Fiducia TogetherDupuytren's contracture
The tissue in the palm thickening and pulling fingers into the hand. Painless, gradual, and the timing of surgery matters.
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.
What it is
Dupuytren's contracture is a thickening of the fascia, the layer of tissue under the skin of the palm. Cords form and gradually pull the fingers towards the palm.
It affects around 4% of people in the UK, more often men over 50, and it runs strongly in families of northern European descent. It is associated with diabetes, epilepsy medication and alcohol.
It is usually painless, which is why people leave it. The ring and little fingers go first.
The practical test everybody uses is the tabletop test: can you lay the hand flat on a table? Once you cannot, referral is appropriate. Waiting until the fingers are fully curled makes correction harder and less complete.
Signs you might notice
A firm lump or dimple in the palm, usually at the base of the ring or little finger.
A cord developing under the skin, running towards the finger.
The finger gradually bending and not straightening fully.
Difficulty laying the hand flat, putting a hand in a pocket, washing the face, or shaking hands.
Usually painless. Pain, or rapid onset, suggests something else.
How it can affect day-to-day life
The functional problems are specific: gloves, pockets, washing, and putting a hand flat on anything.
The condition tends to progress in bursts with long stable periods, which makes people assume it has stopped.
Treatment options are surgery, needle fasciotomy, or in some places injection. Recurrence is common with all of them, and expectations should be set accordingly. Aggressive early treatment is not better.
Supporting someone well
Do the tabletop test periodically. When the hand will not lie flat, ask for referral.
Do not treat early lumps aggressively; treatment is for contracture that affects function, not for a nodule.
After treatment, do the hand therapy and wear the splint as directed. Outcomes depend heavily on it.
Manage diabetes well, since it is associated.
Expect recurrence and plan around it rather than being surprised.
Where to get help
A GP can refer to hand surgery when the tabletop test is positive.
The British Society for Surgery of the Hand publish patient information on the options.
Sudden painful swelling of the palm is not Dupuytren's and needs assessment.
Last reviewed 2026-08-28 by Fiducia Together · Next review due 2027-08-28
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.