Plantar fibromatosis, also known as Ledderhose’s disease, is a condition that causes benign, slow-growing nodules to form along the fascia of the foot. The nodules may grow slowly, undetected for months or even years at a time, followed by sudden, rapid growth. As time passes and the nodules grow, walking may become uncomfortable or painful. While this condition sounds scary, it is relatively rare, and the nodules are almost never malignant. How will you know if the symptoms you’re experiencing are plantar fibromatosis? What causes this condition? Is plantar fibromatosis related to plantar fasciitis? And what are your options for treatment if you are diagnosed with plantar fibromatosis? Here’s what you need to know:
Plantar Fasciitis vs. Plantar Fibromatosis
While both plantar fasciitis
and plantar fibromatosis revolve around the fascia of your feet, the causes of the two conditions are typically considered to be very different. Plantar fasciitis is caused by overuse and trauma to the arch of the foot, while researchers believe that the primary cause of plantar fibromatosis is rooted in genetics.
While there are some researchers who believe that plantar fibromatosis can be triggered by the body’s healing response to a tear in the fascia–a possible connection to plantar fasciitis–this link has not been proven. It is, however, just one more good reason to take good care of your arches!
Regardless, it is possible to have both plantar fasciitis and plantar fibromatosis at the same time. And, depending on the location and severity of the nodules caused by plantar fibromatosis, orthotic inserts
that lift, cushion, and support the arch of the foot may be an effective, non-surgical way to make walking and physical activity more comfortable.
Causes of Plantar Fibromatosis
Researchers are still working to understand the exact cause of plantar fibromatosis, but the general consensus is that the condition is genetically inherited. In other words, if someone in your family has this condition, you’ll want to pay special attention to the symptoms listed below. As with many genetic disorders, the genes for plantar fibromatosis can be influenced by a number of factors which increase the likelihood that you’ll develop this condition. Risk factors for plantar fibromatosis may include alcoholism, smoking, and chronic stress to the feet. There also appears to be a connection between plantar fibromatosis and epilepsy, thyroid conditions, palmar fibromatosis (a condition affects the connective tissue in the hands), and diabetes. Men develop plantar fibromatosis more often than women.
Symptoms of Plantar Fibromatosis
Because the nodules from plantar fibromatosis develop so slowly–and may event stop growing altogether and become dormant for months and years–many people aren’t aware that they have this condition for many years. Usually, the first symptom is a small, painless lump on the sole of the foot. In most cases, this lump appears that the highest part of the arch. Walking or physical activity may become uncomfortable of painful as the lump grows and rubs against your shoes or the ground as you walk. Usually, you’ll only notice this lump in one foot. Only a small percentage of people who have plantar fibromatosis experience the condition in both feet at once.
Diagnosis and Treatment of Plantar Fibromatosis
If you notice symptoms that might indicate plantar fibromatosis, your doctor will likely recommend an MRI or sonogram as a first step. This will help you and your doctor see the extent of the plantar fibromatosis and determine next steps in treatment. If the nodule(s) are small, your doctor will recommend that you avoid direct pressure, and may also recommend orthotic insoles that cushion and support your arch and relieve pressure to the nodules. If conservative treatments aren’t effective, or if the nodules continue to cause pain while walking, your doctor may recommend radiotherapy to reduce the nodules’ size. The side effects of radiotherapy are minor, and this treatment has been shown to be approximately 80% effective (Panizzon & Seegenschmiedt, 2014). Other non-surgical treatment options that you and your doctor may explore include cortisone injections and collagenase
injections. Surgery is usually recommended as a last resort, and only if the nodules cause unmanageable pain. Because the nodules are typically so closely situated to muscles, nerves, and tendons, it can be very difficult to remove all of the nodules. And any portion of the nodules that remain in the foot will continue to grow. Surgery also has a long recovery time and can be very costly. There’s nothing more unsettling that discovering a lump on the foot. And while the symptoms of plantar fibromatosis can be disconcerting, the good news is that most cases can be managed effectively at home, without surgery. Recognizing the symptoms, understanding your options for treatment, and then working with your doctor to determine how to best manage this condition will help get you back on your feet and in control of your health.