I have Dupuytren and I am 44. It started one year ago but both hands are already affected (full range of motion so far though). The disease seems to run in my family and I cannot help monitoring my feet closely to detect any early signs of Ledderhose. I know, this is a bit silly but I am a bit paranoid about this because I already suffered a bad ankle fracture that took months to heal some years ago and I cannot help fearing having my mobility affected long term again.
For a few days now, I have had pain on the sole of one feet, activated by some kinds of motion of the foot and toes. It feels a bit the same as if I had a splinter but I cannot see anything. No bump either. Can you tell me if the early signs are bumps or pain?
Do we have data about how much Dupuytren sufferers are also affected by Ledderhose, especially if Dupuytren happened in a relatively early age and is hereditary and bilateral? My physical therapist tells me Ledderhose is very rare but there are a lot of testimonies here.
I would also love to have some news from Seth. I was really interested in his story and approach and we appear to have the same doctor. I would be curious to know how he is doing now with his hands and feet. Did he try NA on feet?
Foot pain is usually one of the first symptoms of LD, but also symptoms of so many other things. There are also different types and areas of foot pain that may help with any diagnosis. It is difficult to self diagnose LD and is best to ask a podiatrist to feel or palpate your sole whilst you are in a relaxed position. Are you aware of the feeling of a lump walking with bare feet on hard floor or sand? Many symptoms of minor foot injury come and go, as of course our feet take a heavy daily battering. Possibly your gait has altered as a result of your ankle injury and that’s causing what you feel. I would only be concerned if pain persists over many weeks and becomes debilitating. But see a podiatrist anyway to put your mind at rest.
In general PAIN is always to be considered as an "alarming sign" from our body which should always be taken serious, if stays for a prolonged period of time. Pain at the foot (sole) can be caused by a local infection, joint disorder (arthrosis or arthritis), tendon disorder (tendinitis or inflammation of the tendon insertion zone), insufficient vascular supply (e.g. by artheriosclerosis) or nerve root entrapment or metabolic disorders (e.g. diabetic polyneuropathy).
The key symptoms of Plantar Fibromatosis (Ledderhose Disease) are the growing nodules and eventually cords that form within and in between the tissue layers of the plantar fascia and the skin surface on the soles of the feet. The typical affected anatomical zones are marked in the attached figure. According to several studies published in the last years most cases of Ledderhose Disease involve initially only one foot, but in the later stages of the disease more than 25 percent of cases may involve clinical signs (nodules, cords, symptoms) on both feet.
FIRST SIGNS & KEY SYMPTOMS
> subjective sensation of "tightening" of the skin of the foot, but usually no visible wrinkles
> itching, burning or stinging sensations in the surrounding area of the nodules
> pain in the foot as the nodules may grow and compresses nerve routes above and below the plantar fascia
> rarely pain in the foot and ankle joints, which may be made worse by favoring this foot (weight-bearing etc.)
In rare cases the foot balm and the spaces between the toes can also show some signs of the condition (especially nodules). The rear part of the foot is normally not involved. If nodules appear on the backside of the toes, the pressure from these nodules in the foot can cause pain by irritation of the nerve roots and thereby may induce the toes to contract.
DIAGNOSIS OF THE DISORDER
The correct process of diagnosing Ledderhose Disease is important for the further treatment. Clearly, an experienced and qualified physician (Orthopedic Specialist, Podiatrist etc.) is the only person who should diagnose this condition by visible, palpatory and functional examinations. However, not every nodule on the foot is a sign of THIS LEDDERHOSE condition. Those different disorders will require different therapeutic strategies. Some conditions may be serious, and self-diagnosis can put a person at risk of improper treatment, e.g. in case of a benign or malignant soft tissue tumor such as the diagnosis of an aggressive fibromatosis (desmoid tumor). Others may be less harmful like a painful ganglion cyst, which can be operated easily.
Experienced physicians can often identify the disease based on the typical location, the size and type of nodule a person has. In some cases, physicians may order imaging, e.g. X-rays, CT-scans, ultrasound, magnetic resonance imaging to help confirm the diagnosis. I personally prefer the 3D magnetic resonance imaging as it depicts the best details of the existence and actual extension and dimensions of the nodules and cords in the foot sole.
With best regards and wishing for a well qualified diagnostic process in your specific situation,
Hi Isabelle; I am one of those who developed Ledderhose first and then Dupuytrens. I first developed Ledderhose in my right foot in my early teens and to that point I had not had a broken bone or any significant injury. The only potential environmental condition I can think of is that I didn't wear shoes until I went to high school but I take the view that if that were the cause half the kids in Africa would have LD.
First sign for me was pain. When I got up in the morning the pain in my foot made it difficult to walk and running was out of the question. After moving around for a bit the pain subsided. I don't know when this was but may have been when I was 10-12 years old. I'm certain that it was before I went to high school. Some time later a lump appeared in the arch of my right foot. Doctors operated to remove the lump not knowing what it was and the lump reappeared a couple of years later in the same spot but twice the size. No medical records for my to fall back on but a few things help me key in the time line. Specifically I know that I got my NZ drivers license within weeks of turning 15 and I don't recall any disruption between then and when I went went to University a couple of years later so it had to have been before then.
Best add here that this was around 1967-69 and I didn't get a proper diagnosis until 1991 when I had surgery for Dupuytrens in my left hand. Until that time I did not have a diagnosis and I had not connected what was happening with my feet with what was happening with my hands. No internet of course so I only knew what the doctors told me and for the first time I was shown a photograph of a foot and hand that looked just like mine.
Moving forward 40 or so years I have new issues. Over the last couple of years I have grown a mass similar to the original LD lumps behind the toes of my left foot. Then recently I have had pain in my left heal that has felt like I had bruised the bone. Very painful each time I get up and start moving around. I clearly have no medical skills and can be slow to connect the dots as it wasn't until walking extensively in Germany and France over the last three weeks that there was a day that I decided to massage my heal only to discover that there was no pain when I pressed into the heal with my thumbs = not bruised. It was only at this point I realised that it has to have something to do with LD. My guess is that the new LD mass is putting pressure on nerves or tendons and that is presenting itself as pain in my heal.
Already I think I am on a road to a happier place. I now stretch the tendons through the achilles several times a day and its getting better every day. I am simply following what I did all those years ago with the lumps in the arches of my fet but no blisters this time.
Isabelle, Prof. S, and Seph. Thank you for your posts.
Isabelle because I think we all go through this panic phase and having someone verbalize these feelings helps us to not feel so alone.
Prof. S, one of the humblest, most remarkable experts on DD/DC/LD who never seems to tire of explaining to us and teaching us about this disease.
Seph, the history of your own problematic feet gives me, at least, hope that there is a wonderful life to live despite foot pain, it's merely how we deal with this disease and cope with its oftentimes debilitation.
My pain in the foot went away during summer and came back in September.
It is a shooting pain that I feel occasionally (and not every day) on the sole of my left foot when my foot flexes for example when I put my low boots on. I check carefully et regularly the aspect on my feet and still see no bumps, even when I flex the feet.
Did any of you experiment occasional shooting pain in the sole of the foot as a first sign of LD, without any bumps? I wonder if something could start to grow there and annoy a nerve. But given the fact that the pain settled down completely during about a month and then came back, I am not sure it fits well with something growing in there.
I trust no doctor about this here in North America and I will not be able to see a specialized doctor before several months, so your experience of the kind of symptoms experienced with LD would help.
My pain in the foot went away during summer and came back in September.
It is a shooting pain that I feel occasionally (and not every day) on the sole of my left foot when my foot flexes for example when I put my low boots on. I check carefully et regularly the aspect on my feet and still see no bumps, even when I flex the feet.
Did any of you experiment occasional shooting pain in the sole of the foot as a first sign of LD, without any bumps? I wonder if something could start to grow there and annoy a nerve. But given the fact that the pain settled down completely during about a month and then came back, I am not sure it fits well with something growing in there.
I trust no doctor about this here in North America and I will not be able to see a specialized doctor before several months, so your experience of the kind of symptoms experienced with LD would help.
Isabelle
I can’t really add to my previous post, there can be many causes of the pain you describe, and even if one person on here says yes that’s how their LD started, it will be rather meaningless and just add unnecessary angst. So one, just one example of pain when you flex the foot is metatarsalgia, which I have had, but it really emphasises the need to see a professional. It could be a podiatrist or physio or sports doctor if you don’t trust GPs or others in the US.
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