Premium Nahrungsergänzungsmittel | artgerecht

Ledderhose Disease – Causes, Symptoms & Treatment

Ledderhose disease is a benign condition of the foot in which fibrous nodules develop in the plantar fascia. These nodules can cause pain when walking or standing.

Regular tips about health Regular tips about health

Things worth knowing about "Ledderhose disease"

Ledderhose disease is a benign condition of the foot in which fibrous nodules develop in the plantar fascia. These nodules can cause pain when walking or standing.

What is Ledderhose Disease?

Ledderhose disease, medically known as plantar fibromatosis, is a benign but chronically progressive condition of the sole of the foot. It is characterized by the formation of firm fibrous nodules (fibromas) within the plantar fascia – the thick band of connective tissue running along the bottom of the foot from the heel to the toes. The condition was first described in 1894 by German surgeon Georg Ledderhose. Although non-cancerous, the nodules can grow over time and lead to significant pain and functional impairment.

Causes and Risk Factors

The exact cause of Ledderhose disease is not fully understood. It is believed to result from an abnormal proliferation of fibroblasts, leading to excessive collagen deposition in the plantar fascia. The following factors are associated with an increased risk:

Genetic predisposition: The condition frequently runs in families.
Chronic alcohol consumption: Long-term alcohol abuse is considered a contributing factor.
Liver disease: Especially liver cirrhosis has been linked to plantar fibromatosis.
Diabetes mellitus: Elevated blood sugar levels may alter connective tissue structure.
Epilepsy and anticonvulsant medications: Drugs such as phenytoin have been associated with the development of fibromas.
Related fibrotic conditions: A strong association exists with Dupuytren contracture (affecting the hand) and Peyronie disease (affecting penile tissue), suggesting a systemic predisposition to fibrosis.
Repetitive microtrauma: Mechanical stress on the sole of the foot may promote nodule formation.

Symptoms

Symptoms typically develop gradually and may be absent in the early stages:

Palpable, firm nodules along the inner (medial) arch of the foot sole
Tenderness or pain when pressing on the affected area
Pain when walking, standing, or going barefoot
In advanced cases: flexion contracture of the toes (claw toes) if nodules press on tendons
Altered gait due to compensatory movement patterns

Diagnosis

Diagnosis is primarily clinical, based on physical examination of the foot. The physician palpates the sole to assess the size, location, and consistency of the nodules. Additional investigations may include:

Ultrasound (sonography): To evaluate the size and extent of fibromas and to rule out other lesions.
MRI (magnetic resonance imaging): Provides detailed information about the depth and spread of fibromas, especially useful before surgical intervention.
Biopsy: Reserved for unclear cases to exclude malignancy.

Treatment

Ledderhose disease cannot always be fully cured, but symptoms can be effectively managed. Treatment depends on the severity of the condition.

Conservative Treatment

Orthotic insoles and footwear: Pressure-relieving insoles reduce load on affected areas.
Physiotherapy: Stretching and strengthening exercises can help alleviate discomfort.
Corticosteroid injections: Direct injection into the nodules can reduce pain and inflammation.
Extracorporeal shock wave therapy (ESWT): May slow nodule growth and relieve pain.

Radiation Therapy

Radiotherapy is considered an effective treatment option, particularly in early-stage disease. It can inhibit fibrous tissue progression and significantly reduce pain.

Surgical Treatment

In cases involving large, painful nodules or flexion contractures, surgical removal (partial or total fasciectomy) may be necessary. However, recurrence rates after surgery are notable, and the decision to operate should be carefully considered.

Collagenase Injection

Emerging treatment approaches include injection of collagenase (an enzyme that breaks down collagen) to dissolve fibromas. This method is still being evaluated in clinical studies for plantar fibromatosis specifically.

Prognosis

Ledderhose disease follows a chronic course and tends to recur even after successful treatment. Many patients achieve satisfactory symptom relief through conservative measures. When treated early, the prognosis for pain reduction is generally favorable. Complete resolution of the condition is, however, uncommon.

References

Knobloch K, Vogt PM. Plantar fibromatosis (Ledderhose disease). Der Chirurg. 2012;83(6):535–541. DOI: 10.1007/s00104-011-2231-7
Enzinger FM, Weiss SW. Soft Tissue Tumors. 5th ed. Mosby Elsevier; 2008.
Veith NT, Tschernig T, Histing T, Rein S. Plantar fibromatosis – topical review. Foot & Ankle International. 2013;34(12):1742–1746. DOI: 10.1177/1071100713505535

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.

Most read entries

3 Posts in this encyclopedia category