Elbow, Wrist & Hand

What It Is

Dupuytren's contracture is when the layer of fibrous tissue (fascia) lying underneath the skin of the palm and fingers becomes thicker and less flexible (NHS, 2024; Royal Berkshire NHS Foundation Trust, 2024). It is not usually painful, but over time the thickened tissue can pull one or more fingers into a bent position (NHS, 2024). The condition is more common in men than in women, and it usually appears in middle age or later (British Society for Surgery of the Hand, n.d.).

Dupuytren's Contracture Anatomy

Just underneath the skin of your palm there is a layer of tissue, the fascia, that reinforces the skin. In Dupuytren's, firm lumps called nodules form in this tissue, often in line with the ring finger (British Society for Surgery of the Hand, n.d.). The nodules can feel a bit like calluses. In about one in three people, the nodules extend to form cords, which feel like strings under the skin. The cords pull the finger towards the palm and stop it straightening fully (British Society for Surgery of the Hand, n.d.).

Dupuytren's contracture develops very slowly over months or years. It mainly affects the ring and little fingers, and it is common to have it in both hands (NHS, 2024). It is not usually painful, but it can affect how you use your hand (NHS, 2024).

The exact cause is unknown, but it often runs in families, so it can be passed on in the genes. Smoking, drinking lots of alcohol, diabetes and epilepsy are all linked with Dupuytren's (NHS, 2024; British Society for Surgery of the Hand, n.d.). It occasionally appears after an injury or surgery to the hand or wrist (British Society for Surgery of the Hand, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Manage Dupuytren's Contracture

1. Keeping an Eye on It in the Early Stages

Dupuytren's contracture does not usually need any treatment in the early stages (NHS, 2024). Surgery is not needed if your fingers can still be straightened fully. A useful check is whether you can put your hand flat on a table; once you cannot, it is worth discussing treatment with a specialist (British Society for Surgery of the Hand, n.d.).

2. Hand Therapy After Treatment

The specialist will tell you what to expect after treatment, including exercises to do (NHS, 2024). After surgery, your hand may be fitted with a splint to wear at night, and hand therapy is important for recovering movement and function (British Society for Surgery of the Hand, n.d.). Follow your treatment team's own instructions on recovery. Once your surgeon says it's safe, I can support your recovery with scar work, gentle hands-on work and exercises alongside your hand therapy. See the My Approach tab for how I work.

Treatments you may want to discuss with your family doctor or nurse practitioner

If the condition is severe and you cannot straighten your fingers or use your hand normally, your family doctor or nurse practitioner may refer you to a specialist (NHS, 2024).

Options outside my scope

Needle fasciotomy: a needle is inserted at several places along the palm and finger to loosen the cord and straighten the finger, using a local anaesthetic (NHS, 2024).
Fasciectomy: surgery to remove the thickened tissue through a cut along the palm and finger (NHS, 2024; British Society for Surgery of the Hand, n.d.).
Dermofasciectomy: surgery to remove the thickened tissue together with the skin over it, which is replaced with a skin graft (NHS, 2024; British Society for Surgery of the Hand, n.d.).
Collagenase injection: an injection into the cord, which the British Society for Surgery of the Hand (n.d.) says is helpful in some cases.

The specialist will explain the benefits and risks of each option. Risks include bleeding, numbness and infection. Your finger may not be completely straight afterwards, and might not be as strong and flexible as it used to be (NHS, 2024).

How I can help (see the My Approach tab)

Scar work and gentle hands-on work for the hand once your surgeon says it's safe
Exercises that support your hand therapy and rebuild grip strength
Easing tension in the forearm, shoulder and neck

Tips

The condition can come back after treatment. About 20% of people need further treatment within 10 years after a fasciectomy or dermofasciectomy, and about 33% after a needle fasciotomy (Royal Berkshire NHS Foundation Trust, 2024). Most people who need surgery need only one operation in their lifetime (British Society for Surgery of the Hand, n.d.).
There is no cure, and it is not known whether you can prevent it or stop it coming back (NHS, 2024; British Society for Surgery of the Hand, n.d.).
The condition usually gets worse slowly, so it may not be troublesome until quite some time down the line (NHS, 2024).
In many people the nodules never go on to form cords, so it may never go beyond lumps in the palm of the hand (British Society for Surgery of the Hand, n.d.).
Those who drink large quantities of alcohol are more prone to the condition (NHS, 2024).
As you grow older, the condition becomes more common (British Society for Surgery of the Hand, n.d.).

Treatment

My Approach

Dupuytren's contracture is managed by your family doctor or nurse practitioner and, if needed, a hand specialist. Massage can't undo the thickened tissue or straighten a bent finger, but I can help your hand and upper body feel and work better around it, and support your recovery after treatment.

After a needle fasciotomy or surgery, your treatment team decides when you can use the hand, how long you wear a splint and which exercises you do. I work inside those limits and need your surgeon's okay before any hands-on work on the hand.

I start by assessing how far each finger bends and straightens, your grip, and how your wrist, shoulder and neck are coping.

Before Any Treatment

Warmth, then gentle massage and stretching for the palm, fingers and forearm, never forcing a finger straight
Work through the forearm, shoulder, upper back and neck
A warm soak, self-massage and slow finger stretches for home

After Treatment

Nothing on the wound at first, then gentle lymphatic drainage around it for swelling
Scar work once the wound has fully healed
Gentle hands-on work and movement for a stiff hand, alongside your hand therapy exercises
Grip and forearm strengthening as your team allows

If a finger bends further or you can no longer put your hand flat on a table, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Visits are usually weekly, around half an hour, for about six weeks, then we reassess and space them out as you manage more on your own; after surgery, this starts once your surgeon has cleared you. Your treatment team will tell you what recovery to expect, and getting back full use of the hand often takes a few months.

What I Focus On

Working Within Your Team's Limits

Gentle Palm & Finger Mobility

Scar Work

Upper-Body Tension Relief

Grip Strength

Please read

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

See your family doctor or nurse practitioner if one or more of your fingers are bent and you cannot put your hand down flat, or you are having difficulty with daily activities (NHS, 2024).

Sources

References

NHS (2024) Dupuytren's contracture. Available at: https://www.nhs.uk/conditions/dupuytrens-contracture/ (Accessed: 7 October 2026).
British Society for Surgery of the Hand (n.d.) Dupuytren's disease. Available at: https://www.bssh.ac.uk/patients/conditions/25/dupuytrens_disease (Accessed: 7 October 2026).
Royal Berkshire NHS Foundation Trust (2024) Dupuytren's disease (patient information leaflet). Available at: https://royalberkshire.nhs.uk/media/dx4pc0x2/dupuytrens-disease_aug24.pdf (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooDupuytren's Contracture

What It Is

Dupuytren's Contracture Anatomy

Self-Care & Treatment

How to Manage Dupuytren's Contracture

1. Keeping an Eye on It in the Early Stages

2. Hand Therapy After Treatment

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Before Any Treatment

After Treatment

Typical Course

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooDupuytren's Contracture

What It Is

Dupuytren's Contracture Anatomy

Self-Care & Treatment

How to Manage Dupuytren's Contracture

1. Keeping an Eye on It in the Early Stages

2. Hand Therapy After Treatment

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Before Any Treatment

After Treatment

Typical Course

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

References

Related Conditions

Rheumatoid Arthritis

Hand Osteoarthritis

Thumb Osteoarthritis

Trigger Finger

Book a session