Can this natural Dupuytren treatment reverse the bad effects of needle aponeurotomy and Xiaflex injections?

I was diagnosed with Dupuytren’s in 1994. I had a palmar fasciectomy in 2005 on the left hand which failed and resulted in amputation of my little finger in 2008. In 2011 I had a more extensive palmar fasciectomy on the right hand which has also failed. The little and ring finger of my right hand are fully contracted and the ring finger on my left is about 30% contracted and all are getting worse. Do you have data on how your treatments can reverse this condition and that of surgery, needle treatments and Xiaflex?

Are your treatments accepted by insurance companies? Mine, Molina, even denied covering Xiaflex, which I am fighting.

Thank you.

PS: I am very familiar with DMSO having used it on horses for years and would be open to trying it.



Sorry to hear of your bad results with Dupuytren’s hand surgery and Xiaflex injections.  Unfortunately, your experience is more common than what you might imagine.  Please see Dupuytrens Surgery Did Not Go Well   and When to have Dupuytren surgery?     Worsening of Dupuytren’s contracture is not uncommon after DC hand surgery, regardless if your Dupuytren’s surgery was initially successful or not.

As I have repeatedly written here on this DCI website, I am not able to produce data and research results like a multi-billion drug company that controls patient drug intake and has the ability to monitor outcomes.   I can only report what people tell me after they have been on their program for a while.

For every 10-12 reports of success and positive results while following a reasonably aggressive DCI treatment plan I get one report of failure or lack of positive results.  This is a good ratio, especially when you consider how people like to complain as opposed to give compliments and offer thanks.

However, you ask about reversal of bad results of Dupuytren surgery.  That is something you should have asked your various surgeons before they removed so much normal tissue from your hands, and injected enzymes to dissolve tissues in your hand.  Unfortunately you are asking too much of your body to think that taking any kind of superior nutritional program could possibly make new tissue grow back after a surgeon removed it.  It simply cannot be done.  At this point I think you should be interested in simply making the best of a very bad situation.

Since you have had such poor results with what you have tried so far I suggest that you be most conservative from this point forward.  I have never had anyone tell me of any adverse or unexpected results from the work we do here.  Please consider trying this approach to see if you can at least slow down some of the contraction that is going on in your hands.  At this time I think you do not have much to lose.  TRH 

Which home ultrasound unit do you recommend for treating Dupuytren’s contracture?

Which home ultrasound unit do you recommend for treating Dupuytren’s contracture?


First, I do not recommend that a person uses any one single treatment method against a problem so difficult and stubborn as Dupuytren’s contracture.  Using just vitamin E, or just doing hand stretching, or just DMSO applications, or taking just acetyl-L-carnitine, is not going to help recovery very much, if at all. The same with ultrasound therapy.  The palm lumps and cords that develop with Dupuytrens are not going to change if you try a single therapy approach. 

Secondly, it is my experience after working with people from around the world since 2002 that complete or partial recovery from Dupuytren’s is possible when following an aggressive treatment plan consisting of a wide and diverse range of different therapy approaches, as outlined on the DCI website.  Following this kind of approach for a few months works well in a surprisingly high percent of cases.

Lastly, the ultrasound unit that was added to the DCI lineup of treatment methods in November of 2012 is the 3MHz ultrasound machine made by Bellaire Industry, model HS-3040.  It is a great little unit; it is the only portable 3MHz machine that is made with a stainless steel sound head; on top of that it is the only portable 3MHz machine that has received FDA approval as a medical device. Go here to get details about this 3MHz ultrasound machine

Some people make the mistake of trying to use the more popular and more common 1MHz size ultrasound machine but these machines do not put the therapeutic effect of the sound waves where they are needed in Dupuytren’s contracture.  It is necessary to use a 3MHz unit to assure the ultrasound effect is placed toward the surface where the problem of DC is located.  TRH

How can I help the foot tension I have with my Ledderhose disase?

I have nodules in both hands and both feet. I am interested in finding support for working on my feet as the tension in the tendon is increasing.  Any advice or direction is appreciated.

The hand nodules are due to the Dupuytren’s contracture and the foot nodules are due to the Ledderhose disease.  I have worked with many people whose feet problems were reduced as a result of following the DCI treatment strategy.  Many had complete reduction of pain and increased mobility and loss of nodules in the feet while primarily addressing the hand issues.

You would not have foot tension if you did a few things to reduce the density and nodule formation on the bottom of your feet, so your question might not be relevant once you start treatment to assist the process of recovery from your Dupuytren and Ledderhose problems.

If you are concerned about immediate orthopedic support for your feet problem I suggest going to a podiatrist to have an evaluation made of your current situation so that perhaps foot supports (orthotics) can be made for you.  Since these usually cost around $400 or so, you might want to simply start treatment to see how rapidly your feet might improve.   The problem with getting orthotic foot supports made before your start DCI treatment, is that once your feet change – as we hope they do – they will be of little value to you and might delay your recovery by keeping your feet held in the posture they currently present.  

Good luck with your decision about how you will proceed.  TRH    

Should I have a third Needle Aponeurotomy surgery for my Dupuytrens?

Dr. Herazy,

I have dupuytren contracture in my little finger on my left hand and have had needle aponeurotomy done on it twice.   It is aggressive and I was considering the procedure a third time  and just heard about you.  I’d like to try an aggressive treatment with you instead–have I missed an opportunity to improve my situation because of the needle aponeurotomy sessions (because of  scar tissue,etc)?

I’d like to speak to you about it if possible – I have a third needle aponeurotomy session scheduled two months from now (28 Nov) that I’d like to cancel…the contracture comes back quickly and the finger is a bit thicker.  Any advice??

Thank you in advance for your attention to this,

Scott Riviere


Greetings Scott,

Needle aponeurotomy is well known for rapid recurrence of Dupuytren contracture.   Although you did not say how quickly your Dupuytren’s returned after your first and second hand surgery, it is not uncommon for the palm lumps and cords to come back back in two years or so, with the rate of recurrence increasing after each NA surgery. 

The increased thickness of your finger could be due to chronic swelling or edema that is the result of scar tissue that prevents normal drainage of blood and lymph fluid out of the hand.   Or, it could be directly due to scar formation from the internal cutting that is part of the NA technique.  Either way, this is a frequent side effect of hand surgery for Dupuytrens.   

The rapid recurrence of Dupuytren contracture after needle aponeurotomy and scar tissue build-up are two of the nasty consequences of this kind of hand surgery simply because, as you have found out, the technique not only solves nothing but it can leave you worse off than before it was done.      

My advice is that you be extremely cautious about undergoing a third needle aponeurotomy.   What has your surgeon told you about the possible outcomes of a third NA if the first and second did not help you and resulted in undesirable side-effects?    Did he/she say why you should expect the results of this third surgery to be any different than the first two?   Did he/she warn you about further acceleration of the rate of recurrence with each succeeding NA procedure?   Did he/she warn you about the increasing risk of possible injury to blood vessels, nerves and tendons that occurs with each succeeding hand surgery?    Did he/she warn you that these hand surgeries would eventually have to stop?   Did he/she speculate what the eventual condition of your hand might be if you had 4-5-6 surgeries, and how useful, painful, numb or flexible your hand might be?   did he/she discuss with you what your options might be when you can no longer have additional NA surgeries?

Please be even more cautious if you are told that this next surgery will be more extensive to reverse or clean up the problem scar tissue that resulted from the others.  I have never heard of any  “clean-up surgery’ that goes well for the patient; usually it goes in the opposite direction and creates more problems.   Mind you, I am not saying to not have the surgery and I am not saying to not listen to your doctor, I am just saying to use the highest level of caution and prudence when you make this decision.

Time will tell how effective an aggressive Alternative Medicine treatment plan might be to help your current condition.  I have worked many times with people who have a history of past hand surgery who find their problem worse than when they started; some make great improvement, while most make at least a small to moderate amount of change; very few do not at least make some small level of improvement.   I cannot answer you directly about how effective natural therapy might be for you, but considering your options I suggest you consider undergoing an intense round of therapy for 2-3 months to determine how much change your body can make.   You will only know for sure when you give it your best effort.   

I would be pleased to speak to you about your Alternative Medicine treatment options.   The important thing is to not make matters worse at this point.   Simply call me at 847-670-8800.     TRH




Dupuytren surgery question

Dear Dr. Herazy,

My father has been diagnosed with Dupuytren’s some months ago, but only recently has complained about any pain. The pain is not unbearable, it is just a feeling to remind him that it’s there. So nothing big at the moment.
He wants to treat it, but he has asked me to investigate on when is the best time to have the surgery? His hand is still in the early stages of the contracture. Should he have the surgery as early as possible, or is it better to wait until his fingers are contracted more?
Thank you,


Greetings Partin,

I must commend you on being a good daughter to help her father in this way.

You must remember that this site is devoted to the non-drug and non-surgical treatment of Dupuytren contracture.   There are those cases that probably should undergo Dupuytren’s surgery, but in the opinion of DCI surgery for someone like your father should only be done after more conservative measures have failed to improve his situation.

Usually Dupuytren contracture is not painful, except during the early stages and then only for a limited time.  Many of the cases whose hand pain persists and undergo our Alternative Medicine self-care report rather rapid and complete elimination of pain.   If it is only pain relief that your father is interested in, he should not be overly concerned since this usually is self-limited after a short while.  this process of pain relief is something that responds to well with our treatment measures.

Since Dupuytrens will return after all forms of hand surgery, given on average about five years, your father should understand that Dupuytren surgery is not an absolute final treatment for anyone. Typically, after the first surgery when the problem recurs it is a little worse and returns a little sooner after each surgery that is done

An orthopedic surgeon who works with Dupuytren cases will usually decide when and how to perform surgery on the hand based on several factors:

1.  Age of the individual
2. Duration of DC
3. Severity of involvement
4. Degree of limitation of use
5. Degree of reduction of quality of life
6. Family history of DC

7. History of past injury and surgery to hand

While no specific rules exist that determine when Dupuytren surgery should be done,  many surgeons recommend when the large knuckle of the involved finger reaches 30 degrees of flexion contracture.  When the problem returns after surgery or causes more severe contractures after the surgery heals, fusion of the individual finger joints is sometimes recommended.   In the worst case, finger amputation of the finger is recommended if the developing contracture restricts the blood or nerve supply to the finger.   TRH