Plantar Fibromatosis
Benign fibrous nodules in the arch of the foot
Quick Facts
- Type: Benign soft-tissue growth
- Location: Plantar fascia (arch of the foot)
- Also called: Ledderhose disease
- Nature: Non-cancerous
Overview
Plantar fibromatosis, also known as Ledderhose disease, is a condition in which firm, benign (non-cancerous) nodules of fibrous tissue develop within the plantar fascia, the thick band of connective tissue that runs along the arch on the bottom of the foot. A single nodule is often called a plantar fibroma. The lumps can be felt in the arch and may slowly grow or multiply over time.
Unlike plantar fasciitis, which causes heel pain from inflammation, plantar fibromatosis involves an abnormal overgrowth of fibrous tissue. The condition is related to other fibrous tissue disorders, such as Dupuytren's contracture in the hand. It is not cancerous and does not spread to other parts of the body, but the nodules can cause discomfort, especially when walking or wearing shoes.
Symptoms
Common features of plantar fibromatosis include:
- One or more firm lumps in the arch of the foot
- Nodules that are usually fixed and feel rubbery or hard
- Discomfort or pain when standing, walking, or pressing on the lump
- A sensation of stepping on a pebble
- Nodules that may grow slowly over months or years
Many nodules are painless, especially when small. Pain tends to occur when the lump presses against shoes or the ground. Unlike heel-based conditions, the discomfort is centered in the arch.
Causes
The exact cause of plantar fibromatosis is not fully understood. It involves an abnormal buildup of fibrous (collagen) tissue in the plantar fascia. Factors that appear to play a role include:
- Genetic tendency: It can run in families and is associated with other fibrous conditions.
- Associated disorders: A link with Dupuytren's contracture of the hand and similar tissue disorders.
- Foot trauma or repetitive stress: May contribute in some people, though this is not certain.
Certain medications, alcohol use, and some chronic conditions have been suggested as possible contributors, but the connection is not firmly established.
Risk Factors
- A family history of plantar fibromatosis or Dupuytren's contracture
- Having other fibrous tissue disorders
- Being of middle age or older
- Possible association with repetitive foot stress
Diagnosis
A clinician usually diagnoses plantar fibromatosis by examining the foot and feeling the characteristic firm nodules in the arch. To confirm the diagnosis and rule out other growths:
- Ultrasound: Can show the size and nature of the nodules within the fascia.
- MRI: Provides detailed images and helps distinguish a fibroma from other soft-tissue masses.
- Biopsy: Occasionally done if there is any doubt about whether a lump is benign.
Treatment
Treatment depends on how much the nodules bother you. Many cases are managed without surgery:
- Padding and orthotics: Custom insoles or pads redistribute pressure away from the nodule and ease discomfort.
- Footwear changes: Soft, well-cushioned shoes reduce irritation.
- Stretching and physical therapy: May help with comfort and flexibility.
- Injections: Corticosteroid injections can sometimes shrink or soften nodules and relieve pain.
- Surgery: Reserved for painful, persistent nodules that do not respond to other care, though there is a chance the nodules can return after removal.
Because surgery can be followed by recurrence, conservative treatment is usually tried first.
Prevention
- Plantar fibromatosis often cannot be prevented, especially when it runs in families
- Wearing cushioned, supportive footwear may ease symptoms and reduce irritation
- Using orthotics to offload pressure on existing nodules
- Avoiding repeated trauma to the soles of the feet where possible
When to See a Doctor
See a doctor if you notice a lump in the arch of your foot, especially if it is growing, painful, or interfering with walking, so it can be evaluated and other causes ruled out. Seek prompt care if a foot lump grows rapidly, becomes hard and fixed in an unusual way, or is associated with skin changes, since any new or changing growth should be checked to confirm it is benign.
Frequently Asked Questions
Is plantar fibromatosis cancer?
No. Plantar fibromatosis is a benign, non-cancerous overgrowth of fibrous tissue in the arch of the foot. It does not spread to other parts of the body, although the nodules can grow slowly or recur after removal.
How is plantar fibromatosis different from plantar fasciitis?
Plantar fasciitis is inflammation of the plantar fascia that typically causes heel pain, while plantar fibromatosis involves firm lumps of fibrous tissue in the arch. They affect the same band of tissue but in different ways and locations.
What causes the lumps in the foot?
The lumps are caused by an abnormal buildup of fibrous tissue within the plantar fascia. The exact cause is unknown, but genetics play a role, and the condition is linked to other fibrous disorders such as Dupuytren's contracture of the hand.
Can plantar fibromatosis be treated without surgery?
Yes. Many people are managed with padding, orthotics, supportive footwear, stretching, and sometimes injections. Surgery is reserved for painful nodules that do not respond to these measures, partly because nodules can return afterward.
Will the nodules go away on their own?
The nodules usually do not disappear on their own and may grow slowly over time. However, many remain stable and cause little trouble, and symptoms can often be controlled with conservative treatment.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Plantar fibroma.
- MedlinePlus, U.S. National Library of Medicine. Foot injuries and disorders.
- Cleveland Clinic. Plantar fibroma.
- National Organization for Rare Disorders (NORD). Ledderhose disease.