Dupuytren's Contracture

Common Symptoms

• A firm nodule or cord of tissue in the palm, often near the base of the ring or little finger
• Gradual inability to fully straighten one or more fingers
• Tenderness in the nodule, particularly earlier in the condition
• Difficulty with tasks requiring a flat hand, such as putting on gloves or shaking hands fully

Why It Happens

The connective tissue layer beneath the skin of the palm (the palmar fascia) thickens and contracts for reasons that aren't fully understood, though genetics play a significant role — it's more common in people of Northern European descent and often runs in families. It's also associated with diabetes, smoking, and certain other conditions.

Why It Can Become Persistent

Once the connective tissue has contracted, it generally doesn't loosen back up on its own — this is a structural, progressive change in the tissue itself, which is why established contracture typically needs a targeted procedure rather than time or exercise alone to improve.

Who Commonly Gets It

Dupuytren's contracture is most common in men over 40 of Northern European ancestry, and tends to run in families.

How It Is Usually Diagnosed

Diagnosis is clinical, based on the characteristic nodules and cords in the palm and the pattern of finger contracture. A hand specialist can assess severity and monitor progression over time.

Traditional Treatment Options

• Observation: For mild, non-progressive cases without significant functional limitation, monitoring is often appropriate.
• Needle aponeurotomy: A minimally invasive procedure to release the contracted cord using a needle, for appropriate candidates.
• Enzyme injection (collagenase): An FDA-approved injectable option that breaks down the contracted cord for qualifying cases.
• Surgical fasciectomy: Removal of the affected tissue, generally reserved for more significant or recurrent contracture.

Why Someone Might Start Looking for Another Option

Because established treatments for Dupuytren's are procedural (needle release, enzyme injection, or surgery), people with earlier-stage disease — nodules, tenderness, or mild contracture — sometimes look for non-invasive options to address symptoms, which is where shockwave therapy research comes in.

Where Shockwave Therapy May Fit

The evidence here is early and comes from small studies: a pilot study comparing radial and focused shockwave therapy found both reduced pain and improved function, with radial shockwave showing an edge for pain reduction and focused shockwave showing an edge for reducing nodule size; a separate small, uncontrolled study found continued improvement in pain and finger contraction angles over 14 weeks. We want to be direct that these are small, early-stage studies (one without a control group) — this is not established treatment for reversing established contracture, and the enzyme injection and procedural options above remain the primary evidence-based treatments for functionally significant contracture.

How Shockwave Treatment Works for This Area

If considered appropriate after evaluation by a hand specialist, shockwave therapy would be applied to the affected palmar tissue — this would be discussed as an early-stage, symptom-focused option, not a substitute for procedural treatment when contracture is already functionally significant.

What the Treatment Feels Like

Most patients describe a firm tapping or pressure sensation directly over the nodule or cord in the palm; your provider will discuss what to expect.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• Anyone who has not yet had a hand specialist evaluation, particularly with functionally significant contracture
• Anyone seeking this as an alternative to needle aponeurotomy, enzyme injection, or surgery for established, functionally limiting contracture
• Active infection or open wounds at the treatment site

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.