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.
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
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+
- 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
- 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.
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.