Quick Summary
Dupuytren's contracture is a slowly progressive thickening of the tissue in your palm that can pull one or more fingers towards the palm, most often the ring and little fingers. It cannot be reversed by physiotherapy, and established contractures are corrected only by a hand surgeon.
Our physiotherapists focus on what conservative care can genuinely help with — monitoring changes, keeping your hand mobile and functional, supporting your recovery after any surgical procedure, and referring you promptly when specialist treatment is indicated.
What Is Dupuytren's Contracture?
Dupuytren's disease is a benign but progressive thickening of the connective tissue (fascia) in the palm and fingers. Specialised cells called myofibroblasts multiply and lay down excess collagen, gradually shortening the fascia and drawing the finger into a bent position that cannot be straightened fully.
The condition typically progresses through three stages — a firm nodule forms in the palm, a cord then develops running towards the finger, and finally a contracture pulls the finger inward. Skin pitting and puckering are common, and any early tenderness usually settles over time. In roughly one affected person in three, nodules extend into cords that prevent the finger straightening, developing over months and years rather than weeks.
Dupuytren's is common in the UK, affecting around 4% of the population and rising to approximately 20% of those aged over 65. It is up to six times more common in men and is strongly associated with Northern European ancestry.
Sources: NICE Clinical Knowledge Summaries; British Society for Surgery of the Hand (BSSH), 2016; Hindocha et al., Hand, 2009.
Do You Experience These Symptoms?
✓ A firm nodule or lump in the palm, often in line with the ring finger
✓ A thickened cord of tissue running from the palm towards one or more fingers
✓ Pits, dimples or puckering of the skin of the palm
✓ One or more fingers gradually bending towards the palm, most often the ring and little fingers
✓ Increasing difficulty straightening the finger fully, so your hand cannot be laid flat on a table
✓ Difficulty with everyday tasks such as putting your hand in a pocket, washing your face or wearing gloves
✓ Nodules over the back of the finger knuckles (Garrod's pads) in some people
These symptoms can be treated.
The sooner you begin, the better your chances of a smoother recovery.
What Causes Dupuytren's Contracture?
• Genetics and family history
Dupuytren's has a strong hereditary component and often runs in families. If a close relative is affected, or your disease started before the age of 50, you are more likely to have a more aggressive form.
• Ancestry, age and sex
The condition is most common in people of Northern European descent, in men, and with increasing age. Prevalence rises steeply after middle age, which is why new nodules commonly appear from your fifties onwards.
• Diabetes
Diabetes is a well-recognised association, with research suggesting Dupuytren's affects around a quarter to a third of people with diabetes, usually in a milder form. Regular hand checks are sensible if you have diabetes and notice palm changes.
• Smoking and alcohol
Heavier alcohol intake and smoking both modestly increase the risk in a dose-dependent way. This is thought to occur through effects on small blood vessels and tissue oxygenation in the palm.
• Other associations
Links with epilepsy, certain anti-seizure medications, heavy manual work and vibrating tools have been reported, but the evidence remains genuinely uncertain. We present these honestly as unresolved rather than established causes.
How We Treat Dupuytren's Contracture at J&J Therapy
Hands-On Manual Therapy
Our HCPC-registered physiotherapists begin with a thorough hand assessment — examining your nodules and cords, measuring any contracture at the knuckle and finger joints, and using the tabletop test to gauge progression. We are honest with you: manual therapy cannot dissolve cords or reverse an established contracture. Hands-on care can help with comfort, maintaining the mobility of surrounding joints and tissues, and keeping your hand as functional as possible while we monitor the condition and refer you onward at the right moment.
Shockwave Therapy*
Swiss Storz Medical MASTERPULS radial shockwave therapy may complement your manual therapy and exercise programme when your physiotherapist identifies specific indications during assessment — for example, a painful palmar nodule in early disease. Non-invasive and well tolerated, though we are open with you that the evidence for shockwave in Dupuytren's is limited and emerging, and it cannot straighten an established contracture.
Targeted Exercise Programme
Our targeted exercise programmes have two genuine roles. Before any procedure, gentle range-of-motion and stretching exercises may help you maintain mobility and function, though they do not stop the disease progressing. The most important role is after surgery — hand therapy is integral to recovery from fasciectomy, needle fasciotomy or collagenase treatment. We guide you through swelling control, scar management, and progressive exercises to restore finger extension, strength and hand function, and can support night splinting where your surgeon recommends it.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
A finger bending towards the palm noticeably faster than over months — for example, over a few weeks
Spreading redness, increasing pain, swelling, discharge or fever after any hand procedure
Sudden loss of hand function, numbness or an inability to move the finger, particularly after a procedure
Lumps over the knuckles, soles of the feet or elsewhere alongside early-onset palm disease, which may suggest a more aggressive form needing specialist assessment
FAQs About Dupuytren's Contracture
Can physiotherapy straighten my finger?
No — and we will always be honest with you about this. Physiotherapy cannot reverse an established Dupuytren's contracture, and there is little evidence that it slows the disease. What we can do is help you maintain hand mobility and function, ease discomfort from nodules, support your recovery after any procedure, and refer you to a hand surgeon at the right time.
When will I need surgery, and who decides?
Treatment is only needed when the contracture interferes with hand function. Referral to a hand surgeon is usually indicated when the knuckle joint contracture reaches about 30 degrees, when there is any contracture at the middle finger joint, or when you cannot lay your palm flat on a table. We monitor your contracture angles and make a timely referral so you are seen before the condition progresses too far to correct well.
Will it come back after treatment?
It can. Dupuytren's is a chronic condition and no treatment eradicates the underlying disease, so recurrence is common — highest after needle fasciotomy and lower after more extensive surgery such as fasciectomy. Your surgeon will discuss the trade-offs, and we can support your rehabilitation whichever route you take.
Can shockwave therapy help my Dupuytren's contracture?
Possibly, for pain from early nodules — but the evidence is limited and emerging, and shockwave cannot straighten an established contracture. We never offer it as a first-line treatment; we only consider it when your assessment indicates it may help alongside your manual therapy and exercise programme.
Is Dupuytren's contracture painful?
Usually not. It is typically painless, and any tenderness from early nodules tends to settle over time. Because it is not primarily a painful condition, treatment decisions are guided by loss of function rather than pain.
This page is for general information only and does not replace professional medical advice.
Reviewed by Lavya Arigalayan, MSc, HCPC Registered Physiotherapist.
Last reviewed:
2026년 8월 20일