What is the best therapy to treat Dupuytren contracture?

How should I treat my Dupuytrens disease?

“What is the most important product or vitamin I should use to treat the Dupuytren lump on my palm?”  I am asked that question frequently.

The correct response is that there is not any single therapy that is more important than the others; they are ALL important, especially when used together.  Each natural therapy product if taken by itself has limited ability to make a difference with the dense fibrous Dupuytren contracture tissue on the palm of the hand or fingers. However, when they are used together as we advocate at DCI, their combined effort we find is capable of generating a healing response. None when used separately will achieve the clinical results that compare to a broad-based synergistic approach to Dupuytren therapy using Alternative Medicine.

There is simply no way to predict which vitamin or mineral or enzyme therapy will do the most for you, if in fact any can make a difference to the contracted tissue when used alone.    There is no one product that can cause the contracted palmar fascia tissue to be reabsorbed by the body.

Treatment of Dupuytrens like playing baseball – you need all players

It is similar to determining something similar about a baseball team.  You cannot ask “What is the most important position on the team?” and expect a meaningful answer.  Certainly some would answer, “Oh that is easy.  The pitcher is the most important player.”  If that were true, you only have to imagine how much trouble a team would have if there was no short stop or catcher or first baseman, or center fielder on a team, or if you tried to play a game with nine pitchers on the field.  Each player is important in his own way and vital to the ultimate success of the team when they work together.  The same is true with treatment of Dupuytren contracture.

Please read and re-read sections of the DCI website that describe the treatment philosophy and the principle of synergy, found at Dupuytren Contracture Treatment Philosophy.    If you are having any concerns or indecisions about what you are doing while using Alternative Medicine to treat your hand lumps, you owe it to yourself to go over some of these points. Educate yourself well about this terrible problem and come to understand exactly why you are following this course of Alternative Medicine care.

There is a lot of good information for you on the DCI website.   If you haven’t already spent considerable time reading the background and principles that explain why this therapy works for so many people, now is a good time to review what started you thinking in this direction in the first place.  After you understand more about the philosophy that guides this process of eliminating the dense contracted hand tissue, it will be easier to successfully create and follow your own Dupuytren treatment program.

How can natural treatment help Dupuytren contracture?

What does taking vitamins, minerals and enzymes have to do with Dupuytren treatment and these lumps on my palm?

The treatment ideas presented by the Dupuytren Contracture Institute have scientific merit, medical endorsement and wide acceptance – but many do not know it because it has never been explained to them.  In this discussion the reader will understand that the Dupuytren therapy ideas found on this website area within the framework of current medical and scientific thinking; more importantly, they make sense.

Dupuytren contracture treatment philosophy in a nutshell

  • The body does miraculous things.  Every second of every day of your life your body performs complex biological feats that science does not understand – and does not even know about!  The ability of the immune system to keep us healthy, or overcome disease when it occurs, is part of the miraculous ability we all possess.
  • Diet and nutrition help the body stay healthy or overcome disease; it is not possible to stay healthy for very long with poor nutrition; it is possible to improve health with good nutrition.  See below.
  • What the body cannot use and what is not supposed to be in the body, the body will try to reduce in size or eliminate.  Common examples:  gallstones and kidney stones are spontaneously pushed out; excess lung and sinus mucus is normally brought out; a limb or organ that does not work will reduce in size (atrophy); hand calluses disappear and muscles reduce in size once heavy work stops, etc.  The collagen nodules and cords of Dupuytren contracture found in the palm of the hand are not supposed to be there and the body should be able to eliminate them.

>> How to start Dupuytren treatment with Alternative Medicine

>> Dupuytren surgery

>> Dupuytren Contracture Pictures


  • It is possible to intentionally use a variety of techniques to support the repair function of the body against the Dupuytren collagen formation. By supplying a variety of high level quality nutrients vitamins, minerals, enzymes while doing a variety of stretches, exercises and other therapeutic techniques at the same time, it is often possible to enhance the function of the body to reduce or even eliminate the abnormal Dupuytren tissue in the palm of the hand.  The DCI concept for treating Dupuytren contracture is to provide the best environment for natural healing to take place.  When this is done it can sometimes result in rapid and near miraculous changes.
  • Our vitamin, mineral and enzyme products are just a more convenient way to give your nutrition a needed boost when you must be sure your body has enough raw materials to work with.  DCI has built a treatment protocol around our particular selection of high quality pharmaceutical grade nutritional supplements that have proven themselves since 2002.
  • No therapies mentioned on this site are a Dupuytren cure; there is currently no such thing.  Our Dupuytren therapies when taken as a group is intended enhance and support a naturally occurring immune response against a certain type of foreign tissue in a particular part of the body.
  • Sometimes natural therapy helps to increase the ability of the immune system and the person is able to avoid Dupuytren surgery, and sometimes it does not work.  There is no way to know ahead of time if it will be successful for a particular person.

Experts say diet affects healing and immune response 

Do a Google search for “American Cancer Society guidelines on nutrition,” or “diet Mayo Clinic prevent cancer,” or “boost immune system.”  You will find that organized medicine is beginning to admit what common people have known for a long time: Diet is vitally important to promote health and prevent disease. In the last 5-10 years organized medicine has been forced to acknowledge that the food we eat influences the ability of the body to prevent and eliminate many illnesses.   Prior to that time organized medicine laughed at people who said that nutrition could influence disease.

Organized medicine took the position that when a patient was sick, drugs and surgery were the only treatment necessary.  The importance of diet and nutrition is gaining scientific recognition for many serious and complex disease states like Alzheimer’s disease, macular degeneration, AIDS and yes, even cancer.  Now with mounting evidence that they were wrong, the medical position has abruptly changed about diet guidelines for many health problems.

Did I say that diet can cure cancer?  No. All that I have ever said about diet, nutrition and Dupuytren contracture, and all that Mayo Clinic, Harvard School of Medicine, the National Institute of Health and every other medical institution in the world are recently saying, is that diet is important to improve the ability to prevent and even reverse disease – not cure it like a drug, just support or enhance the ability to heal for a better chance of possible reduction or recovery.

This should not really be such a controversial subject.  After all, why do we eat?  We eat not only because food takes good, but because we need the nutrients and fuel that food provides to us.  Food is fuel needed to operate the body.  With bad fuel, the body operates poorly.  With too little fuel, the body operates poorly.  With good fuel, the body operates better.  In an abundance of good fuel, the body has an opportunity to operate to the best of its ability.

Based on the above, the idea of dietary and nutritional treatment of Dupuytren’s contracture should not be too extreme a possibility to consider.

Our Dupuytren treatment philosophy also used in medical practice and agriculture 

Just a few examples:

  1. Medical practice – Holistic medical doctors who follow a more holistic or natural approach to patient care use a nutritional approach to healthcare to a great degree, but even traditional drug-oriented doctors use it also to a lesser degree:
    1. Dietitians work in hospitals because nutrition and diet are especially important to recovery of disease.  That really is the best example to make the case that our treatment concept has scientific merit and medical endorsement.
    2. Cancer – see above.
    3. Infertility (male and female) – every fertility clinic has a standard list of printed instruction of foods to eat and foods to avoid, as well as vitamin and mineral supplements to take to increase fertility.
    4. AIDS – a huge body of information will be found by Goggling “AIDS and nutrition”
    5. Anemia or “tired blood” – eat more iron containing foods like red meat and dark leafy vegetables to increase red blood cell production
    6. Bone fracture – eat more calcium and protein containing foods like dairy products, green vegetables and fish to supply raw materials for bone healing
    7. Animal husbandry and dairy industry – any animal breeder and livestock farmer knows how to treat animal diseases by using vitamins and minerals. They all use vitamins and minerals first to see if they can avoid veterinarian expenses. On their website, the American Zoo Association discusses animal nutrition as a way to now only avoid disease, but to assist the healing ability of all animals they keep
    8. Agriculture – to increase crop yield and prevent plant diseases, farmers add soil nutrients (potassium, phosphorous and nitrogen) at planting time.  Farmers do not waste money.  Any homeowner knows that to have a healthy lawn it must be fertilized often.  All forms of life work better with better nutrition.

Treatment of Dupuytrens disease makes sense

Since 2002 this website has instructed in the use of a combination of common and standard non-drug ((vitamin E, copper, DMSO, enzymes like Neprinol, etc.), and non-surgical (stretching, exercise, massage and non-needle acupuncture) methods to treat Dupuytrens.  This is done to stimulate, support and sustain the natural healing response of the immune system to reduce or eliminate the Dupuytren nodules and cords on the palm.

The Dupuytren Contracture Institute attempts to use all possible methods to increase the body’s ability to heal and repair the nodules and cords on the palm of the hand that are associated with this disease.   If the body does miraculous things every day, why can’t it eliminate the excess collagen that develops in the fascia on the palm of the hand?   From our experience it can, and does in a high percent of cases when the correct techniques are used at the same time to fully support that healing ability of the body.

Only a short therapeutic trial of aggressive natural treatment is needed to learn if your body can reduce or even eliminate the palm lumps of Dupuytren contracture.

What is the difference between needle aponeurotomy and palmar fasciectomy and what are the risks?

Needle aponeurotomy and palmar fasciectomy greatly different

Needle aponeurotomy and palmar fasciectomy are two completely different kinds of Dupuytren contracture surgery.  As with any kind of hand surgery done to release the contractures of Dupuytren disease, each has its own value, risks and limitations.  The risk and limitation of Dupuytren surgery should be considered not only because of the potential permanent consequences (numbness, reduced finger movement, reduced hand strength, reduced sensations and pain) that can occur, but also because hand surgery is not your only Dupuytren therapy option.

Alternative Medicine is a conservative and essentially risk free alternative that could make surgery unnecessary.

Dupuytren’s surgery, even when done well, can have bad unintended consequences as well as stimulate the recurrence of additional nodule and cord formation in the palm.  Since 2002 this website has suggested that anyone with Dupuytren contracture should first consider the conservative non-surgical and non-drug treatment options before attempting irreversible surgery.  To learn about Alternative Medicine self-management, please see Different Way of Looking at Dupuytren Contracture Treatment

What is a needle aponeurotomy?

Needle aponeurotomy, also called palmar fasciotomy, is considered minimally invasive Dupuytren hand surgery since a scalpel is not used to open the skin of the palm.

Needle aponeurotomy is performed by inserting a hypodermic needle into the palm of the hand with the intention to move the needle tip in a variety of directions to cut, tear and weaken the offending cords and contractures in the palm.  Without being able to see the collagen structures he is slashing with the needle tip, the surgeon blindly attempts to destabilize and release those same cords and fascial contractures that prevent full straightening of the involved fingers.

Because these structures cannot be seen as the needle moves, the risk is that nearby nerves, blood vessels and tendons might be accidentally injured or destroyed

What is a palmar fasciectomy?

There are several types or palmar fasciectomy, depending on how much tissue is removed during this type of hand surgery.  Let us begin with the words, palmar fasciectomy.

Palmar refers to the palm of the hand. Fasciectomy refers to a kind of surgery performed on fascia.  Fascia is the thin, white, tough layer of soft tissue that covers, surrounds and lines all organs, structures, tissues and cavities of the body. You can think of fascia like the clear plastic Saran wrap used to cover and protect food.  When you look in the meat case at the butcher shop you can see all kinds of fascia in the cheaper grades of roasts and steaks.   Because hands need extra support and protection from the heavy work they do, there is normally much fascia in the palm.

The ending “-ectomy” means that the surgery is done through an opening in the skin and something is removed – in this case fascia.   So, a palmar fasciectomy is a surgery on the palm during which fascia is removed.

As an interesting aside the reader will note, above, that needle aponeurotomy was noted to also be called a palmar fasciotomy.  The ending, “-otomy” means that the surgery is done to cut into the body but nothing is removed, not even the fascia. A common “-otomy” surgery is a tracheotomy in which a hole is placed in the trachea, so that breathing can take place through the opening, and noting is removed.  So, a palmar fasciotomy is a surgery on the palm during which no fascia is removed.

Not all palmar fasciectomy is performed the same. The type and extent of a palmar fasciectomy is determined by the patient’s history of previous hand injury and surgical treatment, occupation, age, family genetics and family history of the Dupuytren’s contracture, severity and location of contracture, degree of disability, and general health status.

Different types of this Dupuytren surgery include a complete palmar fasciectomy (rarely done because of typically bad results after such large tissue removal), partial or selective palmar fasciectomy, fasciectomy with skin grafting, and amputation.


How can I make my Dupuytren treatment work even better?

Hello Dr. Herazy,

My question concerns making my Dupuytren therapy plan work even better.

I am already using Neprinol, MSM, acetyl-L-carnitine, two kinds of your vitamin E, PABA and quercetin-bromelain.   After a month of faithfully taking these supplements I notice some surprisingly nice changes in the density or hardness of nodules of both hands, the left more than the right, and I can move my fingers 5 to 10 degrees farther away from the palms than I could before.  What else should I add to my treatment plan fore even better results?

Thanks for all your help in the past.


Greetings Corrine,

Glad to know you are doing well and making progress with what you are currently doing.   I am sure you could be making even more changes and seeing more recovery for better finger movement if your plan was balanced.  Right now you are only using internal therapies — you are popping a lot of pills for internal supplementation and not much else.  You need to add some external therapies for direct treatment to your areas of involvement.

Most everyone comes to the DCI site with a medically driven way of looking at treatment.  It is easy to think about taking pills when designing a Dupuytren therapy plan rather than approaching the problem from other directions.  It is always necessary to treat the Dupuytren nodule and cord development with both internal and external therapies.

Internal therapies are those vitamins, minerals, supplements and enzymes that are swallowed and taken to the interior of the body for distribution to all tissues.   It is a good idea to use as many of these internal therapies as you think are needed and appropriate for your case.  These general and system-wide internal therapies are:

  1. Integral E 400/400                               7.   MSM
  2. Maxi-Gamma E                                      8.   Quercetin-bromelain
  3. PABA                                                          9.   Scar-X
  4. Neprinol                                                   10. Acetyl-L-carnitine
  5. Nattokinase                                            11. Pure Harvest Green drink
  6. Fibrozym

Eternal therapies used for Dupuytren contracture are:

  1. Dusa Sal DMSO
  2. Super CP Serum
  3. Unique-E Vitamin E Oil
  4. Genesen acupuncture therapy
  5. Moist heat application

Good treatment is a balance of Internal and External therapies.

On this basis, I suggest that you definitely use moist heat to the hand once or twice a day.  Also consider adding Dusa Sal and the usual compliments to it, Super-CP Serum and Unique-E oil.   Use these for a month or two — of course, while you still continue to take the internal therapies you are now using — to see what kind of additional improvement might occur.  If you are satisfied, continue until your problem reaches a plateau or is gone completely.  If you are not satisfied, then consider adding  the Genesen pens to your plan.

Again, congratulations on your current level of progress.  I trust that these additional changes will earn you more recovery from your Dupuytren problem.  TRH