Medical Questions » Feet Questions » Question No. 373
| Question: | My orthopaedic surgeon has diagnosed the lumps under my foot as Ledderhose' s disease, but says there is not much that can be done for it. Can you tell me more about this condition? |
| Answer: | A fibrous sheet (the plantar fascia) stretches under the skin of the sole to give it a smooth appearance, strength and firmness, and to protect and control the movement of the muscle tendons that cross under it to the toes. If damaged, the plantar fascia may become scarred, contract and thicken into hard lumps that can be felt under the skin. As the damage progresses, the contraction of the fibrous sheet pulls on the tendons that run underneath it to prevent their free movement. This is Ledderhose' s disease.
Men are affected more than women, and a similar condition (Dupuytren' s contracture) occurs in the hand.
The cause is unknown, but may be due to a poor blood supply to the foot (eg. diabetes), and injury to the foot from repeated blows (eg. running).
The symptoms include one or more hard, fixed nodules under the skin of the sole that gradually extend lengthwise along the sole to cause discomfort, pain with walking and loss of toe mobility. Eventually the toes cannot be fully extended, and contract into a claw-like appearance. The middle toes are usually more severely affected than the others.
Treatment involves soft shoe insoles, injection of steroids around the nodule, and in severe cases only, the nodule may be surgically excised. Unfortunately, recurrence after surgery is common, and the lumps are usually persistent. |
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