What is the problem with my hand? Why can’t I straighten out my pinky and ring finger?

No confident answer can be given to this question based on this single finding of fingers that are stuck in the bent position.  One of the possible reasons for fingers that won’t straighten out is Dupuytren contracture.  

Good news about Dupuytren contracture treatment and those bent fingers

Surgery is not always necessary to restore the limited finger movement of Dupuytren’s contracture.  Since 2002 the Dupuytren Contracture Institute has helped people from all parts of the world use natural Alternative Medicine therapy to help those who can’t extend their fingers because of DC.  Our position has always been that while hand surgery is always an option, it makes sense to first attempt non-surgical treatment and therefore possibly avoid the inherent risks of surgery.

Results of Alternative Medicine treatment of Dupuytrens contracture therapy

What is Dupuytren’s contracture?

Dupuytren’s contracture is a soft tissue problem of thickening and shortening of the deep supporting tissue of the hand (palmar fascia), found immediately above the bones and tendons and below the skin of the hand.  This thickening and shortening that takes place below the skin surface causes lumps on the palm of the hand that results in constricted fingers that are bent down toward the palm preventing the hand from being opened without pain.

Dupuytren hand contracture is slowly progressive as the nodules or lumps on the palm of the hand cause the involved fingers to not straighten out and permanently get stuck in the flexed position with the fingertips toward the palm. Both hands are affected half of the time, and the right hand is more often affected when only one hand develops the problem. One or more fingers can be affected at the same time; usually the ring finger won’t extend or the pinky finger won’t extend – or both fingers can’t open normally.

The cause of Dupuytren’s contracture is unknown, but it does appear to have some strong genetic association since seven out of 10 people who are diagnosed with Dupuytren contracture have a family history of the condition.   Further supporting the genetic input of these hand nodules is the finding that those people who have a Scandinavian or North European ancestry (Ireland, England, Wales and Scotland), are far more likely to develop hand nodules than dark skinned people.  It is more common in those over 40 years of age, and men (70%) more often women (30%).  There is still controversy and diverse opinion about the unclear relationship of other disease and environmental factors and the development of Dupuytren contracture:

  • Liver disease
  • Epilepsy
  • Trauma
  • Alcoholism
  • Diabetes

How do I know it is Dupuytren that is causing my fingers to not straighten out? 

As discussed above, there are more than one reason to explain why the pinky and ring finger won’t extend.  The reader can develop a fairly confident conclusion if the hand stiffness is due to Dupuytren contracture when several of these factors are present:

  • Age 40+
  • Male
  • Family descended from England, Ireland, Scotland, Wales, or a Scandinavian country
  • One or more family members have Dupuytren contracture
  • Palm lump at the base of the pinky and/or ring finger
  • Treated for epilepsy
  • Diabetic
  • Alcohol abuse or liver disease

Is this the only thing that could cause my ring finger to not straighten out any more?  Why do I have a bent little finger now?  

First, let’s consider the obvious cause for a lump or density to appear on the palm of anyone’s hand, so you do not have to worry this common and normal palm nodule.   If you have recently begun using your hands in a new way (a new job in a factory or construction, recently started a hobby like gardening or wood working, or heavy housework for a few days in the springtime), that small painful palm lump might be a callus.  Think back to what new activities, or greater work associated with old activities, that could prove your hand nodule is nothing abnormal.

If you cannot otherwise account for the new lumps on the palms, then it could be a rather common condition called Dupuytren’s contracture.

>> Natural Dupuytren Contracture Treatment – FAQs

Let’s also consider another explanation why the hand will not open as it once did:  trigger finger (stenosing tenosynovitis).  This is really not anything more than a swollen tendon in the palm of the hand that periodically locks up finger movement when it encounters a narrowed part of the tendon sheath that surrounds it.   Any finger or thumb can display a trigger finger reaction in which the affected digit suddenly catches while in a bent position and just as suddenly releases the hold – like a trigger when it is pulled and suddenly snaps as it is  released.  Trigger finger can be occasional or frequent, mild or severe, locked in a bent position for a short or prolonged time, and mildly or severely painful.

The great differentiation between the locked finger of trigger finger and Dupuytren contracture is the trigger finger has a very sudden onset and release with a popping sound, and it is apparently normal between episodes.  While the stuck finger of Dupuytren contracture is slowly progressive, and does not release because it is constant.

Let’s explore this problem through a few questions commonly asked by people who want to know more about their inability to extend their fingers.

Are the Dupuytren nodules or cords a type of tumor of the hand?

No, Dupuytren’s contracture is not a cancerous tumor, although certain hand problems that also cause hand pain, reduced finger movement and swelling are cancers (giant cell tumor or epitheliod sarcoma).  This is the reason it is strongly suggested to have your doctor evaluate your hand complaints and determine a clear diagnosis of the condition that is causing the problem straightening out the fingers and making it so you cannot open your hand without pain.

What keeps my fingers bent all the time and why won’t my fingers straighten out?

Dupuytren contracture begins as a thickening of the deep tissue of the palm (palmar fascia), located below the skin and above the bones and tendons of the palm.   This thickened state slowly progresses and the involved tissue also shortens at the same time, gradually allowing less and less movement until the fingers are constricted completely into a modified fist.  In the early stage of Dupuytren contracture as the palm lumps develop, it is not possible to flatten the hand on a tabletop and pain accompanies it. Later as cords develop from the nodules, the reduced finger movement makes the stiff fingers more pronounced until they come closer to the palm of the hand.

Is this why my pinky finger and ring finger won’t extend open?

Exactly.  People comment that when their Dupuytren contracture starts they can’t open the hand without pain and they experience great clumsiness.  Over time this changes to gradually prevent the  involved finger so it won’t straighten out completely, sometimes eventually constricting finger movement completely.

Is this the reason I can’t open my hand without pain?

Pain is a common complaint when Dupuytren contracture begins, often described as constant stinging and burning pain wherever there are lumps on the palm of the hand.   Over time as each finger gets stuck in a constant bent position, less pain is felt usually.

Generally, Dupuytren contracture is not thought of as a very painful condition; it is known mostly for the bent fingers, inability to fully open the hand, and the palm lumps.

Comments

12 Responses to “What is the problem with my hand? Why can’t I straighten out my pinky and ring finger?”
  1. Tina Ferry says:

    I been having times were my ring finger won’t open. .. but then after a little while. …it does open
    .
    Would this be considered the first stage of Dupuytren’s contracture?

  2. Dr.Herazy says:

    No, Tina, what you report does not sound like Dupuytren’s contracture. You probably have a trigger finger developing. I suggest you see your doctor about it. TRH

  3. Andrea Shulman says:

    None of my fingers are strait except my thumb( from the middle up) it’s been this way my entire life…
    Would this information about Dupuytren’s contracture apply to me?

  4. Dr.Herazy says:

    Greetings Andrea,

    No, there is little chance you have Dupuytren ‘s contracture. What you suggest you have is a mild congenital deformity of your hands. Dupuytren’s contracture is a fibrous buildup of foreign tissue in the palms and fingers that occurs usually in people during the 4th to 5th decade of life (sometimes earlier) in one or two of their hands which previously did not display such fibrous tissue. As a result of these fibrous nodules and cords the typical Dupuytren’s contracture of one or more fingers develops in which there is reduced extension (straightening) of the involved fingers. TRH

  5. Mike says:

    This Dupuytren’s contracture started before the end of my tour in eastern asia and i went to several doctors when my fingers on my right hand got worse they basically said i was to young for AR and said it was Dupuytrens. And yes i do have nodes in my palm and yes i have gone thru my family history and no one has any hand problems. i keep check with the military but no new info.
    Could acupuncture help or cure to get my fingers back ?

  6. Dr.Herazy says:

    Greetings again Mike,

    You ask if acupuncture could help or cure your Dupuytren’s contracture. No one can give you a yes or no answer to that question because Dupuytren’s contracture is a very difficult condition with so many complex factors that affect recovery. I can only shrug my shoulders and speculate that it probably could help to a degree, maybe a little or maybe a lot.

    One thing I do know is that the DCI method, in addition to about 12 other therapies, also uses a non-needle acupuncture device to deliver stimulation to acupuncture points around the Dupuytren’s contracture palm lumps and cords. Since 2002 I have seen that the larger the Alt Med plan that is used to support the body’s ability to heal the DC fibrous tissue, the better the results are likely to be. That is why DCI proposes that multiple therapies are used against Dupuytren’s contracture. I have not seen that any one Alt Med therapy method or product is sufficient to help the body get rid of the Dupuytren’s contracture material. Look around this website to see this idea makes sense to you. Good luck with your Duppuytren’s contracture, sir. TRH

  7. Mike Sauber says:

    I’m of Scandinavian heritage, over 40 and have an older brother who has Dupuytren’s Contracture. I have a lump on my right palm below baby finger, but no signs of contraction yet. I just got a broken blood vessel right next to it below my ring finger. As it has healed, it appears to be a hard spot very similar to my pinky lump. Perhaps the lump was there before and never noticed it until the broken blood vessel? Is there any relationship with a broken blood vessel and Dupuytren’s contacture?

  8. Dr.Herazy says:

    Greetings Mike,

    Dupuytren’s contracture is not known specifically to be caused by broken blood vessels in the hand; for DC to occur broken blood vessels must not always be present. However, hand trauma can serve as a DC trigger in those who are otherwise genetically predisposed to this problem. You might have sustained hand trauma along the way that broke some blood vessels and led to your Dupuytren’s contracture. TRH

  9. Diane says:

    I’ve had Dupuytren’s contracture for 25 years. I’ve had the needle aponeurotomy treatment twice with Dr. Eaton. It worked out well. As time has gone by my left hand pinky finger is too far gone for treatment but I would like to work on my ring finger which is not bent that far. I went to a hand surgeon who suggested that he would like to cut the cord, take out the lump, and then suture the cord back together. He said it is a very simple operation he can do in his office. I’m a little concerned and don’t know what to do. I could find no information on the Dupuytren’s contracture website mentioning cutting the cord and sewing it back together. Please can someone help me?

    Should I do this?

    Diane

  10. Dr.Herazy says:

    Greetings Diane,

    Sorry to hear about the progression of your Dupuytren’s contracture. Dr. Eaton is an excellent and well-known hand surgeon.

    Your recurrence of Dupuytren’s contracture after needle aponeurotomy is common. Further, that it has progressed beyond the initial state so that no more needle aponeurotomy can be done is typical of Dupuytren’s contracture. Many people have to stop after a second hand surgery, like you, but a few go farther before they are also forced to stop. Some do not have any other option after a few Dupuytren’s contracture surgeries but amputation. This is why DCI suggests that people first attempt non-surgical Alt Med treatment that avoids this recurrence issue.

    I cannot advise you about hand surgery; for that you have to consult a local doctor who can actually examine your Dupuytren’s contracture. But, I can tell you I have not heard of a reattaching or resectioning a surgically cut Dupuytren’s contracture cord; when a cord is cut it is typically left that way. I have no idea of how common or typical this procedure is, or the success rate; you need to find this out. This might be a rather new procedure. For this reason I suggest being very cautious how you approach this option. For starters I would definitely find out how many of these particular surgeries this other hand doctor has done, as well as learn as much about him and his practice as possible. I would also get a second opinion, perhaps from Dr. Eaton, about this resectioning procedure. Good luck with your Dupuytren’s contracture. TRH

  11. Jesse Whisenhunt says:

    I dont know if I have trigger finger or Dupuytren’s Contracture and getting the VA to do test is dam near impossible. My fingers are straight and can bend. However, keeping them straight I have a constant burning sensation in my palm (left). In the past and when I exercise (use to) my hands would look up in what I describe as a claw. I would have to force them to straighten and hold them that way until it passes. My hand never made a popping sound. I feel no pain just burning. I can no longer do push ups and some other exercise due to my hand. Fingers on my right hand can be raised as if I was trying to pop the joint. But on my left hand they are like trying to straighten a steel bar, thus unable to “pop” the joint. Extension that is what I meant by popping.

    So what test will verify is Dupuytren’s Contracture or not and what can I do to help it so it will not get worse?

  12. Dr.Herazy says:

    Greetings Jesse,

    Based on your description of your left hand problem, it is my opinion you do not have Dupuytren’s contracture. A variable and pliable contracture of the entire hand, without any observable nodule or cord formation, does not at all sound like Dupuytren’s contracture – and that is a good thing.

    However, I cannot offer you any clear idea what might be going with that hand; perhaps it is a chronic soft tissue involvement of the major joints of the left hand related to past injury or repeated stress. Getting to an orthopedic specialist who would do an evaluation would be your best bet.

    Good luck to you, sir. TRH

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