I had XRT in Germany in 2007 at the early stages of my own Dupuytren's. If I had a NA and the Dupuyrten's returned to the extent I qualified under the terms of my insurance company to get Xiaflex I would go to a doctor that does both NA and Xiaflex for treatment.

The Xiaflex is injected one day and it works over a 12 hour period. When the doctor a day later manipulates the hand there is no reason not to perform NA at the same time. Xiaflex is safer around nerve bundles in the hands but it is not 100% effective and so a quick NA the next day provides a better result, and in my own case as much better long term benefit.

By the way even with Xiaflex the doctor should first numb your hand before making the injections and should do so again the following day before doing the manipulation. As long as your hand is numb on the second day it is ready for the NA.

A doctor with experience with NA and with Xiaflex will know which to use where for best effect.