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Ledderhose disease: Treatments, diet, and surgery

Ledderhose disease or plantar fibromatosis is a rare condition affecting the bottom of the feet. It is named after Dr. Georg Ledderhose who detailed the disorder in 1894. The disease is also called Morbus Ledderhose.

Ledderhose disease is characterized by a buildup of connective tissue in the feet. This connective tissue forms into lumps or nodules on the soles of the feet. The nodules occur in the fascia, which is a layer of connective tissue that runs throughout much of the body and, in this case, connects the heel bone to the toes.

The nodules are usually painless at first but may grow and cause discomfort or pain. They can also become inflamed and irritated, which may make the pain worse. Nodules will grow slowly but will stop growing eventually and stay one size.

Fast facts on ledderhose disease:

  • Clumping of the fascia at the soles of the feet causes the disease.
  • There are a few different ways of treating Ledderhose disease. Treatment depends on the severity and progress of the nodules.
  • There are many home remedies that people can take to help treat the disorder or reduce its symptoms.

Treatment options

People with Ledderhose disease have a few different options for treatment, including natural remedies. Individuals with the condition should talk to a doctor before starting any course of treatment.

Home treatment

Ledderhose disease
Image credit: Herecomesdoc, 2013

Gentle stretching of the foot may help ease tight connective tissues in the feet.

Regular massage is another way to bring mobility to the area and may also help relieve pain.

During a massage, it is important to avoid the nodules themselves, as they can be very painful when touched. Focusing on gently stretching the tissues around them is the best way to ease symptoms.

Physical therapy

Physical therapy is often recommended for cases of Ledderhose disease. A physical therapist may recommend specific exercises based on the location and size of the nodules. During sessions, physical therapists may massage the feet and give someone splints to help relieve the nodules.

Surgery

If noninvasive options do not help, a doctor may recommend surgery to get rid of the painful nodules. 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. However, there is no guarantee that symptoms will not return.

Natural treatments

There are some alternative treatment options for connective tissue disorders, such as Ledderhose disease and Dupuytren contracture, which affects the hands. For instance, the Dupuytren Contracture Institute recommend the use of dimethyl sulfoxide (DMSO) in some cases of connective tissue disorders, applying it directly to the affected area. DMSO is a colorless and oily liquid.

Other possible alternative therapies include iodine and copper, which DMSO helps the skin absorb.

These treatments may not be right for everyone and are not proven to work in every case. Furthermore, any treatment method should be discussed with a doctor beforehand.


Causes and risk factors

men drinking beer
Regular, long-term, alcohol consumption may be a risk factor associated with Ledderhose disease.

The fascia is a layer of connective tissue that runs throughout much of the body. When this connective tissue thickens, it can clump together and form tough nodules.

The exact cause of Ledderhose disease is unknown, but it would appear that genes and environment both have roles. Though it is benign, Ledderhose disease may also be linked to other forms of fibromatosis, including Dupuytren’s or Peyronie disease.

There are some risk factors associated with the disorder. These include:

  • long-term regular alcohol consumption
  • liver disease
  • repeated trauma to the feet
  • diabetes
  • epilepsy
  • some medications

Ledderhose disease can occur at any age but is most common in middle-aged people and seniors. It is also more common in men than in women.

Symptoms

man with painful foot
Pain in the foot and tightening of the skin may be symptoms of Ledderhose disease.

The hallmark symptoms of Ledderhose disease are the tough nodules that form on the soles of the feet. According to a study published in The Journal of Clinical and Aesthetic Dermatology, most cases involve only one foot. About 25 percent of cases involve nodules on both feet.

Other symptoms of Ledderhose disease can include:

  • tightening of the skin of the foot
  • itching, stinging sensation in the surrounding area
  • pain in the foot as the lump grows
  • pain in the ankle joints, which may be made worse by favoring the nodules

The toes can also show signs of the condition in some cases. It is rare, but nodules may appear on the toes, and the pressure from the nodules in the foot can cause the toes to contract.


Diagnosis

Correctly diagnosing Ledderhose disease is important for treatment. A qualified doctor is the only person who should diagnose this condition. Not every nodule on the foot is a sign of the condition, and different disorders will require altogether different therapies. Some conditions may be serious, and self-diagnosis can put a person at risk of improper treatment.

Doctors can often identify the disease based on the type of nodule a person has. In some cases, doctors may order X-rays or other imaging tests to help confirm the diagnosis.

Does diet play a role in the condition?

There does not seem to be any specific diet that will help prevent the disorder. Drinking alcoholic beverages only in moderation may reduce the risk of forming nodules. It may also help prevent and avoid injuries to the feet.

Stretching the feet before any strenuous activity and regularly walking barefoot may also help.


Outlook

Ledderhose disease is rare, and it is not completely understood. The exact cause is unknown, which means there is also very little known about how to prevent it.

There are various treatment options available which may affect each person in a different way. In some cases, Ledderhose disease disappears on its own. Other people may find that they need regular intervention to simply keep symptoms tolerable.

Recurrence of the condition is common. Even with successful treatment, there is no guarantee that the nodules will not come back over time.

Working directly with a doctor and physical therapist is the best way to ensure a comprehensive treatment plan for each icase of Ledderhose disease.

Categories:   Fitness & Health

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