While some people with Dupuytren’s may only have the bumps underneath the skin, most experience worsening symptoms that can result in impaired function and mobility of the fingers without treatment. “Eventually, patients have a difficult time straightening their fingers,” said Dr. Osei.

For those who may experience a tough time putting their fingers into gloves, this might be a sign of Dupuytren’s. “Because of a finger bend, you might find it difficult to straighten your finger to get a glove on,” noted Dr. Osei. Similarly, when you go to put your hands in your pockets, four fingers might go in just fine, but one may get caught on the pocket.

Dr. Osei explained the condition doesn’t usually affect the ability to grip objects or make a fist, fortunately, however you may notice that you have a decreased range of motion in your fingers and hand. If you play golf or tennis, you may find that you can’t hold the tennis racket or golf club the way you used to.

Getting the correct diagnosis as early as possible can lead to treatment working more effectively. “When people haven’t heard of Dupuytren’s, they can’t recognize when it happens,” cited Dr. Osei. “That leads to delays of people coming into the office. We find that the earlier you recognize it and treat it appropriately, the better outcomes patients have,” he added.

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Patients who only have some bumps in the hand that aren't causing discomfort or interfering with daily activity, may not require treatment according to the American Academy of Orthopaedic Surgeons (AAOS). However, patients who are unable to lay their hand flat on a table, will likely need to be treated, noted Dr. Osei.

Enzyme injections are a nonsurgical treatment option that can lead to faster recovery and possibly better control of the disease. An enzyme called collagenase clostridium histolyticum is injected into the cord in the palm to soften and weaken it. “The enzyme works by breaking down the cord,” explained Dr. Osei. The patient then comes back to their physician’s office a day or two later, at which point the physician will move the hand to break the cord, enabling the patient to straighten their fingers. While there is a lower risk of complications compared to surgery, depending on the location of the contracture, there may be a greater risk of injuring a nerve or blood vessel in your fingers, noted Dr. Osei.

Needle aponeurotomy is another nonsurgical outpatient treatment, which the patient receives an injection of anesthetic in the area with the Dupuytren’s cord. A physician then takes a small needle and perforates the cord so it can snap, allowing the fingers to straighten. “This is much like breaking up a rope with a jagged rock,” explained Dr. Osei.

A physician will gauge whether a patient should be treated with surgery based on how serious the Dupuytren’s contracture is. “To me, the severity of the contracture is the biggest criteria,” said Dr. Osei. Everyone heals differently, and some may experience more swelling or discomfort than others, but by 8 weeks post-surgery, the majority of patients are able to do most activities, he added.

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Dr. Carlson explained Dupuytren’s disease forms scars in your palm for no reason, typically beginning in your 50s or 60s. Often this takes shape as a lump or cord in the palm or fingers. Dupuytren’s disease also occurs in the soles of the feet or alongside Peyronie’s disease. It is a genetic condition, however your parents or children will not necessarily have it. It is more common in men and people of Nordic descent. When it occurs in women, they more commonly have a relative with the disease.

Cords can cause the fingers to contract, preventing a person from straightening them. If there is no contracture, treatment is usually not necessary. Once contracture starts, there are several options for treatment.

According to Dr. Carlson, surgery is the gold standard and involves removing all diseased scar tissue. This allows the finger joints to straighten and has a 5% chance of requiring another procedure within five years. Collagenase clostridium is injectable medication that dissolves collagen, which makes up the cords.

Needle aponeurotomy is a procedure in which the surgeon uses a needle to cut the cords and extend the finger. This similarly does not require surgery but carries a small risk of injuring a nerve in the finger and has a higher recurrence rate. It is better to treat contracture once it begins instead of waiting for it to be severe. If you think you may have Dupuytren’s, Dr. Carlson advised to see a healthcare provider to determine if treatment is needed.

This article appeared in the print edition on February 28, 2021.