How does a Dupuytren nodule form on the palm?

Dupuytren nodules and cords are different

Dupuytren nodule formation, the first sign of Dupuytren contracture, usually affects males 50 years and over, especially those of northern European descent.  Although the size and shape are variable they are usually range in size from a dime to a quarter, although they can be smaller and larger than this.   Typically a person will first notice a small bump or lump on the palm that increases over time.

Dupuytren nodules are different from other connective tissues of the palm at the cellular level in two ways:  there is an increased activity and growth of two types of connective tissue cells called the fibroblast and myofibroblast; there is greater production of a connective tissue protein called collagen.  As these fibroblasts and collagen are laid down in the palm of the hand, it causes first nodule formation, and later Dupuytren cord formation.  The presence of these two structures is associated with progressive thickening, puckering and adherence to the skin, resulting in palmar fascial contractures and later flexion of the involved finger(s) under the skin of the palm (specifically, the pre-tendinous bands of the palmar fascia).

Dupuytren nodules are different from Dupuytren cords at the cellular level in that there are fewer myofibroblasts and fibroblasts in the cord, and they are irregularly scattered in all directions in the nodules they are in a distinctly parallel pattern in the cord.

The most common site for these palm lumps is at the base of the 4th (ring) and 5th little) fingers.  The Dupuytren nodule at first can resemble a common callus and is often painless, unless touched; occasionally the pain is more significant and lasts for some long while.

Dupuytren lump on the palm

What triggers the Dupuytren lump on the palm nodules to form is still a medical mystery, but seems to be related to liver disease, smoking, trauma and diabetes amongst a few lesser factors.

As the palmar tissue slowly thickens and tightens over months to years, it can develop into Dupuytren cords that flex the involved finger(s) down toward the palm of the hand.  In severe cases the Dupuytren nodules and cords can cause such marked finger(s) flexion that hand function is compromised for common activities of daily living (personal hygiene, dressing, opening a door, putting the hand into a pocket, etc.), so that the individual is functionally disabled.

The progress of Dupuytren nodule development is typically slow, unpredictable and sporadic, without detectible exciting factors.  As the disease progresses over time, the thickened and dense tissue infiltrates between and around normal tissue structures (tendons, ligaments, nerves, blood vessels).

While the medical profession (surgeons) commonly state that the primary treatment option for Dupuytren contracture is surgery to remove the nodule and cord formation, as well as contracted tissue around involved joints, a small but growing segment of the medical profession agrees that non-drug and non-surgical treatment is an effective option that should be attempted before resorting to the surgical route.

For more information how to reverse and eliminate, or at least reduce, Dupuytren nodules and cords see natural Dupuytren treatment.

>> Testimonials from Dupuytren Contracture Institute

>> How to start Dupuytren treatment with Alternative Medicine

>> Dupuytren Contracture Treatment – FAQs


Genesen Acutouch and Dupuytren treatment question

Dear Dr. Herazy,
I am attempting to help my wife deal with her Dupuytren’s contracture. We are interested in the acupuncture approach, and our budget is limited, so to buy a Genesen pen set is a stretch. We have a piezo electric acupuncture device which we thought we would try first to see if it seems to be the right approach, and if we felt confident it would, then we would invest in the Genesen technology. MY QUESTION OF YOU IS WHETHER YOU WOULD BE WILLING TO GIVE US THE ACUPUNCTURE PROTOCAL SO WE COULD DO OUR TEST PROCEDURE FIRST. Thanks for considering this request. Barry Snyder

Greetings Barry,

I applaud you for helping your wife deal with her Dupuytren contracture.   Many men are not that way.

The piezo equipment you have produces a micro-burst of static electricity, which is directed into an acupuncture point by placing the tip of the device over the desired location.  When the piezo device delivers this current it is felt as a very intense and brief electrical shock.  I have practiced acupuncture for almost 40 years, and I have taught acupuncture on the post-graduate level, and I have never run across any professional who used piezo stimulation to seriously treat anyone.  It can be done, I suppose it might do some good, but it was not thought of as a desired way to utilize acupuncture concepts.

The Genesen Acutouch instruments generate infrared energy, a flow of ionic energy, and magnetic energy, which are directed into a pair of acupuncture points by placing the pen tips over the desired location.   When the Genesen pens deliver this trio of energy currents into the tissue there is usually no immediate sensation; it takes sometimes from five to 30 seconds to begin to feel the flow of energy with the Genesen pens.  The sensation is most often felt as either warmth, pressure, light touch or tingling, or even like ants crawling or water flowing on the skin.  More and more professional acupuncturists use the Genesen pens, not only in the U.S., but also in Asia and the rest of the world.  Half of the people who purchase Genesen pens from Online Natural Healthcare LLC are acupuncturists.  Twenty five years ago, before I heard of the Genesen equipment I used peizo stimulator on acupuncture points but stopped after a short while for lack of good clinical results.

The two devices deliver different types of energy and are not thought of in the same way in the acupuncture universe.  For this reason your idea is interesting and commendable, but the two devices are not interchangeable in what they do and the expected therapeutic results would not be the same. The results earned by one — or the lack of results of one — would not indicate what would happen with the other.

If I gave to you the acupuncture protocol used for the Genesen Acutouch device, and you used it with your piezo device, the results or lack of results could not and should not be thought of as indicating what the Genesen Acutouch device could do for your wife.  The instructions would be useless since the devices are not the same in any measurable way.

I can help you in another way.  I can tell you that if your wife is to receive any therapeutic benefit from the piezo stimulators the technique is very simple.  Merely place the piezo device near her palm nodule or cord and place your finger on a point on the opposite side of the same nodule or cord.   Go around the periphery of the nodule or cord several times stimulating the pairs of points you select.  Try that for a few weeks and see what happens.  You might get lucky and make a few good things happen for her.

Lastly, after almost ten years experience with Dupuytren contracture, using just the piezo device alone will likely have limited results.  You will find that it is necessary to combine this treatment or any external physical treatment with internal therapies (vitamin E, MSM, PABA, etc.) such as you find explained on the DCI website.  You must use a large array of therapies in combination to have a good therapeutic effect on the Dupuytren nodules and cords.

Please let me know how it went for her.  Good luck to both of you.   TRH

What Dupuytren treatment do I recommend?

i have had dupuytrens and peyronies for over ten years. tried neprinol for several months and just about everything else too, castor oil, heat lamp, dmso. i even tried experimental homeopathic injection but nothing worked and i finally gave up. but i would like to try again with a medium plan. but i have lots of dmso and have already taken neprinol so would like to start with it. what do you recommend and how much will it cost? also, i really appreciate your peryronies site and the work you do.  thanks. i hope to hear from soon as i am ready to order.


Your email is very much like four or five I have received each week for many years.  Almost every day someone will write an email reciting a list of things he tried for a while that did not work for either his Peyronie’s disease or Dupuytren contracture, or both.   Any time you use these products as a solo therapy, and yo do not use them in the correct way, you cannot be surprised to get no results.    There is not a thing in world wrong with Neprinol, or heat, or DMSO – they are all good therapies.  However, each must individually be used correctly, and they work best when used in combination with other therapies to create a synergistic effect that supports and enhances your natural healing ability.  Used separately, and used in an inefficient manner, you will not see much happen.  When you follow the DCI concepts and learn how to approach your problem in this unique way you are much more likely to see good things happen with your Dupuytren nodules and Peyronie’s plaque.

Your injections could have injured your shaft by traumatizing the tunica albuginea.   It does not really matter what you inject into the penis, you cannot treat your tunica albuginea like a pin cushion and not expect things to happen in a penis that already has shown a tendency to over-produce scar material in response to injury.  I see this all the time when men inject erection producing medication, or cortisone, or anything else into the shaft.  Please do not do this any more.

You ask what I recommend.  I recommend that before you begin any kind of treatment that you first get “Peyronie’s Disease Handbook” from the PDI store.    Read it so you know more about treating your PD in the right way.  I cannot recommend anyone particular way that you should go about treating yourself.  That is a decision you have to make; you will be able to do that after you read this book.

The medium size plan is the most popular entry for both Peyronie and Dupuytren treatment.  If you decide to start with it you will have a lot of good therapy to work with.  Please pay attention to the many instructions that come with it so you know how to correctly use each one.

Please contact me if you have any specific questions about treating your problem.   TRH