Overview

Ledderhose disease is a rare condition that causes connective tissue to build up and create hard lumps on the bottoms of the feet. These lumps form along the plantar fascia — the band of tissue that connects your heel bone with your toes. The growths aren’t cancerous, but they can cause pain, especially when you walk.

This condition is related to other connective tissue diseases, especially Dupuytren’s contracture. Often these conditions occur together.

Ledderhose disease can start at any age, but it usually affects those who are middle-aged or older.

The disease got its name from German surgeon Dr. Georg Ledderhose, who first described it in 1894. Today it’s sometimes called plantar fibromatosis.

Symptoms

The primary symptom of Ledderhose disease is hard lumps on the soles of one or both of your feet. These lumps can be painful, especially when you walk. Though rare, the thickened skin can pull back on your toes.

Other symptoms include:

  • pain in your foot and ankle joints
  • tightening of the skin
  • pins-and-needles sensation

Causes

Thickening of the connective tissue, called fascia, causes the hard lumps to form on the soles of your feet. Ledderhose disease often affects people with other connective tissue diseases, including Dupuytren’s contracture, knuckle pads, and Peyronie’s disease. Up to half of people with Ledderhose disease also have Dupuytren’s contracture.

Though the exact cause of Ledderhose disease isn’t known, both genes and the environment may play roles. The disease is more common in middle-aged and older people, and it occurs much more often in men than in women.

Other factors that may increase your risk of developing Ledderhose include:

  • chronic liver disease
  • diabetes
  • certain medications for epilepsy
  • long-term alcohol use
  • repeated injuries to your foot

Treatment options

To start, you might try wearing soft shoe inserts to relieve pressure on the lumps and pad your foot so it doesn’t hurt as much when you walk. On the inserts, cut out the area around your lumps to create space for them.

Gentle stretches, massage, and icing the sole of your foot can help with pain. You can also try nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin IB, Advil) or naproxen (Naprosyn) to reduce pain and swelling.

If these interventions don’t help, you might try physical therapy. Your physical therapist can recommend stretching exercises, massage your feet, and give you splints to relieve the hard growths. Another option is to get injections of steroid medicine into the bottoms of your feet to improve inflammation and relieve pain.

If these treatments don’t work and the lump is very painful, your doctor might recommend a type of surgery called fasciectomy. During this procedure, the surgeon will remove part or all of the thickened tissue from your foot. The surgery can leave scars, and Ledderhose disease can eventually come back. Radiation treatment can lower the risk of the disease coming back.

Cryosurgery is another treatment option. Your doctor inserts very cold probes into the lumps to freeze and kill the extra tissue.

A newer treatment uses injections of an enzyme called collagenase to break down the thickened tissue. This treatment is also used for Dupuytren’s contracture.

Prevention

Because doctors don’t know exactly what causes Ledderhose disease, it may not be possible to prevent. Drinking alcohol only in moderation and avoiding injuries to your feet may lower your risk.

Complications

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. However, the procedure can cause complications such as:

  • infection
  • painful scars
  • trouble wearing shoes

Outlook

Treatments can improve the symptoms of Ledderhose disease. Sometimes the condition goes away on its own without treatment.

Less often, the disease gets worse slowly over time. And even when it’s successfully treated, it can come back.

You’re more likely to have a recurrence if any of the following applies:

  • You got the disease before age 50.
  • You have it in both feet.
  • You have a family history of the condition.
  • You’re male.