent have a higher risk.
Lifestyle factors: Alcohol use and smoking have been linked to increased risk.
Can You Prevent Dupuytren's Contracture?
Unfortunately, there is no guaranteed way to prevent Dupuytren's Contracture, especially if you have a strong genetic predisposition. However, managing certain lifestyle choices may help reduce the risk or delay its onset.
Avoid smoking: Smoking is linked to blood vessel constriction, which may influence tissue changes.
Limit alcohol: Excessive alcohol intake may increase risk.
Control diabetes: Dupuytren's is more common in people with diabetes, so maintaining good blood sugar control may help.
Is Dupuytren's Contracture Genetic?
Yes, Dupuytren's Contracture is strongly linked to genetics. If you have a family history of the condition, you have a higher chance of developing it. It is often referred to as a hereditary condition, especially prevalent among those of Northern European ancestry.
This doesn’t mean you’re guaranteed to develop it, but you may want to keep an eye out for early signs and consult a healthcare provider if you notice symptoms.
What Helps Dupuytren's Contracture?
While Dupuytren's Contracture cannot be cured entirely, several treatments and management strategies can help maintain hand function and slow progression.
Stretching and hand therapy: Gentle exercises may improve flexibility in early stages.
Splinting: In some cases, night splints may be recommended to keep fingers extended.
Steroid injections: Can reduce inflammation in early stages.
How to Treat Dupuytren's Contracture
When the condition begins to interfere with your hand function, more active treatments may be helpful. These treatments for Dupuytren's Contracture can range from minimally invasive procedures to surgery.
Surgery (fasciectomy): In more severe cases, the thickened tissue is surgically removed.
Needle aponeurotomy: A needle is used to break the cords of tissue causing finger contraction.
Enzyme injections (collagenase): An enzyme is injected to soften and break down the cords.
What Makes Dupuytren's Contracture Worse?
Several factors may accelerate the progression or severity of Dupuytren's Contracture. Understanding these can help you avoid worsening the condition.
Ignoring symptoms: Delaying treatment can make eventual correction more difficult.
Injury to the hand: Trauma may exacerbate symptoms.
Smoking and heavy alcohol use: Both are associated with higher risk and more aggressive progression.
Do Certain Careers Make Dupuytren's Contracture More Likely?
Overuse or certain jobs have not been definitively proven to cause Dupuytren’s Contracture. While it might seem like repetitive hand use or manual labor is the culprit (especially because many people who do physical work notice the symptoms), research hasn’t confirmed a direct cause-and-effect link.
Some people used to think Dupuytren’s Contracture was mostly a problem for manual laborers because of things like hand strain or using vibrating tools. But more recent research shows it can affect anyone, no matter what kind of job they have, even people who work at desks all day. Physical work might make the symptoms show up sooner, but it doesn’t actually cause the condition. If anything, overusing your hands once Dupuytren’s has started might make it worse, but it’s not the root cause.
Making practical adjustments to your daily activities can help you maintain your independence and comfort as you manage Dupuytren's Contracture.
Modify tools and grips: Use ergonomic handles and adaptive devices for easier grip.
Stay active: Gentle hand stretches and overall fitness support circulation and mobility.
Monitor for progression: Regularly assess hand function and stay in touch with a provider.
When to See an Orthopedic Hand Specialist for Dupuytren's Contracture
If you notice any signs of finger contracture or thickened tissuein your palm, you should see a hand specialist. Early diagnosis can lead to better treatment outcomes.
Signs it’s time to see a specialist:
You can’t lay your hand flat on a table.
You notice visible cords or lumps.
Daily tasks like writing or grasping are becoming difficult.
How a Hand Specialist Diagnoses Dupuytren's Contracture
Diagnosis usually involves a physical examination. An orthopaedic hand specialist will assess the flexibility of your fingers and look for nodules or cords in the palm.
What the evaluation includes:
Tabletop test: You try to lay your hand flat on a table.
Palpation: The doctor feels for cords and nodules.
Range of motion: They assess how far you can move your fingers.
Yes, while there is no cure, Dupuytren's Contracture is treatable. With appropriate care, many people regain much of their hand function or prevent further deterioration. Early intervention is often key.
Treatment outcomes vary based on the severity of the condition and the method used. Some treatments offer lasting relief, while others may need to be repeated.
The Future with Dupuytren's Contracture
Living with Dupuytren's Contracture can be manageable with awareness and timely care. Many people continue to live active, fulfilling lives with the help of therapy, medical treatments, and modifications. Emerging therapies and surgical techniques continue to improve outcomes.
Stay informed, stay proactive, and don’t hesitate to seek help when changes begin.
What Not to Do If You Have Dupuytren's Contracture
Avoiding certain actions can help prevent further damage or worsening of the condition.
Do not ignore changes: Early symptoms matter.
Avoid forceful stretching or self-treatment: This can injure tissue.
Don’t skip follow-ups: Regular monitoring can catch progression early.
Avoid smoking and excessive alcohol: Both contribute to worsening the condition.
This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.
