# Plantar fibromatosis (Ledderhose disease)

> Plantar fibromatosis (Ledderhose disease) is a benign thickening of the tissue under the foot that forms firm, slow-growing lumps along the arch. Comfortable footwear, adjusting activity and sometimes insoles ease pressure. See your GP soon if a lump grows quickly or looks unusual.

Guide in [Heel and arch pain](https://footanklelowerlimb.com.au/learn/topics/heel-and-arch-pain), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/plantar-fibromatosis
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **It's a firm lump in the sole,** a slow-growing thickening of the tissue under your arch that is usually harmless.
- **Many lumps need little:** one that doesn't hurt can often be left alone, and a sore one usually starts with comfortable footwear, adjusting activity and sometimes insoles.
- **There are other options** if self-care isn't enough, and your GP or podiatrist can help you weigh them up.
- **A lump that changes quickly needs checking:** see your GP soon if one grows fast, looks unusual, or comes with night pain, past cancer or unexplained weight loss.

## What is plantar fibromatosis?

Plantar fibromatosis, also called Ledderhose disease, is a benign (not cancerous) overgrowth of the plantar fascia, the band of tissue under your foot [1][2]. It forms one or more firm, slow-growing lumps, called plantar fibromas, usually along the arch [2]. Plantar fibromas are usually benign, with a very low chance of being cancer [2].

It's rare. It mostly affects middle-aged people, and it has been reported in children, but how common it is isn't well known [3]. It can affect one foot or both, and both feet are involved in about a quarter of cases [4]. It sometimes occurs alongside Dupuytren's disease, a similar thickening in the palm of the hand [5].

## What causes it, and who gets it?

The cause isn't known [2]. It has been linked with, though not shown to be caused by, older age, injury to the foot, diabetes, epilepsy and anti-seizure medicines, alcohol, liver disease and smoking [4][3]. Men are affected about twice as often as women [4], and a family tendency may play a part [4].

A link isn't a diagnosis. Having one of these doesn't mean you'll develop a lump, and a lump on your sole shouldn't be put down to fibromatosis until it has been checked.

## What does it feel like, and how is it diagnosed?

Most people notice a firm lump in the arch, often 0.5–3.0 cm across, that grows slowly [3]. It's often painless at first and may become sore as it enlarges [3]. Pressure from shoes over the lump is a common cause of pain [2], and tight shoes, walking barefoot and standing for long periods can make it worse [3].

A podiatrist or doctor can usually diagnose it from your history and by feeling the lump, and X-rays aren't routinely needed [6]. An ultrasound or MRI scan can help confirm it, and a biopsy (a small tissue sample) is sometimes taken if cancer is a concern [3]. Other problems, such as plantar fasciitis, tarsal tunnel syndrome and a stress fracture of the heel bone, can cause sole or heel pain and can occur at the same time [3], so try not to self-diagnose sole pain [7].

## What helps first?

Care usually starts with simple steps: learning about the condition, changing your footwear, adjusting your activity (especially avoiding high-impact sports), and insoles, also called orthoses, to take pressure off the lump [8]. A lump that isn't causing pain can be left alone and watched [9].

Choose comfortable shoes that don't press on the lump. If you're given orthoses, build up wearing them as your podiatrist advises, and keep them out of sport or vigorous activity until you've finished the wearing plan and they feel fully comfortable [10]. If you have diabetes, avoid shoes with seams that can rub your foot [10]. A podiatrist can help if the lump is limiting your activity [11].

The evidence behind these steps is weak, and results are debated [1], so review how you're going with your podiatrist.

## What helps if that isn't enough?

If the lump is still sore or limiting you after sensible self-care, see your GP or a podiatrist. They can check again for anything else going on [13] and talk through other options. Shockwave therapy can be considered, though the evidence for it is limited [11]. Radiotherapy may be worth considering for early-stage fascial fibromatosis, the wider group of conditions this belongs to [12], and surgery is another option your doctor can discuss [1].

It isn't clear yet how well each option works or how often lumps return, because better trials are still needed [1]. It's worth hearing the benefits and risks before any procedure.

## What's the outlook, and can it come back?

Plantar fibromatosis is benign and usually grows slowly [8]. Many lumps stay painless, but some become sore and get in the way of standing, walking or running [8]. Occasionally it is more aggressive and causes the toes to tighten or curl (contractures) [5]. A lump that grows or becomes painful needs a further look, sometimes with a scan [2].

It isn't clear yet whether anything prevents a lump coming back after treatment or stops it growing. What you can do is keep an eye on it and have changes checked.

> [!tip] Try this
> Measure your lump with a ruler, or take a photo beside a coin, and note the date. Look again every few weeks, so you can tell your podiatrist or GP whether it has changed.

## When to see a podiatrist

Most plantar fibromas are benign [2], but some changes should be checked. See your GP or a podiatrist soon if:

- a lump grows quickly, looks unusual, or is getting bigger for no clear reason [14][15][9];
- you've had cancer before, or you've lost weight without trying [13];
- you have pain at night, or pain that isn't linked to activity [13];
- sole pain hasn't improved after 2 weeks of home care, or you have tingling, loss of feeling or weakness in your foot, or you have diabetes [7][15].

The following needs urgent medical assessment, at your GP or a podiatrist the same day, a Medicare Urgent Care Clinic or the emergency department: a red, hot, swollen foot [13]; severe pain with a fever or feeling unwell [11]; a calf that is swollen, red, hot and painful [13]; or, if you have diabetes or reduced feeling in your feet, unexpected pain or a sudden change in the shape of your foot [13][15]. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

## Common questions

### Is a plantar fibroma cancer?

Usually not. Plantar fibromas are benign, which means non-cancerous, and the chance of one being cancer is very low. A podiatrist or GP can examine any lump on your sole and arrange a scan if the diagnosis isn't clear, so it's worth having a new lump looked at rather than guessing.

### Is Ledderhose disease the same as plantar fasciitis?

No. Both affect the plantar fascia, the band of tissue under your foot, but they are separate conditions. Plantar fasciitis is the most common cause of heel pain. Ledderhose disease forms firm lumps along the arch. Because other causes of sole pain can occur at the same time, it helps to have your pain assessed.

### Does a plantar fibroma need treatment if it doesn't hurt?

Not usually. A fibroma that isn't causing pain can be left alone and watched. It helps to note its size and look again every few weeks. If it grows, becomes painful or starts to limit what you can do, a podiatrist or GP can review it and talk through your options.

## Further reading

- [Plantar fibromatosis (Ledderhose disease) on Clindice](https://clindice.com/plantar-fibromatosis)
- [40 TOPIC Plantar Fibroma](https://www.wyevalley.nhs.uk/media/102818/40_PLANTAR_FIBROMA.pdf), NHS
- [Pain in the bottom of the foot](https://www.nhs.uk/symptoms/foot-pain/pain-in-the-bottom-of-the-foot/), NHS
- [Plantar fibroma](https://www.kentcht.nhs.uk/leaflet/plantar-fibroma/), NHS
- [Foot and Ankle Pain Pathway (Age 16+)](https://www.dgft.nhs.uk/wp-content/uploads/2026/10/Foot-and-Ankle-Pain-v1.8.pdf), NHS

## Sources

1. Current concepts about treatment options of plantar fibromatosis: A systematic review of the literature · Fuiano M, Mosca M, Caravelli S et al. · Foot and Ankle Surgery · 2019. https://doi.org/10.1016/j.fas.2018.06.001
2. Plantar fibroma · Kent Community Health NHS Foundation Trust · 2024. https://www.kentcht.nhs.uk/leaflet/plantar-fibroma/
3. The etiology, evaluation, and management of plantar fibromatosis · Young JR, Sternbach S, Willinger M et al. · Orthopedic Research and Reviews · 2019. https://doi.org/10.2147/orr.s154289
4. Ledderhose's Disease: An Up-to-Date Review of a Rare Non-Malignant Disorder · Tomac A, Ion AP, Opriș DR et al. · Clinics and Practice · 2023. https://doi.org/10.3390/clinpract13050106
5. Clinical, histological and therapeutic modern approach of Ledderhose disease · Neagu TP, Ţigliş M, Popescu A et al. · Romanian Journal of Morphology and Embryology = Revue Roumaine de Morphologie et Embryologie · 2018. https://pubmed.ncbi.nlm.nih.gov/30534806/
6. The Surgical Treatment of Plantar Fibromatosis With Multiple Large Nodules on the Medial Aspect of the Left Sole With No Recurrence at the Five-Year Follow-Up · Lyrtzis C, Sidiropoulou ZR, Arhonidu A et al. · Cureus · 2025. https://doi.org/10.7759/cureus.99349
7. Pain in the bottom of the foot · NHS. https://www.nhs.uk/symptoms/foot-pain/pain-in-the-bottom-of-the-foot/
8. Ultrasound in the diagnosis and management of plantar fibromatosis (ledderhose disease): A case report · Skalli S, Mestour K, Akhrif I et al. · Radiology Case Reports · 2026. https://doi.org/10.1016/j.radcr.2026.01.038
9. GP Pathway for foot and ankle soft tissue lumps and bumps Lesion Summary Table · NHS. https://best.barnsleyccg.nhs.uk/media/fqsdbroa/foot-lesion-summary-table-pdf.pdf
10. Information about your insole or foot orthoses · NHS. https://www.esht.nhs.uk/wp-content/uploads/2020/09/0840.pdf
11. Foot and Heel Problems - South & West · South & West. https://southwest.devonformularyguidance.nhs.uk/referral-guidance/western-locality/musculoskeletal/foot-and-heel-problems
12. Radiotherapy in fascial fibromatosis: a case series, literature review and considerations for treatment of early-stage disease · Grenfell S, Borg M · Journal of Medical Imaging and Radiation Oncology · 2014. https://doi.org/10.1111/1754-9485.12178
13. Red flags | Right Decisions · NHS. https://www.rightdecisions.scot.nhs.uk/ggc-msk-foot-and-ankle/initial-assessment/red-flags/
14. Lumps - bumps and ganglia | Right Decisions · NHS. https://rightdecisions.scot.nhs.uk/nhs-tayside-refguide/surgery-and-orthopaedics/orthopaedic-and-trauma-surgery/foot-and-ankle-service/lumps-bumps-and-ganglia/
15. Ganglion · NHS. https://rms.cornwall.nhs.uk/primary_care_clinical_referral_criteria/primary_care_clinical_referral_criteria/orthopaedics/primary_care_clinical_referral_criteria/primary_care_clinical_referral_criteria/orthopaedics/foot_and_ankle_referral/primary_care_clinical_referral_criteria/prima

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This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.