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I Can’t Open My Hand All the Way: A Look at Dupuytren’s Disease

Last updated on November 3, 2021 By Kira Davis MPT 9 Comments

Why can’t I open my hand?

There is an interesting phenomenon in the world of hand illness called Dupuytren’s disease. It is a progressive illness that causes a contracture on the palm of the hand, making it difficult to fully open. This causes many problems including the following:

  • difficulty being able to grasp
  • difficulty with basic dressing
  • difficulty reaching into pockets
  • difficulty with personal hygiene.

The interesting thing about this disease is who gets it. It generally occurs in men in their 50s and women in their 60s. Men are also more likely to get this disease with ratios ranging from 2:1 to 10:1. Luckily, treatment results for both genders are similar.

This disease is commonly seen in Caucasians of Celtic or Viking descent. It is also prevalent in Japan, but not in other Asian countries, and it is very uncommon in Africans or Hispanics. Some other factors that have been commonly seen with Dupuytrens are Diabetes, alcoholism, family history, epilepsy (those taking Phenobarbital), AIDS, smoking, and vascular disorders.

grandparents playing with grandchildren

How did I get this?

The cause of Dupuytren’s disease is unknown, so a particular occupation or hand injury does not lead to somebody having this. However, this illness is hereditary, so if you are injured and are predisposed to Dupuytren’s, you may develop the symptoms that lead to hand contracture.

What does it look like?

People with Dupuytren’s disease develop cords on the palm of their hand. Dependent on where the cord is located will determine what the contracture will look like or determine how much functional limitation a person will ultimately have. Nodules also form.

The nodules tend to be the first sign of Dupuytren’s disease. Nodules can be tender or painful. These are easily seen, as they are more superficial than tendons in the palm. Because of this, cords without nodules are associated with more severe contractures.

How do I treat this?

Studies show that physical or occupational therapy alone does not achieve lasting effects. The best benefit of rehab is getting patient education and measurable data so only one visit is typically what is appropriate prior to any further treatments.

There are a many current treatments for Dupuytren’s contractures. Some are considered surgical and some are not. There are various types of surgical procedures that can be performed. Non-surgical procedures include using a needle to poke the cords, essentially releasing them; another procedure involves injecting an enzyme into the hand at the cord. The enzyme basically makes the cord very weak and then the hand is aggressively stretched a day later to rupture the cords. After any of these procedures, hand therapy is generally recommended for a few months.

If you think that you may be developing Dupuytren’s contracture and don’t know what to do next, contact your friendly therapists at PhysioDC and see us to get some further education on the matter, get some measurements of your mobility taken, and get some recommendations of medical providers that are in your area who may be able to help you.

Filed Under: Featured, Physical Therapy Tagged With: Hand Wrist & Elbow



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About Kira Davis MPT

Kira Davis has been practicing as a licensed physical therapist (license #PT870656) in the outpatient orthopedic setting since 2006 in the metropolitan Washington, DC area. She received her Masters of Physical therapy in 2005 from Howard University and her Bachelor of Science with a concentration in the Pre-Physical Therapy program in 2003 from Howard University. She has experience addressing many types of sports injuries and is herself an avid soccer player. Trained in classical dance since the age of 3 and an active dance student, she strives to be one of the area's elite physical therapists for the dance community.

FTC Compliance Disclaimer: PhysioDC.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com; proceeds from product sales help cover the operational & maintenance costs for the site.

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Discussion

  1. Darlene Bruehl says

    August 6, 2018 at 10:33 am

    My mother-in-law is 93 and is in stage 4 Alzheimers. She is always clinging to her purse straps, or holding a folded up kleenex in her fist. My sister-n-law insists she has arthritis, but the problem presented three weeks ago when my brother and sister-in-law were caring for mom while we took a couple of weeks off. My brother-in-law sits next to mom and she holds/squeezes his hand all day.
    It’s worse in the morning, and after rubbing pain creme and taking some pain med and using her hand for eating and holding a coffee cup, she seems fine.

    Reply
    • Dan Baumstark, MSPT, CHT says

      August 6, 2018 at 10:41 am

      This is probably just an effect of her constant clenching. Bring this up to the doc next time she has an appointment. She might benefit from a “pan splint” for the hand. This is something that serves to keep her hand flat.

      Reply
  2. Craig says

    January 11, 2019 at 11:09 am

    I’m losing strength in my left hand. My middle and ring finger won’t straighten. I can raise the first and last fingers but the other 2 stay at about a 30° angle. I’m straining to raise them but they just won’t move. There is like no strength if those fingers are bent in to my palm and I put pressure on them and try to move them.

    Reply
    • Dan Baumstark, MSPT, CHT says

      January 13, 2019 at 10:58 am

      I definitely think that a trip to a hand orthopedist would shed some light on this situation. This may very well be a Dupuytren’s contracture, the MD should be able to tell you that with a quick evaluation. The treatment for this is much less of a bother than it used to be!

      Reply
  3. Matthew Perry Sr says

    June 9, 2019 at 3:55 am

    I woke up not Being able to Open my Left Hand and my Fingers Are Kinda Closed On Their Own ! When I went to Sleep it was Fine ? It’s Been like this all day ? And its 4 am and it reminds me of my Grandfather Hand after his Stroke ! I Thought that’s What Happened To Me ! But everything else is Okay ! Except for my Hand it closes fine And strong but to Open it all the way feels like it’s Paralyzed to Some degree ! But I’m 50 yrs old and has Many Fusions in my Lumbar and Have Had Some Very Bad Issues With Getting Any Sleep For Sometime fo lately ! I’m just Scared it’s Permanent ??? Thank You for any help on what could have happened ???

    Reply
    • Dan Baumstark, MSPT, CHT says

      June 9, 2019 at 8:51 am

      This could be one of several things. Sometimes people fall asleep on the effected side and kink one of the nerves. It sounds to me like you might have done that?? This would manifest as a lack of ability to open the fingers up or extend your wrist. I would see your local doc about this to get a definitive diagnosis. Thses things usually come back, but in the case of a nerve getting kinked it can take some time.

      Reply
  4. George Turner says

    March 13, 2020 at 11:52 am

    My pinky finger ring finger and middle finger on my left hand are almost closed to palm and i cant open them. They only hurt if i do any excessive lifting
    Im 60 years old and had to quit work and was wondering if this is a disability?

    Reply
    • Dan Baumstark, MSPT, CHT says

      March 13, 2020 at 12:21 pm

      Hey George I think that you should see an orthopedist about this. They can give you some injections that can open that hand right up. This would be worth doing. I am not sure if it is a definable disability, but it certainly would keep you from being able to use your hand effectively.

      Reply
  5. Karo says

    May 25, 2022 at 1:58 am

    Hello and good day, I read your post and I appreciate the information. I can barely open both my hands, my fingers tend to rub against themselves, my grips are not strong, I can barely hold my phone right now, my fingers cannot open half way through my palm

    Reply

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