What is Ledderhose Disease?
Ledderhose Disease which is also known by the name of plantar fibromatosis is a rare pathological condition where the base or the bottom of the feet gets affected. The condition causes gradual buildup of connective tissue in the feet. This buildup results in formation of nodules at the base of the feet at the fascia at the connective tissue that joins the heel bone to the toes. These nodules do not cause any pain initially but if they grow in size may cause significant discomfort.
At times, these nodules become irritated and inflamed worsening the discomfort. Generally, the nodules in Ledderhose Disease grow very slowly and eventually stop growing at one time with the nodule staying the same size.
What Causes Ledderhose Disease?
Fascia is termed as a layer of connective tissue that is present almost all over the body. Nodules such as those seen with Ledderhose Disease forms when this fascia gets thick and clumps are formed. In cases, of Ledderhose Disease, why this fascia becomes thick is not known but researchers believe that both genetic makeup and the environmental factors play a role in this disease.
Ledderhose Disease is a benign condition but some studies suggest it to be associated with conditions like Dupuytren’s or Peyronie disease. However, there are some risk factors that increase the vulnerability of an individual having Ledderhose Disease. These factors include chronic alcohol abuse, liver dysfunction, and frequent foot traumas. People with diabetes, epilepsy, and certain classes of medications also increase the risk of developing Ledderhose Disease. This condition can affect people of any age but is mostly seen in people between 30 and 50 years of age and males tend to get more affected by it than females.
What are the Symptoms of Ledderhose Disease?
The presence of thick and firm nodules at the base of the feet is the classic presenting feature of Ledderhose Disease. This is seen generally in one foot even though there are about 20% cases where both feet are involved. Aside from this, the skin around the affected foot gets extremely tight. There is severe itching sensation around the affected area. If the lump starts growing, there will be pain and discomfort around the area.
The joints in the ankle also are extremely painful due to the nodules caused by Ledderhose Disease. In rare cases, the nodules appear in the toes and the symptoms are additionally seen in the toes as well due to pressure created by the nodules on the toes.
How is Ledderhose Disease Diagnosed?
It is vital for an accurate diagnosis of Ledderhose Disease for effective treatment. It should be noted that nodules can form in the foot due to various other reasons aside from Ledderhose Disease as well. Thus, diagnosis is only made by a skilled physician with expertise in conditions like Ledderhose Disease.
The diagnosis of this condition is made by observing the type of nodule that the patient has. Radiographic studies in the form of x-rays are also at times used for a confirmed diagnosis of Ledderhose Disease.
How is Ledderhose Disease Treated?
There are quite a few ways of dealing with Ledderhose Disease. This includes certain natural treatments as well. It is best to have a detailed discussion about the treatment options available with the treating physician and choose the option best suited for the patient. The best way to deal with Ledderhose Disease is to practice gentle stretching on a daily basis. This lessens up the tight connective tissues in the feet and makes the discomfort remarkably less.
Massaging the area regularly is also quite an effective way to deal with the symptoms of Ledderhose Disease. This improves mobility and pain caused due to the condition. Care should be taken during massage that the nodules directly are not touched as they tend to make the pain worse, especially when palpated directly. Just gentle massage around the area of the nodule is a good way to get relief from the symptoms.
Physical therapy is considered to be the best way to treat Ledderhose Disease. Based on the severity of the nodules and the discomfort level, the physical therapist suggests exercises for symptom relief. In some cases, the therapist also gives splints to provide relief from the symptoms of Ledderhose Disease. In cases where conservative treatments fail to provide any improvement in the symptoms, then surgery is recommended. The procedure involves removal of the painful nodules from the feet. The procedure is medically termed as fasciectomy.
Even though surgery for Ledderhose Disease in most cases is successful, there is always a high likelihood of recurrence. Some physicians opt for radiation treatment after surgery to prevent any recurrence of the nodules. However, the success rate of this form of treatment is not known in the literature.
Apart from these treatment options, there are also certain natural remedies that are quite effective in the treatment of Ledderhose Disease. Iodine and copper are believed to be extremely effective for treatment of the nodules. However, it should be noted that these treatments should be started only after the consent of a physician as different people react differently to these natural remedies.
What Is The Overall Prognosis For Ledderhose Disease?
Ledderhose Disease is an extremely rare condition and many facts about it are still unknown. What causes the fascia to thicken and form nodules at the base of the feet still remains a mystery. This is the reason why treatments and preventive measures are quite limited. Massage and physical therapy by far are the most effective way of calming down the symptoms of Ledderhose Disease. There are also some natural remedies in the form of copper and iodine but the effect that it has on the condition is still not well known.
There are some cases where Ledderhose Disease goes away on its own without requiring any treatment. However, these cases are quite few and regular massaging and physical therapy is recommended for everyone with a known diagnosis of Ledderhose Disease. The chances of a recurrence of the condition after a successful surgery is quite common which further strengthens the need for conservative approach for treatment of Ledderhose Disease.
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