How should I change my Dupuytren’s contracture treatment plan for best results?

I have been applying the recommended Dupuytrens therapy for about four months with increases to try to get to the maximum.  Currently I am taking both E vitamins internally and vitamin E, copper and DMSO externally.  I started with Neprinol a few weeks ago and currently take 2 querecitin/bromelain, 4 Neprinol, fundamental sulfur and PABA twice a day. After the DMSO treatment I stretch and massage my fingers and the palm of my hand that has some blister-like areas over the palm where I think I should be massaging but it concerns me that I may be increasing the blisters by so doing.  I hope I am proceeding correctly with the massage. I have not seen any appreciable improvement except that before the DMSO and massage I get a reading of 122 and then it has gone to 126 – 128 after the stretch and massage however it reverts to 122 by the next treatment time. I have been getting good reduction of an external scar from a previous surgery on my other hand by an aggressive stretching and massage as well as scraping (as though it was a callous) after the DMSO treatment. I am not sure if the internal and external therapies are working as they should although I think I am using a pretty aggressive plan. Hopefully I am on track.


Greetings DLB,

Yes, you are on the right track for your Dupuytren’s contracture treatment but I think you need to be more proactive with your plan. 

You are using your assumption for what an aggressive plan might look like, and you are counting pills to tell yourself that you are following an aggressive plan, to tell yourself that your plan is active and aggressive when in fact it is not.   Based on my experience with plans that have been developed over time that are getting results, I see that they are larger and more aggressive than what you are taking currently. 

If you have followed this plan for four months with increases as you say, then you have either started at an extremely low dosage, or you have increased your therapy intake very slowly with many weeks or even months between increases, or you have increased at a very low level of intake per increase.  Perhaps all of these are true, since you did not give information how you came to be taking this current dosage level.  This lack of information of how you have been working these increases puts me at a disadvantage to guide you to make increases going forward. 

I do not know what you mean by a blister on your palm.  When you mention blister in your email I would have to assume you know what a blister looks like and what to do about that.  If you mean a nodule or lump of denser than normal tissue that is consistent with Dupuytren’s contracture, then I can comment about that type of finding.

There is early indication of progress in that the increased temporary movement from 122 to 126/128 is not small.  A lot of people would like to have that change happen in the early part of their treatment course.   Over time, and with appropriate increase of your intake you should see these numbers increase as well as notice reduction of size, shape, density and adhesion of the nodules and cords.

Overall, your plan is rather modest in spite of it being applied for the last four months.  It seems you are being very conservative and slow in your response to the results that you are earning. I suggest that you consider increasing the Neprinol intake to 9/day, following the directions that are given to you with each order.  I cannot describe that long detailed procedure to work up to 9/day in this email response.  All you need to do is to read and follow the directions you already have that explain how to increase therapy levels safely and effectively.  I also suggest that you contact me about a phone discussion so I can get down to some of the details of how you should be stretching your contacted palm tissue.  I suspect you might be going about this incorrectly, and if so this might be an additional factor in your slow response.    TRH

Does Neprinol replace the Nattokinase, Fibrozym and Quercetin Bromelain Complex in the treatment of Dupuytrens?

Dr Herazy,

Does Neprinol replace the Nattokinase, Fibrozym and Quercetin Bromelain Complex in the treatment of Dupuytrens?


Mike Scully


Greetings Mike,

People who follow the Dupuytren Contracture Institute treatment concept use Neprinol in one of two ways – either as a total substitute for the other enzyme products, or in addition to them (usually with the Neprinol being the primary enzyme source and the others being used as a minor role).  The choice is yours.  I have long advised people to try Neprinol both way while assessing for which method brings about best change in the hand lump.

I would consider trying just the Neprinol by itself, and see how it works for you and the palm lumps.  If that is not enough to get your fibrous tissue to change favorably, then bring back the Fibrozym or Nattokinase, or Quercetin/Bromelain if you are also using it, or all of them.  A common strategy that is used is to take about 6-8 Neprinol daily, while taking 2-3 Fibrozym and 2-3 Nattokinase daily; all of these are taken between meals, as I am sure you know.  However, you also must know that Dupuytrens treatment is not just about using systemic enzymes to reduce the lumps on the palms.   You must also use other nutrients as  and treatment strategies at the same time to support the best change possible.

You must keep experimenting to learn what makes your scar respond favorably and then continue with that.   TRH

How many lawsuits for Xiaflex used to treat Dupuytren’s contracture?

Lawsuits for Xiaflex are never easy

Lawsuits for Xiaflex difficult to count

“How do I find out how many lawsuits for Xiaflex injections there are for personal damage?  The injection caused great harm and damage to my finger….including necrosis.”

The number of lawsuits for Xiaflex procedures is not widely available. This is not by accident.  The medical and drug industries do not make that information public.  Google “how many lawsuits for Xiaflex injections,” and no hard numbers come up.  Perhaps a good attorney might be able to say how many Xiaflex lawsuits have occurred.

However, there is another way to get an idea about the number of lawsuits for Xiaflex injuries.  Simply go to online sources of information about Xiaflex.  Learn what people are saying about what happened to them after a Xiaflex procedure.  Once you learn what happens to people after a Xiaflex procedure, you can assume how likely they might be to take legal action.  Sources:

  • FDA Xiaflex information and comments
  • Xiaflex information
  • Xiaflex information
  • DCI and NHE LLC information from Xiaflex patients

Xiaflex complaints received by the FDA each year    

Year    Total complaints

2012              39
2013  23
2014  40
2015  342
2016  420
2017  320
2018  411
2019  659

Each year the Food and Drug Administration (FDA) reports the number of complaints it receives about many drugs – including Xiaflex.  The chart to the left shows that number of Xiaflex complaints increases each year.  Therefore, the number of lawsuits for Xiaflex treatment is likely increasing, also.  Although not an exact number, a trend is easy to see.

If the FDA determines that the complaints have reached an excessive number, they will investigate.                                    

Additional information is available on the FDA website concerning type, location and degree of injury in these Xiaflex complaints.   Compare the FDA Xiaflex complaints to your complaints for an idea how reasonable a Xiaflex lawsuit might be.

Satisfaction rating on

Visit to read patient reports about Xiaflex usage.   Patients give a satisfaction rating for their Xiaflex outcomes.  On a scale of 1-10, with 10 being the highest satisfaction, and 1 being the lowest satisfaction, the majority of people give a low satisfaction rating.  In fact, in May 2020, of nine total people responding, the average satisfaction level was 2.1 out of a possible 10 – shocking.

From this, a person can assume there is a large trend of unhappiness with Xiaflex.  This low level of dissatisfaction could easily cause patients to start a Xiaflex lawsuit. rating gives low star rating for Xiaflex allows patients to rate the drugs they take on a 1-5 star scale. These patients also tell stories about their drug usage.  They also rate the effectiveness, ease of use and satisfaction with many drugs.  Anyone thinking about Xiaflex should read the WebMD page about Xiaflex.

On this page, 81 patients who had the Xiaflex procedure provide stories about what happened to them.   As a group, they are not very satisfied after having the Xiaflex procedure.   In May of 2020, the satisfaction level with Xiaflex is 2.42 stars out of a possible 5 stars. This insight should give you an idea how people feel about a Xiaflex lawsuit.

More reports about lawsuits for Xiaflex

Unfortunately, as the use of Xiaflex becomes more common, DCI and Natural Health Education LLC receives more stories like yours.  Typical stories all mention some degree of injury or destruction of finger and hand muscles, joints, nerves, flesh and blood vessels.  Of course, these injuries cause a wide range of mild to severe problems.  For example, loss of hand function, pain, loss of feeling, weakness, limited movement and flesh erosion wounds needing reconstructive surgery by a plastic surgeon.  Many of these people say they already have a Xiaflex lawsuit for their severe injuries.

Although rare, we have heard of two cases leading to amputation as a final solution.  One was a finger amputation. The other, a partial hand amputation.  It is reasonable to assume there is a high percent of lawsuits for Xiaflex injuries in such extreme cases.

Tissue necrosis

Sorry to hear of your bad Xiaflex reaction.  You mentioned that necrosis of your finger occurred.

Necrosis is the unnatural and premature death of some or all cells in an organ or tissue.  Causes include loss of blood supply, freezing, burning, infection, toxins, trauma or digestion by enzymes.  The area affected can be large or small.  Necrosis can result in a wide variety of serious and painful side effects in any tissue close to the site of Xiaflex injections.

Tissue necrosis is a serious complication.  It is perhaps the most common and potentially complicated injury after a Xiaflex procedure goes wrong. This is true because the nature of necrosis is that the tissue dies and does not heal.  Tissue destroyed by necrosis does not come back.

Locate an attorney for a Xiaflex lawsuit

Lawsuits for Xiaflex are never simple or easy. You want someone working for you who has conducted at least several Xiaflex lawsuits.  However, the Xiaflex procedure is relatively new.  For this reason, not many lawyers have much experience in this area.  For helpful ideas to locate a great attorney specifically for this problem, see Xiaflex lawsuit.

Good luck with your hand.

Why is Xiaflex not indicated for palmar nodules?


Why is Xiaflex not indicated for palmar nodules? If it weakens and dissolves the cord, why would it not dissolve a nodule?

Thank you,



Greetings RSW,

The fact is a Xiaflex injection would weaken and dissolve a palm nodule, but then you would have a hole in the palm of your hand.   For this reason Xiaflex is only used to treat Dupuytren cords which are below the surface of the skin.

Of course, with Xiaflex injections the medical profession knows that the Dupuytren cords will return rather quickly, usually just a few years, and more injections would then be used.  There are two problems in doing this:  1. No one knows what happens to the body with repeated Xiaflex injections.  2. Each time a person has a Xiaflex injection as a Dupuytrens treatment he or she runs the risk of having the Xiaflex dissolve normal tissue and cause problems greater than having Dupuytren’s contracture.  For this reason we strongly suggest that anyone with Dupuytrens contracture first attempts to correct their problem using Alternative Medicine.  TRH     

What does Dupuytren’s contracture look like?

Pictures of Dupuytren’s contracture show lumps in the palm, cords and fingers deformity   

Before displaying several Dupuytren contracture pictures it might be helpful to explain that there are two primary lesions associated with this problem.

  1. Dupuytren nodule or lump on the palm surface – This often looks like a callus on the palm or melted wax on the palm surface, usually located at the base of the 4th (ring) or 5th (pinky) fingers.  The skin is often dimpled or depressed along with a slightly raised surface, and will often appear to be a slightly darker color due to the thickening of the tissue that is taking place, similar to a callus.  As the condition progresses you will probably notice the palm lump having more clearly defined edges, deeper depressions or dimples, and thicker over time.
  2. Dupuytren cord below the palm surface – You will not directly see the cord since it is below the surface of the skin.  A cord raises the skin surface like one of the larger ligaments that you notice standing out and pushing the skin up, on the inside surface of your wrist or the bend of your elbow, when you make a fist or lift something heavy.  A cord will be found extending from the upper palm at one end to the base of the finger at the other end.  As the condition progresses you will probably notice the cord getting thicker and more pronounced over time.

In addition to the appearance of the skin related to Dupuytren’s contracture, there is also the condition of the finger flexion that is part of the visual image that is important.  As the contractures continue to thicken and shorten the involved fingers begin to flex down toward the palm.  Over time those fingers will slowly and progressively become bent, unable to straighten completely, and will be somewhat claw-like in appearance.

These Dupuytren’s disease pictures that follow should be used only for general knowledge, to compare or confirm what the reader might be experiencing, or just to see how severe the finger contracture and hand deformity can develop. In the early stages of Dupuytrens contracture everyone feels worried about the small – and sometimes large – changes in the appearance of the hand.  Not knowing about a problem and how bad it can become can be the worse part of a condition like this.

No picture of Dupuytren contracture will look exactly like what you might be experiencing.  Therefore, they are not intended to assist in making a diagnosis of Dupuytren’s contracture.  If you have not yet visited your doctor to have your hand lumps examined, allow these Dupuytren pictures to motivate you to seek prompt medical attention and a doctor’s opinion about your problem. Perhaps after studying these Dupuytren images you will feel relieved you are not so bad off in comparison to other people’s situation.

Hopefully, these Dupuytren’s pictures will be helpful to understand what this problem can look like, motivate you to get a thorough medical evaluation, and then get busy following an aggressive Alternative Medicine therapy plan to improve your changes for self-recovery to overcome your problem.  Click on Dupuytrens Treatment, to determine how to incorporate the aggressive use of multiple conservative measures to treat the fibrous thickening you might be experiencing.

Please feel free to contribute your own Dupuytren contracture pictures to DCI for inclusion on this page.

picture of Picture of Dupuytren contracture of left hand, showing well developed palm lump and pit formation with moderate ring finger flexion


picture of Picture of Dupuytren contracture of left hand, showing cord and advanced flexion of ring finger








Picture of Dupuytren lumps or nodules at base of 2nd and 3rd fingers of left hand






Dupuytren cord and little finger contracture of left hand, clearly defined on palmPicture of Dupuytrens, right hand with palm lump at base of pinky fingerPicture of Dupuytren lump on palm of right hand with slight flexion of middle finger







Dupuytren contracture picture, lump on palm of right hand, deep dimples and thickeningPicture of bilateral Dupuytren's contracture, clearly showing cords and riing finger contracture worse on the left hand







Dupuytren's contracture photo, left hand, well developed nodule or lump on palm and moderate finger flexionPicture of Dupuytren disease, multiple lumps on palms of both hand