My hand was at about the same stage as you describe - no contracture of fingers, tightness across the palm and some cupping, reduced span across palm from thumb to pinky, reduced span across the web from thumb to forefinger, some visible cords and some deep, itchy crawly feeling in the palm. I was always conscious of the weird stuff going on in my hand/palm.
I chose NA to flatten the palm. It was not a problem at all. I followed about 4 months later with RT. My radiologist said that getting NA first so the hand could lay flat was the thing to do. RT has stopped, or at least slowed the progression. No more itchy crawly feeling. Increased span beyond even what NA did.
My position was to NOT wait until I had folded up fingers. I'm glad I chose what I did, although I was uneasy at the time. I evaluated everything and made my decision based on all the info I could find. I'll do both again if the same thing occurs in my left hand.
Just read the info in links you can find in the menus on the left. Read people's experiences in this Forum, ask every question you think of. After you know all your options, you will be able to decide. Only you can know that because each person, each hand is different.

@Tam1,
From what I have researched, but mostly from my experience and from experiences posted on this Forum, NA doesn't seem to be a trauma that triggers Dupuys, whereas surgery is a much more invasive process that may. I would agree. Others have attributed an injury or trauma to their hand as seeming to trigger or make their Dupuytren's worse. In my case, I had no trauma or injury, only 70 birthdays which you can say add up to something like trauma. (The first thing I ever read about DD was that it occurs mostly to people in their 6th or 7th decade. I loved that subtle way of saying, "You're old! I use it now, "I'm not old, just in my 7th decade.")
From the start I was aggressive in searching for alternative treatments to avoid ever having to have my hand drawn up into a claw or to ever need surgery, so I pursued NA for my early DD. I was not accepted for Xiaflex clinical trials because my hand wasn't contracted enough. My NA doctor, a hand specialist/surgeon used to do the full surgery for Dupuy's Contracture before he learned about NA. Now, he prefers to do the alternative treatment. Surgery seems to always be an option after NA, but sometimes NA isn't feasible after surgery is my understanding. (Others on the Forum, please correct me if I'm off base on this.)
Just my preference, but I did not want my DD to progress to severe contracture. If joints are too bent, it is much more difficult to release for various reasons.
My radiologist said the best sequence is NA first to release any contracture, then RT. I had cords in my palm and some contracture caused by those cords. I was and still am fortunate not to have contracture in the PIP and DIP joint. Even the metacarpal joints were affected very little, mostly in my thumb. DD was just busy doing it's thing in my palm.
If you don't have any contracture but active DD, RT will likely work to prevent contracture. RT helps with the nodules but it will not release cords that have already contracted. My intent with RT was to keep DD from progressing and I didn't expect or care if it made it better, however my RT did reduce the tightness in my palm but not completely. I took that as an unexpected bonus.
Not sure I answered your question. Feel free to ask me or others. This is a very helpful group of people.

I think flojos suggestion with radiotherapy for the early stage is most interesting;
fo me it was the only causative treatment getting to the point where the disease
apperas to be active - NA or any type of surgery will not interfere with the bad
guys i.e. the growing fibroblasts (the mother cells of all fibrocytes) which produce
the nodules. Only radiotherpy can prevent these bad guys to continue with their
work ... its really convincing to me!

What shall a needle or knife care for these cells ? If you are lucky, they don't
recognize the trauma, but otherwise the may get wild and cause further growth.

Luba,
So sorry the second NA isn't lasting. I'm glad that at least it's better.
There is no manual, no prescription, no prognosis, absolutely nothing that applies consistently to this disease other than it is weird. I'm glad that this site and the people on the Forum provide information about treatment options that others can use to make decisions about what to do. If it hadn't been for this Forum, I don't know what I would have done or how my hands would be by now. Thanks, Wolfgang and Dupuytren Society, for making this possible!!

Hi Luba,
I was wondering, you said the DIP and the Pip joint on your pinkie were both involved. Was that from a cord coming up from your palm or just from nodules? In my case, there are no cords coming from my palm, but the pinky has a large nodule that is causing it to bend at the PIP joint and possibly the top joint (is that the DIP?) seems to be bending also.
I can see it getting worse day by day.

Paula