I started having what the doctor thought was plantar fasciitis about a year ago. After physical therapy didn't help it became obvious that something else was wrong. It seems I have a problem called Ledderhose disease. What's the best treatment for this condition?

Ledderhose disease of the feet is the same as Dupuytren's disease of the hands. There's an abnormal increase in the amount of fibrous tissue on the bottom of the foot. It replaces the normal connective tissue and causes the fascia to become like scar tissue.

You may see some bumps or nodules on the bottom of your feet. Most patients find it painful to walk when these are present. Treatment to keep the tissue stretched and as soft and pliant as possible is advised. Physical therapy may still be appropriate but you'll probably also need a shoe insert or orthosis to keep the tissues from tightening up even more when walking.

Surgery may be advised but the problem comes back in more than half the cases. At the present time there is no cure and no effective treatment for everyone.