What is this Lump in My Palm? Understanding Dupuytren's Contracture
- baysidehandtherapy
- Aug 5, 2022
- 3 min read
Updated: Feb 18
Have you noticed a firm lump or thickened area forming in the palm of your hand? Perhaps it is becoming harder to lay your hand flat, or one or more fingers seem to be slowly curling towards the palm. If this sounds familiar, you may have a condition called Dupuytren’s contracture — a common yet often misunderstood problem that affects the hand.
At Bayside Hand Therapy, we often see people who are concerned about a new lump in their palm. The good news is that not every lump is something to worry about, but it’s always worth getting it checked by a qualified health professional. Understanding what’s happening in your hand is the first step towards getting the right treatment.
What is Dupuytren's Contracture?
Dupuytren’s contracture (pronounced dew-pwee-tron’s) is a condition that affects the connective tissue just under the skin of your palm, known as the palmar fascia. Over time, this tissue can thicken and tighten, forming small nodules or cords. These cords may gradually pull one or more fingers into a bent position, making it difficult to straighten them fully. The cords may look like a thickened tendon, but Dupuytren’s disease does not involve the tendons, only the tissue between the tendons and the skin. Occasionally there is puckering of the skin due to the contracted tissue pulling on the skin.
This condition most commonly affects the ring and little fingers, although it can occur in any finger or even the thumb. Although it is generally not painful, the lump in the palm is sometimes tender when it first develops. The tightness can also be uncomfortable when the affected finger is stretched back.
For some people the disease may not progress any further than the nodules near the crease in the palm. For others, over time there may be further thickening and shortening of the fascia which causes tight bands to form. Thickened cords can limit finger extension. As the condition progresses, it can become difficult to perform daily tasks such as shaking hands, washing your face, or putting your hand in your pocket.
What causes Dupuytren’s contracture?
The exact cause of Dupuytren’s contracture isn’t fully understood, but it may be influenced by several factors, including:
Genetics: It often runs in families, particularly in people of Scottish or Irish ancestry
Age and gender: The condition tends to appear after the age of 50 and affects men more commonly than women.
Recent injury or surgery to the hand : Dupuytren’s occasionally appears soon after an injury or unrelated surgery to the hand.
How likely is it that my Dupuytren’s contracture will progress?
The course of Dupuytren’s is difficult to predict but research suggests that once someone has developed a nodule, over the next 10 years:
1 in 10 will go away
2 in 10 will develop a bend in the finger that may require surgery
7 in 10 will have little change and therefore not require surgery.
How is Dupuytren’s contracture diagnosed?
Diagnosis is usually straight forward and can be made through a physical examination by a qualified hand therapist or specialist.
There are some other conditions which can mimic Dupuytren’s contracture. Trigger finger can also cause a tender lump in the palm due to thickening of a tendon pulley, however unlike Dupuytren’s contracture, where the flexed finger cannot be extended, a trigger finger temporarily gets stuck in a flexed position but can usually be corrected with effort or with the help of the other hand.
Another extremely rare cause for a lump in the palm is a tumour, but it should be emphasized that tumours in the hand are extremely rare.
What are the treatment options?
In mild cases, no immediate treatment is needed — simply monitoring the condition can be enough.
If the condition progresses and the bent finger is starting to interfere with hand use, surgery to remove the cords may be recommended. Following surgery, hand therapy is essential to help ensure that the finger/s remain straight afterwards, and to reduce swelling, soften the scars and restore full flexion and strength.
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