David William Zeltser, MD
Stiff hands can interfere with quality of life, whether it creates just a mild annoyance or a severe limitation. Treatment depends on the cause; stiffness can originate with injury, arthritis, tendonitis, or a variety of other causes. A hand surgeon can help determine the underlying problem and implement an appropriate treatment plan that may involve home exercises, hand therapy, injections, and in some cases, surgery.
Why can’t I straighten my finger?
Dupuytren’s Contracture is a benign disorder of the hand that may result in tightening of the palm and bending of the fingers. When it begins, the palm or finger(s) appear to have bumps and later may develop a rope-y appearance. It is not usually painful, but in some cases, discomfort is reported. The condition is most common in men (almost 5 to 1 versus women) of Northwestern European descent and onset increases with age (over 40).
The condition usually starts with the first knuckle. If it progresses, the middle knuckle may also bend. The fingers most affected are the ring and small, with possible progression to the long, index and thumb. Early signs of Dupuytren’s Contracture may include the appearance of “pitting/dimpling” in the palm. It may become difficult to place the hand on a flat surface, put on gloves, or put the hand in a pocket.
Dr. Steven H. Goldberg answers your questions about Dupuytren’s contracture.
I noticed a new lump on the palm of my hand, and I noticed my tendon is visible and tight where I can’t fully straighten my finger. What could this be?
Dupuytren’s contracture, or fibromatosis, is a condition that can cause lumps on the palm of the hand; it also causes cords on the palm or fingers. The cord is not the tendon but rather a thickening of the fascia, a normal structure below the skin. The cord contains myofibroblasts which have a muscle-like quality that pull on the skin causing puckering, dimpling, and bending of the finger. The lumps and cords can also occur on the soles of the feet. Some people are more likely to have this disease due to genetics.
How do you know this lump is Dupuytren’s and not cancer?
Most lumps in the palm are not cancerous. Skin cancers are more common in sun-exposed areas, so a lump on the back of the hand is more likely to be cancerous compared to one on the palm. Dupuytren’s lumps in the palm of the hand most commonly form in the ring and small finger. Skin puckering or dimpling can occur, and you typically can’t fully straighten your fingers. This loss of motion is less common with other masses or tumors. Dupuytren’s lumps are typically not painful and usually do not grow much. A more worrisome bump or lump is often painful, can have rapid growth, and can either be painful at night or when resting. If a patient is very concerned about the lump, it can be surgically biopsied to confirm it is Dupuytren’s contracture.
The lumps can be uncomfortable in some people, but Dupuytren’s contracture is not typically painful. Sometimes, no treatment is necessary for this condition. For more severe cases, treatment options may include injections, medicine or hand therapy.
Watch this short video to learn more. Read about Dupuytren’s contracture on www.HandCare.org.
