Plantar Fibromatosis aka Ledderhose Disease - Foot Pain Explored (2024)

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Written By: Chloe WilsonBSc(Hons) Physiotherapy
Reviewed By:FPE Medical Review Board

Plantar Fibromatosis aka Ledderhose Disease - Foot Pain Explored (1)

Plantar Fibromatosis is a foot condition where a small nodule, a fibroma, grows in the arch of the foot on the plantar fascia.

A plantar fibroma is a benign growth i.e. non-cancerous, which tends to be slow growing and usually less than an inch in size.

Plantar fibromatosis is often painless but, depending on the location and size of the nodules, it can start to causefoot arch painwhen you are on your feet.

Other medical terms for plantar fibromatosis include Ledderhose Disease, after Georg Ledderhose who first identified the disease in 1894, Morbus Ledderhose and Plantar Fascial Fibromatosis. It is a similar condition to Dupytren’s contracture which occurs in the hand causing flexion of the fingers.

What Is Plantar Fibromatosis?

In plantar fibromatosis, thickenings develop in the plantar fascia, the thick band of fibrous tissue on the bottom of the foot.

Plantar Fibromatosis aka Ledderhose Disease - Foot Pain Explored (2)

The plantar fascia runs between the heel and the toes, helping to support the arches of the foot.

The thickenings in the plantar fascia can end up forming small nodules, plantar fibromas, usually in the central or medial portions of the plantar fascia. There may be one solitary nodule or a cluster of nodules may develop.

Ledderhose Disease is a relatively minor condition but can cause foot arch pain with weight bearing activities such as standing and walking. Plantar fibromatosis usually only affects one foot, but in 25% of cases, both feet are affected. It should not be confused withplantar fasciitiswhere there is inflammation and degeneration of the plantar fascia.

Plantar Fibromatosis Symptoms

Common symptoms of Ledderhose Disease include:

Plantar Fibromatosis aka Ledderhose Disease - Foot Pain Explored (3)

  • Visible Nodule: The most common symptom of plantar fibromatosis is a small lump under the skin on the sole of the foot. These nodules tend to be on the inner side of the sole of the foot, at the highest point of the foot arch.

    Plantar Fibroma nodules are usually small in size, usually measuring less than one inch and feel firm to touch. They may remain the same size, grow over time or more nodules may gradually appear forming a cluster. The nodules can most easily be seen by dorsiflexing the foot – pulling the toes up. The plantar fibroma growths remain permanently unless removed surgically, they don’t just spontaneously resolve.

  • Foot Pain:Often plantar fascial fibromatosis is entirely painless, but as the lump grows it may start to cause problems. Foot pain from plantar fibromatosis tends to occur when there is pressure directly on the plantar fibroma nodule, either from prodding it, pressure from shoes or weight bearing through the foot when standing, walking or running
  • Toe Stiffness:As plantar fibromatosis progresses, it can cause thickening of the plantar fascia. This can result in contractures and tightness which cause the toes to bend, limiting toe movements, causing stiffness and making walking difficult.

Plantar fibromatosis may go undetected for years if it is not causing any pain.

What Causes Ledderhose Disease?

The underlying cause of plantar fibromatosis is unknown but there are a number of factors which are thought to be linked with Ledderhose disease:

  • Genetics:A family history of Ledderhose Disease or Dupuytren's Contracture in the hands are the strongest risk factor for developing plantar fibromatosis
  • Gender: Plantar Fibromatosis is more common in men then women with a male:female ratio of 2:1
  • Medical Conditions:Diabetes, epilepsy, liver disease and Peyronie’s disease are thought to be associated with increased risk of developing plantar fibroma
  • Long-term Alcohol Consumption: is thought to increase the risk of developing Ledderhose Disease
  • Repetitive Foot Trauma:it is thought that plantar fibromatosis may develop as a result of small tears in the plantar fascia. As the body tries to heal itself, it goes into overdrive, laying down too much new tissue which forms the nodules

Diagnosing Ledderhose Disease

Your doctor may be able to diagnose plantar fibromatosis through clinical examination.

If there is any doubt, an MRI scan (Magnetic Resonance Imaging) is usually the imaging of choice as there are other conditions than present in a similar fashion, such as plantar fasciitis.

MRI tends to be more accurate than x-ray or ultrasound at diagnosing plantar fibromatosis, showing the full extent of the condition.

Treating Plantar Fibromatosis

Plantar fibromatosis treatment usually involves a combination of the following:

  • Observation: Asymptomatic nodules, i.e. those that aren’t causing any pain, will most likely just be monitored. The nodules will never disappear, but they may never cause any problems.
  • Injections:Corticosteroid injections can help relieve the pain and are most effective in the early stages of plantar fibromatosis and when given under ultrasound guidance
  • Orthotics:Wearing shoe insoles or special padding can help to reduce the force through the nodules, making walking more comfortable
  • Physiotherapy:Treatment such as exercises, ultrasound and shock wave therapy may help reduce plantar fibromatosis pain.
  • Radiotherapy:If the nodule is growing and active then radiotherapy can be used to shrink and soften the lump. Whilst it won't get rid of the plantar fibroma completely, it may help delay progression for a number of years
  • Surgery: Surgery for plantar fibromatosis should only be considered when there have been prolonged high pain levels and resultant decreased activity levels over a number of months.

You can find out loads more about each of these treatment options including the pros and cons of each in the Plantar Fibroma Treatment article.

Your Questions Answered

  1. Can A Plantar Fibroma Go Away? Without treatment a plantar fibroma is unlikely to get smaller or go away. The symptoms of plantar fibromatosis will settle with treatment, but the fibroma itself will remain unless surgically removed.
  2. Is Plantar Fibromatosis Cancerous? No, a plantar fibroma is not cancerous. It is simply a mass of fibrous tissue in the foot which is completely benign i.e. non-malignant.
  3. Is Plantar Fibromatosis The Same Thing As Plantar Fasciitis?No, fibromatosis and fasciitis are different conditions. Plantar fibromatosis is when a nodule grows in part of the plantar fascia. Plantar fasciitis is when there is damage and inflammation to the plantar fascia.
  4. Is Ledderhose Disease Painful?Some people with Ledderhose disease do not get any pain at all, and may be completely unaware of the plantar fibroma. As the fibroma grows however, it may start pushing on surrounding tissues and causing pain when there is any pressure through the foot.
  5. How Common Is Plantar Fibromatosis?Plantar Fibromatosis is a relatively rare disease which affects less than 1% of the population. This figure however rises to around 25% in people over the age of 65. Ledderhose Disease is 10 times more in common in men than women.
  6. How Do You Stretch A Plantar Fibroma?You cannot stretch a plantar fibroma directly, but you can stretch the plantar fascia which it sits in. Rolling a golf ball or can underneath your foot is a great way to stretch out the area. Visit the plantar fascia stretches section to find out loads more.
  7. What Is The Plantar Fibromatosis ICD 10 Code? The 2021 icd 10 code for plantar fibromatosis is M72.2.

What Else Can Help

You can find out loads more about the different treatment and prevention options in the Treatment For Plantar Fibroma article.

There are a number of other conditions that can cause pain in the bottom of the foot. If plantar fibromatosis isn’t sounding quite like your problem, visit the foot arch pain page in the diagnosis section for help working out what may be causing your problem.

Related Articles

Common Symptoms
May 10, 2022

Diagnosis ChartMay 17, 2022

Foot Pain Treatment
November 4, 2020

Page Last Updated: 06/11/20
Next Review Due: 06/11/22

References

1. The Journal of Clinical and Aesthetic Dermatology - Ledderhose Disease: An Unusual Presentation. D. Fausto de Souza, L. Micaelo, T. Cuzzi andM. Ramos-e-Silva. September 2010

2. American Journal of Surgery -Incidence and treatment of recurrent plantar fibromatosis by surgery and postoperative radiotherapy. de Bree E,Zoetmulder F,Keus R,Peterse H and van Coevorden F. January 2004

3. Foot & Ankle Specialist Journal -Plantar Fibromatosis: Pathophysiology, Surgical and Nonsurgical Therapies: An Evidence-Based Review. Carroll P, Henshaw R, Garwood C,Raspovic K,Kumar D

Plantar Fibromatosis aka Ledderhose Disease - Foot Pain Explored (2024)

FAQs

What is the treatment for Ledderhose disease? ›

The most common surgery for Ledderhose disease is a fasciectomy, the removal of the fascial tissue. The success rate for this surgery is mixed, as the disease can eventually come back. Some doctors recommend radiation treatment after surgery, to reduce the risk of recurrence.

How do you get Ledderhose disease? ›

Repeated trauma, long-term alcohol consumption, chronic liver disease, diabetes, and epilepsy have also been reported in association with this condition. The exact cause of Ledderhose disease is not known, but heredity is thought to play a role in many cases.

What does plantar fibroma pain feel like? ›

The most common symptom of a plantar fibroma is pain on the bottom of your foot, usually in the arch. You'll likely notice this pain for the first time when wearing shoes that put pressure on the plantar fibroma under your skin. Depending on how big it is, a plantar fibroma can cause pressure on your foot.

Is Ledderhose disease serious? ›

It affects the plantar fascia, which is the thick layer of tissue (ligament) that protects and supports the bottom of your foot. If you have Ledderhose disease, small, hard nodules develop slowly on the bottom of your feet. These nodules are noncancerous (benign) thickening of this ligament.

Is plantar fibromatosis a disability? ›

Therefore, for a period of approximately two months, people who have undergone a surgery to remove a plantar fibroma will experience a disability. If the tumor or tumors are larger, or if there are more of them, the person may have a disability for a longer period of time.

Is Ledderhose disease curable? ›

Ledderhose disease usually doesn't cause problems, but sometimes it can slowly get worse. The pain and feeling of a lump in your foot can make it hard to stand or walk. In rare cases, the disease is disabling. Surgery to treat it relieves pain and can prevent Ledderhose disease from coming back.

How do you get rid of a plantar fibroma? ›

Treatment for a Plantar Fibroma
  1. Steroid injections. Putting corticosteroid medication into the nodule may help it shrink it, which will reduce or relieve the pain. ...
  2. Shoe inserts. If your doctor determines the nodule is not growing anymore, they may suggest using custom shoe inserts. ...
  3. Stretching. ...
  4. Physical therapy.
Apr 13, 2021

Is plantar fasciitis the same as Ledderhose disease? ›

Plantar fasciitis and Ledderhose disease are conditions that affect the feet. Both are a major source of pain and discomfort, but they each have different symptoms and treatments.

How big can a plantar fibroma get? ›

This tissue covers the area from your heel to your toes and stabilizes your foot arch. A plantar fibroma, which grows slowly over time, can develop on one foot or both feet. The nodule is typically less than 1 inch in size. A single lesion is referred to as a plantar fibroma.

What shoes should I wear with plantar fibroma? ›

OTC OrthoticWe generally recommend a supportive shoe like running shoe with a rigid heel counter, supportive midsole and lace up features as well as the addition of a firm arch support.

Should you massage plantar fibroma? ›

Treating Plantar Fibroma

A few weeks is the typical treatment time for plantar fibroma. Massaging the foot with a foam roller, tennis ball, or frozen water bottle can help release tension in the foot. Stretching the foot is important too. It can lengthen the tissues and increase circulation.

How long does it take for a plantar fibroma to go away? ›

At least 1-2 weeks, if you can keep your foot elevated and stay on crutches, or longer if this is not possible. It will take at least 6 weeks for the excised portion of the plantar fibroma to heal in a cast or CAM boot.

Is plantar fibroma rare? ›

Plantar fibromatosis (Ledderhose disease) is a rare, benign, hyperproliferative fibrous tissue disorder resulting in the formation of nodules along the plantar fascia.

Why is it called Ledderhose disease? ›

In the beginning, where nodules start growing in the fascia of the foot the disease is minor. Over time walking becomes painful. The disease is named after Georg Ledderhose, a German surgeon who described the condition for the first time in 1894.

Is plantar fasciitis the same as plantar fibromatosis? ›

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.

How do you get rid of a plantar fibroma naturally? ›

Plantar Fibroma Treatment, Information and Solutions - YouTube

What causes fibromatosis? ›

What causes fibromatosis? The cause of fibromatosis remains unclear. In some types of fibromatosis such as desmoid tumours, it is thought that the condition may be related to trauma, hormonal factors, or have a genetic association.

Is Ledderhose disease a connective tissue disease? ›

Ledderhose disease, also called plantar fibromatosis or Dupuytren's of the foot, is a benign thickening of the connective tissue (fascia) in the sole of your foot. It typically starts as a small lump, called a plantar fibroma, in the arch of your foot and may not affect your life for some time.

Is plantar fasciitis the same as Ledderhose disease? ›

Plantar fasciitis and Ledderhose disease are conditions that affect the feet. Both are a major source of pain and discomfort, but they each have different symptoms and treatments.

How do you get rid of a plantar fibroma? ›

Treatment for a Plantar Fibroma
  1. Steroid injections. Putting corticosteroid medication into the nodule may help it shrink it, which will reduce or relieve the pain. ...
  2. Shoe inserts. If your doctor determines the nodule is not growing anymore, they may suggest using custom shoe inserts. ...
  3. Stretching. ...
  4. Physical therapy.
Apr 13, 2021

Can you massage plantar fibroma? ›

Treating Plantar Fibroma

A few weeks is the typical treatment time for plantar fibroma. Massaging the foot with a foam roller, tennis ball, or frozen water bottle can help release tension in the foot.

Is Ledderhose disease a connective tissue disease? ›

Ledderhose disease, also called plantar fibromatosis or Dupuytren's of the foot, is a benign thickening of the connective tissue (fascia) in the sole of your foot. It typically starts as a small lump, called a plantar fibroma, in the arch of your foot and may not affect your life for some time.

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