Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board
Plantar Fibromatosis is a foot condition where a small nodule, a plantar fibroma, grows in the arch of the foot on the plantar fascia.
A plantar fibroma is a benign growth i.e. non-cancerous, which tends to be slow growing and usually less than an inch in size.
Plantar fibromatosis is often painless but, depending on the location and size of the nodules, it can start to cause foot arch pain when you are on your feet.
Other medical terms for plantar fibromatosis include Ledderhose Disease, after Georg Ledderhose who first identified the disease in 1894, Morbus Ledderhose and Plantar Fascial Fibromatosis. It is a similar condition to Dupytren’s contracture which occurs in the hand causing flexion of the fingers.
In plantar fibromatosis, thickenings develop in the plantar fascia, the thick band of fibrous tissue on the bottom of the foot.
The plantar fascia runs between the heel and the toes, helping to support the arches of the foot.
The thickenings in the plantar fascia can end up forming small nodules, plantar fibromas, usually in the central or medial portions of the plantar fascia. There may be one solitary nodule or a cluster of nodules may develop. Plantar fibromas are one of the most common causes of a lump on bottom of foot.
Ledderhose Disease is a relatively minor condition but can cause foot arch pain with weight bearing activities such as standing and walking. Plantar fibromatosis usually only affects one foot, but in 25% of cases, both feet are affected. It should not be confused with plantar fasciitis where there is inflammation and degeneration of the plantar fascia.
Common symptoms of Ledderhose Disease include:
Plantar fibroma nodules are usually small in size, typically measuring less than one inch and feel firm to touch. They may remain the same size, grow over time or more nodules may gradually appear forming a cluster. They are one of the most common causes of a bump on the bottom of the foot.
The nodules can most easily be seen by dorsiflexing the foot – pulling the toes up. The plantar fibroma growths remain permanently unless removed surgically, they don’t just spontaneously resolve.
Plantar fibromatosis may go undetected for years if it is not causing any pain.
The underlying cause of plantar fibromatosis is unknown but there are a number of factors which are thought to be linked with Ledderhose disease:
Your doctor may be able to diagnose plantar fibromatosis through clinical examination.
If there is any doubt, an MRI scan (Magnetic Resonance Imaging) is usually the imaging of choice as there are other conditions than cause a bump under the foot or present in a similar fashion, such as plantar fasciitis.
MRI tends to be more accurate than x-ray or ultrasound at diagnosing plantar fibromatosis, showing the full extent of the condition.
Plantar fibromatosis treatment usually involves a combination of the following:
Asymptomatic nodules, i.e. those that aren’t causing any pain, will most likely just be monitored. The nodules will never disappear, but they may never cause any problems.
Corticosteroid injections can help relieve the pain and are most effective in the early stages of plantar fibromatosis and when given under ultrasound guidance.
Wearing shoe insoles or special padding can help to reduce the force through plantar fibroma nodules, making walking more comfortable.
Treatment such as exercises, ultrasound and shock wave therapy may help reduce plantar fibromatosis pain.
If the plantar fibroma nodule is growing and active then radiotherapy can be used to shrink and soften the lump. Whilst it won't get rid of the plantar fibroma completely, it may help delay progression for a number of years
Surgery for plantar fibromatosis should only be considered when there have been prolonged high pain levels and resultant decreased activity levels over a number of months.
You can find out loads more about each of these treatment options including the pros and cons of each in the Plantar Fibroma Treatment article.
You can find out loads more about the different treatment and prevention options in the Treatment For Plantar Fibroma article.
There are a number of other conditions that can cause pain in the bottom of the foot. If plantar fibromatosis isn’t sounding quite like your problem, visit the foot arch pain page in the diagnosis section for help working out what may be causing your problem.
You may also be interested in the following articles:
Page Last Updated: 02/22/23
Next Review Due: 02/22/25
January 27, 2023
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September 18, 2022
1. The Journal of Clinical and Aesthetic Dermatology - Ledderhose Disease: An Unusual Presentation. D. Fausto de Souza, L. Micaelo, T. Cuzzi and M. Ramos-e-Silva. September 2010
2. American Journal of Surgery - Incidence and treatment of recurrent plantar fibromatosis by surgery and postoperative radiotherapy. de Bree E, Zoetmulder F, Keus R, Peterse H and van Coevorden F. January 2004
3. Foot & Ankle Specialist Journal - Plantar Fibromatosis: Pathophysiology, Surgical and Nonsurgical Therapies: An Evidence-Based Review. Carroll P, Henshaw R, Garwood C, Raspovic K, Kumar D