How effective is alternative Dupuytren treatment if the finger is completely bent?

Hello,  I was just wondering how effective the alternative Dupuytren treatment is on someone whose ring finger is completely bent down towards the palm and will not straighten out.  Is this treatment effective on a severe case as this?  Or is it more beneficial to someone just starting to notice the nodules on the palm of their hand before losing use of their hand with deformity of their finger?

Please advise.  I would appreciate any other information that you may have on this disease.  I am trying to research this for my significant other who is having more and more discomfort with his hand.

Thanks so much!



Your concern and questions about effectiveness of Dupuytren treatment are common.

DCI is not capable of conducting the kind of research necessary to answer your question in the way I would like to giving you specific numbers for a controlled double-blind study.  For this reason, allow me to give you the benefit of my experience since 2002 while dealing with people from around the world who have finger contractures.  My experience is that for every 10-12 emails and phone conversations I receive reporting partial or complete success with the DCI method of Dupuytren treatment, I receive one report of failure.  Ten to 12 successes compared to one failure is pretty good.  It is human nature to complain and be negative far more than it is to compliment and be positive.  Because of this I take this 10 to 12:1 ratio to indicate significantly positive DCI treatment results.  I wish we had the ability to conduct multimillion dollar research, like the government or a drug company, so I could give you the statistics you are looking for.  For the time being is the best information I can offer.    

Duration and severity of Dupuytren contracture do not seem to be significant predictive factors that I can determine based on past results; sometimes severe cases do better than mild cases; sometimes chronic (old) problems respond as good as or better than acute (recent) problems. The greatest predictor of success or failure of alternative care has consistently proven to be aggressiveness of Dupuytren treatment and the person’s ability to closely monitor and define changes in size, shape, density, surface features, and degree of movement of nodules and cords.

There are well over 500 pages of information about Alt Med treatment of Dupuytren’s contracture on the DCI website. If you spend a little time reading and evaluating the DCI site you will have all the information you will need. If you have a specific question about Dupuytren treatment you would like answered please send it to me and I will do my best to provide an answer.

You will note that there is no change in the Dupuytren treatment approach if the fingers  are completely bent down or not, and there is no change in the treatment if the ring finger is involved as compared to the little or middle fingers. 

In other words, the DCI approach starts out the same if the fingers are mildly or severely bent; if one, two or three fingers are involved; if one hand or both are involved; if slight nodule or severe cord formation is involved; even if the person has had prior Dupuytren’s contracture surgery or not – the DCI approach starts the same for everyone.  This is so because the Dupuytren treatment is not directed specifically to the hand, but to the person.  This means that the DCI concept of care is intended to not treat the disease, but to treat the person who has the disease so the immune response is supported and strengthened.  By enabling the immune response of the person who has the problem to do a better job, it is our theory that each person will heal to the best of his or her ability to remove the offending fibrous nodules and cords, or at least slow down the progression of this problem.

Can a person get Dupuytrens in the feet?

Hi Dr. Herazy. Can a person get dupuytrens in the feet? I’ve already had surgery on both hands, but I also have 5 or 6 nodules in both feet. Any information would be appreciated.
Thank You.


Although you cannot actually develop Dupuytrens in the feet, I know what you mean.   The answer to your question is that there is indeed a condition of the soles of the feet that resembles Dupuytren’s contracture.  In this foot problem excessive an fibrous tissue reaction occurs with nodule formation.  It resembles the contracted and fibrous tissue of Dupuytren’s contracture, with painful nodules, lumps and contracture formation on the bottom of the feet.  In this sense, Dupuytrens in the feet is called Ledderhose disease.

 You might also enjoy reading the post, Any suggestions for lady with a strong family association with Dupuytren contracture and Ledderhose disease?

I have had people who have treated their Ledderhose disease using the DCI treatment protocol and they have reported success.  You might consider this as an option before having foot surgery.  TRH

Dupuytrens treatment: Which supplements should I start with to increase dosage?

Hi Dr. Herazy, I am taking the supplements recommended on the large plan for Dupuytrens treatment and am doing fine with the program. I would like to ramp up the dosages that I am taking. Can you please give me a recommendation as to which supplement or supplements I should start with to increase the dosages?  I am really eager to get rid of this Dupuytren’s contracture and I want to do it the right way.


Rod Wade


Greetings Rod,

Before replying, I will assume that you have carefully measured your hand nodules and cords as well as your limitations of hand movement before starting your Dupuytren treatment.  Otherwise, you will not know for sure when those early improvements in your hand and Dupuytren’s contracture will occur.

You must have a clear, detailed and accurate assessment of the size, shape, density, surface features of the palm nodules and cords.  Also, you need to measure the the distance of the involved finger tips to the wrist.  Lastly, you should also know the exact distance of your palm to the top of a table when you try to flatten your hand on it.  If you do not have these last measurements you can learn about this process at  Hand contracture measurement for Dupuytren treatment It is critical that you know have this information to guide you to your correct Dupuytrens treatment dosage.

OK, I have to mention this particular information to everyone because this is such an important part of the process of directing your treatment of Dupuytrens.  Even so, many people think they can skip it.  Wrong!  Skipping this step is a sure way to get confused and lost on your way to eliminating your hand contracture problem.  Decide to not only do it, but do it as carefully and exactly as you can.

Now to answer your question about changing dosage as your large Dupuytrens treatment plan progresses.

For most people, especially when they are in the early phases of Dupuytrens treatment, it works best to increase your dosage of one enzyme product (Neprinol, Nattokinase 1500, Fibrozym or  Bromelain 5000 and Neprinol).  Also, a tthis same time, increase one of the support products (acetyl-L-carnitine, Bromelain 500,Fundamental Sulfur or MSM, PABA, Quercetin-Bromelain, Scar-X homeopathic remedy, Omega T, etc.).  Check for improvement in the condition of the hand every 7-10 days, using all of the methods and areas mentioned in my second paragraph.  In this way every 7-10 days two therapies are increased, with increase of the enzymes than support therapies.  With this double increase in your large Dupuytrens treatment the changes are gradual but consistent.

Make no increase or change in your therapy dosage as soon as you notice the first small improvement in the hand nodules, cords or reduction of finger contracture.  Simply continue doing what you were doing to get to that point when the good progress started; maintain that same dosage and therapy activity until either your Dupuytrens goes away or your progresses stalls.  If it stalls or stops progressing then you once again increase your plan until the favorable changes start up again.

Do not be too eager to add to your therapy plans. Do not increase the number of therapies until you  have thoroughly explored all the possible dosage levels, and combinations of dosage levels that you can try during each 7-10 day cycle.  Do not make your plan too complicated too early by adding more therapies than the original 11 parts of the large plan. Work deeply into the various dosages and combinations of what you already have in front of you, than add in new therapies.   

You might also want to read How do I make my Dupuytren treatment plan better?

If you have a specific question about this subject of dosage in your Dupuytrens treatment plan I would be most happy to hear it and answer as best I can.  These particular questions about higher dosage are so unique to the individual.  Fore this reason it is often necessary to set up a telephone discussion so we can talk about your particular situation and get the best answer fore you.  Written generalities are often not as good as a one-on-one discussion about what is going on in your specific experience.   Please contact me about any other questions concerning Dupuytrens treatment you might have.  TRH

Can you give me guidance with my Dupuytrens treatment plan?

I need some guidance with my Dupuytrens treatment plan. I understand “tissue response guides dosage”, but I am (better package) taking multiple (6) oral products with multiple dosages. If I don’t see progress after 3 weeks, then which product dosages should I increase first? It doesn’t seem logical to increase all 6 at once, but increasing only one at a time would be a slow process. Can you give me some additional guidance on my next step if the starting dosages don’t do the trick?

I am also curious if you had insight as to the relative merits of adding additional products vs increasing the dose of the products I already have. While I am not rich, the cost is not my major concern… healing the condition is.


Thank you for some interesting questions about Dupuytrens treatment

Which particular therapies to increase first is dependent on what dosage you are currently taking.  For most people the dosage of vitamin E stops at 800-1200 IU daily; a few have taken higher dosages of vitamin E but it is not common.  So there is not much room to increase vitamin E dosage.  

As a general approach to increasing dosage after the initial round at the start of self-treatment: the systemic enzymes (Nattokinase 1500, Fibrozym, Bromelain and Neprinol) are increased earlier and to a greater level than the other support therapies (acetyl-L-carnitine, PABA, Fundamental Sulfur or MSM, Quercetin-Bromelain, Scar-X homeopathic remedy, Omega T).   More work and alteration of enzyme dosage is done than with the other therapies.   I tend to favor an increase of enzyme intake and an increase of one of the support therapies per 7-10 day period when no change is noted in the nodule or cord tissue.  If you follow this approach with your Dupuytrens treatment you will not make drastic or quick changes in your plan, but you will move it along nicely.

When the first change in the scar structure is noticed then no additional changes are made to the plan –until the tissue stops changing as it sometimes happens.

Your last question is most interesting, when you requestedinsight as to the relative merits of adding additional products vs. increasing the dose of the products…”     I find that people are far too eager and quick to add to their therapy plans – they make their plans too large too early, and only make it more complicated than it needs to be.  Many people make the mistake of increasing dosage once of a particular product and then assume they can go no higher.  It is far better to work deeply into the area of greater dosage and explore all the combinations of higher dosages that are possible before even thinking about adding another therapy item to your lineup.  

If you have a specific question about this subject of dosage in your Dupuytrens treatment plan I would be most happy to hear it and answer as best I can.  Most often these particular matters of higher dosage are so unique to the individual  and the particular dosages you are using, as well as the level of tissue change that you have noticed, that it is sometimes necessary to set up a telephone discussion so we can talk about your particular situation and get the best answer fore you.  Written generalities are often not as good as a one-on-one discussion about what is going on in your specific experience.   Please contact me if you feel you have to do so.     TRH


Knuckle pads: Is there a topical treatment for these Garrods pads and my Dupuytren’s contracture?

I have DC and also knuckle pads or (Garrods pads) too…… Are there any topical treatments that can be useful in reducing the size of these knuckle pads?


Knuckle pads or Garrod’s pads  (or Garrod’s disease) are another of the excess fibrous tissue problems that affect people who have ancestry from northern Europe.  In the case of knuckle pads the problem appears as a clearly defined thickening and darkening of the tissue of the knuckles of one or both hands.  When a person develops this problem it usually affects the knuckles of all fingers, not just one or two.

They are located at the base of fingers or the first joint up from there at the  proximal interphalangeal or PIP joints of the hands.    They appear as a smooth, firm, slightly tender and slightly darker skin-colored elevation ranging anywhere from .25 to 1.5 inches in diameter. 

Knuckle pads or Garrod pads are commonly associated with Dupuytren contracture.  They are seen in about half of the cases of Dupuytren’s contracture; when they occur usually indicate a more severe form of Dupuytrens disease.

Over the years I have communicated with people who have noticed their knuckle pads reduce in size and tenderness after following a standard treatment protocol as outlined in the DCI website. The typical response when the knuckle pads begin to reduce their size, thickness and soreness is for this change to happen rather early, sometimes even before the Dupuytren cords or nodules begin to soften or reduce in size.

All DCI related treatment of Dupuytren’s contracture includes topical treatment consisting of Dusa-Sal DMSO, Super CP Serum and Unique-E vitamin E oil.  If you have some special concern about the appearance of your hands and wish to concentrate treatment to the knuckles, I cannot think of a reason that you could not apply additional DMSO, copper serum and vitamin E to these ares.

If you need further information about the Alternative Medicine treatment of Dupuytren’s contracture and knuckle pads, please let me know.  TRH