Many people first notice a small lump in the palm of their hand. At first it may not be painful and might not seem particularly significant. Months or even years later, they may notice increasing tightness in the palm or difficulty fully straightening one or more fingers.
For people living with Dupuytren’s contracture, this gradual progression can make everyday activities such as gripping objects, shaking hands or placing the hand flat on a table increasingly difficult.
At Feet & Motion Podiatry Clinic in Horsham, we offer Extracorporeal Shockwave Therapy (ESWT) as one of the treatment options for carefully selected patients with Dupuytren’s contracture. While the evidence is still developing, recent research suggests it may offer benefits for some people, particularly during the earlier stages of the condition.
What is Dupuytren’s contracture?
Dupuytren’s contracture develops when the fascia—a layer of connective tissue beneath the skin of the palm—gradually thickens and tightens.
The exact cause isn’t fully understood, although genetics play a significant role. It is more common in men over the age of 50 and is associated with factors including diabetes, smoking and excessive alcohol consumption.
The condition usually progresses slowly. Early signs often include small nodules or lumps within the palm that can gradually develop into fibrous cords, restricting finger movement over time. While not everyone experiences pain, many people notice increasing stiffness and reduced hand function as the condition progresses.
What is Shockwave Therapy?
Extracorporeal Shockwave Therapy (ESWT) is a well-established treatment used for a wide range of tendon and soft tissue conditions.
It delivers controlled acoustic waves into affected tissues, creating a mechanical stimulus that encourages a biological healing response and tissue remodelling.
Treatment is completely non-invasive, requires no injections or surgery, and sessions are typically short, allowing patients to return to their normal activities immediately afterwards.
Can shockwave therapy help Dupuytren’s contracture?
Research into shockwave therapy for Dupuytren’s contracture is still evolving.
A 2024 systematic review, published in the Archives of Physical Medicine and Rehabilitation, analysed six clinical studies involving 145 patients. The review found improvements in pain, hand function and patient satisfaction following treatment, while also concluding that larger, high-quality clinical trials are still needed to better understand which patients are most likely to benefit (Archives of Physical Medicine and Rehabilitation, 2024).
Unlike some tendon conditions, shockwave therapy for Dupuytren’s contracture is not currently supported by the same breadth of national guidance or clinical evidence. This is why careful patient selection and an open discussion about the current evidence are so important.
It’s also important to understand what shockwave therapy is—and isn’t—designed to do.
The aim isn’t to straighten fingers that have already developed significant contractures or replace surgery where surgery is the most appropriate treatment. Instead, treatment is aimed at reducing pain, improving tissue mobility and potentially slowing symptom progression in carefully selected patients.
Is shockwave therapy suitable for everyone?
No.
At Feet & Motion, we don’t recommend shockwave therapy simply because someone has Dupuytren’s contracture.
Every patient undergoes a detailed assessment before treatment is recommended. This allows us to understand your symptoms, consider the stage of your condition and discuss whether the current evidence suggests you’re likely to benefit from ESWT.
Shockwave therapy may be most appropriate for people with painful nodules or earlier-stage disease, where the aim is to improve comfort and hand function rather than correct established finger contractures.
At Feet & Motion, we only recommend shockwave therapy when we believe the potential benefits outweigh the limitations of the current evidence. We’ll always explain what is known, what remains uncertain and whether we feel treatment is appropriate for your individual circumstances.
Our approach at Feet & Motion
We believe treatment decisions should always be guided by the best available evidence and tailored to the individual.
Where appropriate, shockwave therapy may form one part of your overall management plan alongside advice about activity modification, stretching, monitoring and ongoing review.
Our goal is to help you remain as active, comfortable and independent as possible while ensuring you understand both the potential benefits and the limitations of treatment.
Thinking about shockwave therapy?
If you’ve been diagnosed with Dupuytren’s contracture and would like to explore whether shockwave therapy could be an appropriate treatment option, we’d be happy to discuss the current evidence, explain what treatment involves and help you decide whether it’s likely to benefit your particular situation.
At Feet & Motion, our aim isn’t simply to provide treatment. It’s to ensure you understand your options, make an informed decision and receive care that’s appropriate for your individual circumstances.
Olive Giles
Natalie Kitchener