Dupuytren’s treatment in the UK
Dupuytren’s disease (Dupuytren’s contracture) is a benign condition where the tissue under the skin of your palm thickens. It often starts as a small lump or nodule. For some people, it gradually causes your finger to bend towards your palm. Different treatments are available for different stages. Low-dose radiotherapy is a non-surgical option during the early stages while the disease is still developing.
Many patients with hand symptoms are told to come back when their finger bends. At Dupuytren’s UK, Dr Richard Shaffer can look at your hand, explain where you are and tell you honestly whether treatment, monitoring or waiting makes the most sense.
Where are you on the Dupuytren’s journey?
Dupuytren’s disease develops at different speeds in different people. Some might notice a small lump that barely changes for years, while others might experience new nodules, then a cord, then difficulty straightening their finger. Knowing how far your Dupuytren’s has progressed is the first step in choosing a suitable treatment.
“I’ve found a lump in my palm.”
This is a nodule: a firm lump, most often at the base of your ring or little finger. It is usually painless. Itching, tenderness or recent growth may be signs that the disease is active. Specialists may recommend assessing and monitoring the nodule at this stage, and sometimes radiotherapy if it is changing.
“Things seem to be getting worse.”
You may notice that a cord or band has formed under your skin from your palm towards your finger. Your fingers still straighten fully or almost fully. Radiotherapy can be an option to consider at this stage.
“My finger is starting to bend” or “I can’t straighten my finger.”
This describes contracture, where your fingers are pulled into a bent position. Treatment options at this later stage may include needle treatment or surgery, as radiotherapy can be less suitable once your finger has bent significantly.
One distinction worth knowing
Dupuytren’s disease starts with the first nodule. “Contracture” is the later stage, once a finger will not straighten. Many people have Dupuytren’s disease for years without experiencing contracture.
Nodule or callus?
A callus is part of the skin, so you can pinch and lift it with the skin. A Dupuytren’s nodule is fixed underneath and will not lift.
Dupuytren’s contracture treatment options in the UK
No treatment can permanently cure Dupuytren’s disease. Instead, Dupuytren’s treatments aim to slow down the disease or straighten a finger that has bent. The most suitable option for you will largely depend on your stage. Radiotherapy is aimed at early, changing disease. Needle treatment and surgery are used for fingers that have already bent.
| Option | Stage it suits | What it typically involves | Typical Recovery | Availability in the UK |
|---|---|---|---|---|
| Monitoring | Early symptoms, like a small nodule and no bent finger | Monitor every 2 months, tracking the results with photos, and review if anything changes | None | NHS and private |
| Low-dose radiotherapy | Early disease that is still changing, with fingers that partially or fully straighten | A short course of outpatient appointments, a few minutes each, using low-energy X-rays. No anaesthetic and no incision | Most people carry on with normal activities | Mainly private |
| Needle aponeurotomy (needle fasciotomy) | A bent finger with a clear cord | Local anaesthetic is applied, and a fine needle is used to divide the cord. The procedure is quick, but the cord can return, so it may need repeating | A few days | NHS and private |
| Fasciectomy (surgery) | A significant finger bend that affects your daily life | An operation to remove the diseased tissue. A skin graft is sometimes needed | 6-8 weeks, with hand therapy | NHS and private |
| Collagenase injection | A bent finger with a clear cord | An enzyme injection to weaken the cord. It is often mentioned on overseas websites | Not applicable | Not currently available in the UK |
What does not help
There is no good evidence that stretching, massage, splints on their own or supplements can change your symptoms or stop Dupuytren’s from progressing. Do not try to pull your finger straight. Forcing it creates strain, which can irritate the tissue and make the condition progress faster.
One reassurance
Having radiotherapy does not rule out needle treatment or surgery later.
Not sure which fits you?
Book a consultationRadiotherapy for early Dupuytren’s disease
Low-dose radiotherapy uses carefully targeted, low-dose X-rays to calm the tissue changes behind early Dupuytren’s. It is designed to stop the disease from getting worse. It does not straighten a finger that has already bent.
What makes treatment most worthwhile:
- Nodules in your palm. These are the firm lumps that often appear first. You don't need to have cords.
- Fingers that can still straighten, or almost straighten. This is essential. Radiotherapy works best before a finger starts to bend.
- New lumps appearing in your palm or elsewhere in your hand
- Existing lumps getting bigger
Radiotherapy is generally not suitable once a significant contracture has developed.
What treatment involves
A short course of outpatient appointments, each lasting a few minutes. There is no anaesthetic, no incision and no recovery period, so most people carry on working and driving. You may notice temporary red or dry skin in the treated area, and Dr Shaffer will advise you on aftercare.
What the evidence says
NICE has found no major safety concerns with radiotherapy as a treatment for early Dupuytren’s. Results vary because the disease is unpredictable, and some lumps stop growing on their own anyway. Radiotherapy is not guaranteed to stop your finger from bending, and it involves a very small, theoretical long-term risk of skin cancer from the X-rays in the area treated.
Why timing matters
Your skin can only safely handle a limited amount of radiotherapy in a lifetime. If your condition is stable, Dr Shaffer may recommend waiting until your symptoms truly need treatment.
Your consultation is with Dr Richard Shaffer
Dr Richard Shaffer is a Consultant Clinical Oncologist who has treated around 3,500 patients with benign conditions, including Dupuytren’s and Ledderhose disease. He also trains other consultants in radiotherapy for benign conditions.
Dr Shaffer set up Dupuytren’s UK to offer non-surgical care to people with early Dupuytren’s and Ledderhose disease, who are often told there is nothing to be done until their finger bends.
During your appointment, he will examine your hand, assess your symptoms and explain your available options. He can advise you honestly on whether radiotherapy, surgery, or simple monitoring are best for you at your specific stage.
What happens when you get in touch
Getting started is simple, and you do not need to have it all worked out first.
Get in touch. Book a consultation online, send an enquiry, call 07584 532397 or message us on WhatsApp. You do not need a GP referral to see Dr Shaffer. Once you book, we’ll send you a confirmation email with a short health questionnaire and our patient information leaflet.
Have your consultation. Your first appointment can be in person in London, Guildford, Nottingham or Manchester. Dr Shaffer will look at your hand and talk you through your options.
Create a plan. If radiotherapy suits you, he will explain what it involves and what you can expect. If monitoring or another treatment suits you better, he will say so and give you detailed instructions.
Treatment and follow-up. Your treatment will take place at whichever of our 16 centres is most convenient for you.
Patients in their own words
These stories reflect individual experiences, and results vary from person to person. They are here so you can hear what the process felt like for people in a similar position.
NHS, private insurance and self-pay
Dupuytren’s treatments usually only become available through the NHS once your finger has bent enough to affect your daily life. Available treatments usually involve needle treatment or surgery. During earlier stages, it does mean that your symptoms will usually be monitored rather than treated.
On the NHS: Radiotherapy for early Dupuytren’s is not widely available, so most people who choose this option pay privately. That does not affect your NHS care: you can stay with your GP or hand surgeon and have further NHS treatment later if you need it.
With private medical insurance: Bupa, Vitality and WPA generally fund radiotherapy for Dupuytren's, depending on your policy. AXA and Aviva do not currently cover it for Dupuytren's, although Aviva does cover it for Ledderhose disease.
Whichever insurer you're with, the first step is to get authorisation for your initial consultation. Once you've seen Dr Shaffer, we'll talk you through how your treatment is funded.
If you are paying yourself: We can give you a quote for your treatment before you commit to anything. Contact us for an estimate.
Payment and insurance informationWhere you will be seen and treated
Dr Shaffer sees patients for consultations in London, Guildford, Nottingham and Manchester. He prefers to see everyone face to face, because examining your hand gives him the best basis for advising you.
Once treatment is agreed, it can be done at any of our 16 centres across the UK, so you can choose whichever suits you best. Find your nearest centre below.
Video consultations are only offered in exceptional cases, such as for patients based overseas. It is harder to assess your hand and plan treatment that way, so please talk to us first if you can't travel.
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