New Customer – how to select your best treatment plan

Suggestions to help you start Dupuytren’s contracture treatment.

Use these descriptions to get an idea how you want to start your recovery.  Decide which plan applies most closely to your situation.

Remember, the larger your treatment plan the more help you give to your body for successful healing.

 Small Dupuytren’s treatment plan suggested: 

  • DC less than 12 months.
  • DC is very slowly advancing.
  • DC is not known in my family; I am first in family to have DC.
  • One hand involved at this time.
  • No observable tissue changes at this time; no knots, lumps or dimples on palm; no finger cords­; fingers just feel tight and achy. ­
  • Full finger range of motion; can flatten palm against in tabletop test.
  • Any age.
  • Generally good health.
  • Non-cigarette smoker for at least the last 20 years.
  • History of no to little hand stress – non-manual labor all of life; played no musical. instruments; no history of hand injury.
  • No prior Dupuytren or other hand surgery; no Xiaflex injection.

Tabletop test to flatten hand in Dupuytren contracture to determine improvement or regression. Click-if-describes-you-small




Medium Dupuytren’s treatment plan suggested: 

  • DC between 12-24 months.
  • DC is moderately advancing.
  • DC is in one other family member.
  • Two hands involved.
  • Mild to moderate knots, lumps or dimples on palm; mild to moderate finger cords.
  • Slight to moderate reduction of finger range of motion; some difficulty flattening palm in tabletop test.
  • Any age.
  • Generally good health.
  • Moderate cigarette smoker now; used to smoke, but not now.
  • History of mild to moderate hand stress – manual labor all of life; played musical. instruments; history of mild to moderate hand injury.
  • One prior Dupuytren or other hand surgery; one Xiaflex injection.

Tabletop test to flatten hand in Dupuytren contracture. Click-if-describes-you-medium




Large Dupuytren’s treatment plan suggested: 

  • DC longer than 24 months.
  • DC is rapidly advancing; or, recently started to develop at a faster rate.
  • DC is in two or more family members.
  • Two hands involved, one of them severe.
  • Moderate to severe fibrous knots on palm; moderate to severe finger cords.
  • Moderate to severe reduction of finger range of motion; difficulty flattening palm in tabletop test.
  • Under 50 years old, or over 70 years old.
  • Heavy cigarette smoker.
  • Generally poor health or complicated medical history.
  • History of moderate to severe hand stress – heavy manual labor all of life; professional or semi-professional musician; history of serious hand injury or hand surgery.
  • One or more prior Dupuytren or other hand surgery; one or more Xiaflex injections.
  • Poor surgical results.

 Flatten your hand in the tabletop test with natural treatment for Dupuytren contracture. Click-if-describes-you-large


Do better in the tabletop test

If you do better in the tabletop test, you will do better living your life. And this website is all about reducing, and even getting rid of, your Dupuytren’s contracture so you don’t ever have to think about the tabletop test again for the rest of your life.

You don’t have to follow a DCI plan.  Create your own plan based on the ideas found in the “Worksheet to build or modify a Dupuytren’s contracture disease treatment plan with your doctor”.   Many decide to use a Large Dupuytren’s treatment plan simply because they want to do as much as possible to help themselves, even when their problem is relatively mild.


17 thoughts on “New Customer – how to select your best treatment plan

  1. John Trexler says:

    The small plan most closely fits my history of Dupuytren’s contracture except for a couple things. I am 66 and have had it only in the left hand on the ring finger for maybe 20 years and it is NOT aggressive, has not advanced very noticeably but is annoying. Can’t flatten hand on table unless I force it flat. No prior surgery and no family history. Non smoker and in good health. The other two plans just don’t fit well yet I want to see improvement. What is your suggestion? John

  2. Dr.Herazy says:

    Greetings John,

    Not many people are as fortunate to have such a slow moving case of Dupuytren’s contracture. Because of your unique history with DC I would really appreciate it if you would reply to our 5-minute Dupuytren’s contracture survey on variability. Thanks in advance.

    I always suggest that any treatment plan for DC be as aggressive as you can afford to sustain for at least 3-4 months to see how you will respond; please refer to the expense information for each plan to get an estimate of monthly costs. There is not that much difference between the monthly plan costs from one to the other, once the initial purchase is made.

    Your DC is a stubborn and tenacious problem that has continued for 20 years, don’t you think? For this reason it might take a strong effort to assist your body to remove those deep fibrous tissues. I suggest if you cannot afford the medium or large DCI treatment plan that you consider the small plan expanded with 1-2 additional therapy items to assure success.

    Let me know if you need any help along the way with your Dupuytren’s contracture treatment. TRH

  3. John Trexler says:

    I was surprised by your quick response, but thought I would get an email, glad I checked back on this site and saw this, might have missed it. I will reply to the survey but where do I see it? Is it a survey after getting the product? I will check back here to see about the survey then order the small plan for now and find if I get any results at all. Is there any chance of allergy to any of the supplements?

  4. John Trexler says:

    Thanks Doc, I did the survey, wish I could send a picture of the hand. Glad no allergic reaction because I just recently became sensitive to aspirin after a lifetime of no problem. I’ll order the Small plan for now and see what happens.

  5. Carol Orrell says:

    I see that you highly recommend the Genesen Acutouch pen. I am very interested in it, but I do not see any customer testimonials on the website or am I missing something. I also did a web search and found little. If it is so wonderful if used correctly for 220 conditions, why can I find so little information on results for Dupuytran? Thank you in advance for your response.

  6. Dr. Herazy says:

    Greetings Carol,

    Good question. I do not have a great answer, except that I think it has something to do with the fact that the Genesen Acutouch pens are so integral to the practice of acupuncture and that they originate in South Korea where they are very popular, that they do not receive the exposure or attention they deserve. How much attention or clamor do you observe in this country for acupuncture in general – a 5000 year old healing art that has probably delivered more treatment over history than has medicine? What gets attention in modern society has marketability and profitability for a limited number of people who can benefit by it, and the Genesen pens to do not have much of that. They are just relatively inexpensive little devices that individual doctors or various types use to help patients.

    Another reason they are not as widely accepted in our modern culture is that they deal with those subtle energy forms which are also integral with the practice of acupuncture and the martial arts. Those who have studied and use Chi (qi) in their lives know all about this. Those mysterious groups of people you see practicing Tai Chi in the parks are doing it for a reason; they say it is exercise, but it is more. It is not spoken of to the uninitiated. Accepted and understood in the East, and scoffed in the West.

    When I was in active practice many years ago I was slowly shifting my work over more and more to the Genesen pens than to traditional needles. I had some great results with those strange golden sticks! TRH

  7. Cecile Bengtsson says:

    The small plan seems to fit best. I do have a knot in the palm of my left hand, below the affected finger. I cannot get this finger unbent without using my other hand. I also have trigger finger on the middle finger of my right hand. It came after hand surgery around the thumb and the wrist three years ago. It’s not painful and doesn’t interfere with my activities. The hand surgeon didn’t seem to believe it was related to the surgery.

  8. Dr. Herazy says:

    Greetings Cecile,

    This article about selecting your best Dupuytren’s contracture treatment plan helps many people get treatment started. However, once started, it is the response to treatment that determines how treatment proceeds. While there is some general similarity in most successful treatment plans, each one eventually is modified in some way. The idea is to seek out those dosages and therapies that give the best therapeutic response; people seem to need slightly different combinations and different dosages of therapies for greatest effectiveness.

    You will receive full instructions how to use correctly whatever DCI treatment plan you select. Part of this information discusses how to monitor your hand for improvement in the size, shape, density and degree of mobility of the DC palm lump. This is very important. It is the response of the tissue, or lack of response, that determines how a plan is managed. This determines how dosages or or various therapies are used over time. Some people note improvement of the size, shape, density and mobility of their palm lump early in treatment. They do not need to increase their dosages very much, or to add to their plan. Other people must continue to increase their dosages, or to add to their plans, before seeing improvement of the size, shape, density or mobility of their palm lump. They need to mount a larger and more aggressive treatment before their tissue responds to treatment. The DCI instructions explain all this in detail.

    How Dupuytren’s contracture is successfully treated is not based on what you think you might need to recover. It is based on what your tissue eventually shows you is needed to recover. At this time, we do not know what is needed to assist the healing of Dupuytren’s contracture for each individual. We have a good idea of the wide complexity of the problem, and we have a good idea how to guide that recovery process. We have a good idea how to help a person build the plan their hand shows them they need. This is why we receive 8-10 reports of moderate to marked improvement of DC for every one report of failure. This success is based on the idea of carefully watching how the palm lump and cord size, shape, density and mobility responds to the DCI protocol. We advise modifying and expanding the treatment plan until the palm lump shows signs of reduction and elimination.

    This is why I have advocated for many years that “A person should start treatment with the largest plan they can afford to use for 3-4 months. During this time they should carefully follow the DCI protocol, to determine if they will respond to this form of therapy. Far more people respond favorably, when the plan is used properly, than not.”

    I receive many reports from people like you of Dupuytren’s contracture starting after hand surgery. This suggests there is some causal relationship between the two. Doctors admit that Dupuytren’s contracture can and does start after hand trauma of many kinds. Yet, they but do not admit that hand surgery – no matter how deep and extensive the cutting – is a form of hand trauma. This is an issue that the surgeons will deny as long as they can.

    Good luck, Cecile, and let me know if I can help you in any way as your conservative hand treatment proceeds. TRH

  9. Leo Petix says:

    Hello, my Dupuytren’s contracture began about ten years ago and has progressed to both hands. A friend suggested laser treatment to soften scar tissue. Any experience with this type of treatment? Thanks, Leo

  10. Dr. Herazy says:

    Greetings Leo,

    I have tried many times to communicate with soft laser manufacturers about the use of this form of therapy for Dupuytren’s contracture. When I pose the appropriate questions, they reply that they have no experience with DC.

    It strikes me as strange, because it would seem that Dupuytren’s contraction should be responsive to cold laser treatment. Yet, in spite of numerous attempts, I never receive the kind of reply I assume would exist. I take this to mean that laser is either outright ineffective, or that no investigator has looked into this issue seriously. For this reason I cannot recommend it to anyone. TRH

  11. Shirley says:

    I had an injury 10 months ago that causes inflammation to my right hand that didn’t go away (PT, Advil). Just a few weeks ago, two pea sized lumps appeared in my palm under my ring and middle fingers, so I fear Dupuytren’s contracture is starting. If there’s a cord, it’s not going up my finger Yet but I do feel a thickening towards my wrist . I looked at the various plans and although most of plan one applies, some things in two apply as well. I want to approach this aggressively and hopefully reverse it (no family history). I’m stumped as to which Dupuytren’s contracture plan to get. You say get the most aggressive plan you can afford. My fingers are not curling and I can still lay my palm flat. Would I still get plan 3 to be aggressive?

  12. Dr. Herazy says:

    Greetings Shirley,

    All reasonable concerns about a new case of Dupuytren’s contracture, and a great question.

    Usually, if a cord is going to form, it will take some time to develop; often it takes many months to appear. A few weeks would be considerably faster than for the average cord to develop. So, on this basis, at this time it is too soon to judge the extent and speed your Dupuytren’s contracture might be developing.

    You stated it is your wish to approach your DC treated aggressively. If that is the case, then that should say a lot about which plan to start with. However, aggressiveness of a plan is not solely determined by the size of the plan or what elements of treatment are in the plan. Aggressiveness of treatment of Dupuytren’s contracture is much more determined by how you faithfully and intently you increase your therapy dosages. By this I mean that a Medium Plan can be poorly applied, with slow and irregular increases of dosage, and thus not be aggressive at all. Conversely a Small Plan can be intently applied with strong and regular increases of dosage, and thus be very aggressive. It not what you get, but how you use it that primarily determines aggressiveness of Dupuytren’s contracture treatment.

    All elements and aspects of DCI treatment of Dupuytren’s contracture are fully explained with the information that comes with each order. You will know how to use and apply whatever treatment plan you decide upon. The important thing is to make a decision, get started, and follow the suggestions for successful treatment. Of those who faithfully and accurately use the DCI treatment instructions, I find that 8-10 people report moderate to marked success over their Dupuytren’s contracture problem, for every one person who reports failure.

    Please let me know how I can help you. TRH

  13. 88TRH88 says:

    Greetings C.,

    The two DMSO products we use for Dupuytren’s contracture treatment are Dusa Sal and PMD. Simply, the difference between the two is that the PMD has slightly more in it.

    Both contain 60% dimethyl sulfoxide (DMSO), urea, deonized water, methyl salicilate to protect the skin and natrosol (thickening and gelling agent from cellulose). The purpose of keeping the DMSO at 60% concentration is to allow frequent use; at higher concentration the skin could easily become overly dry and irritated by he frequent use DCI recommends.

    The Dusa Sal DMSO also contains vitamin E.

    The PMD DMSO also contains MSM (dimethyl sulfone) and PABA (para-amino benzoic acid) which are important in cellular repair. The reason PMD DMSO does not contain vitamin E is that DCI suggests the liberal application of vitamin E as a topical treatment during DMSO treatment in quantities far greater than what is in Dusa Sal.

    Either can be used for Dupuytren’s contracture. TRH

  14. Kaelan Shannon says:

    I do a lot of crafting – i.e. needlework, crocheting – and have noticed that my 4th finger (next to little finger) on both hands gets “stuck” periodically and i have to manually open it up – I have been using moist heat in the morning and stretching exercises but am not sure that is enough – what would you recommend – I do notice when I wake up my 2 fingers are definitely “stuck” towards my palms. Thanks.

  15. Dr. Herazy says:

    Greetings Kaelan,

    Your commentary makes it sound like you more likely have a problem with a trigger finger on your 4th fingers. This often develops from those who overuse and stress their hands. Please refer to other posts and articles I have written about the Dupuytren’s Contracture Institute website for treatment of trigger finger.

    Having said that, given your very Celtic name, you could be genetically predisposed to Dupuytren’s contracture. Your finger locking up periodically could be an early symptom of developing DC. I suggest you have your hands examined by someone who is well-versed in Dupuytren’s contracture to diagnose your problem.

    If your hand problem turns out to be DC, I suggest you place yourself on an aggressive program of natural treatment of Dupuytren’s contracture as you see on this website. Good luck. TRH

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