Monday, 21 November 2011

Treatments for Plantar Fibromas

Over the years I have done a lot of research into the different options available for people with Ledderhose / plantar fibroma's and although there are treatments out there none are a cure. Below are some therapies that might help, I found some of the details for these from http://www.dupuytren-online.info/ledderhose_therapies.html and on the British Dupuytren's Society.

Radiation therapy – 

It is thought that radiation therapy can help stop the progression of the disease however this only works if it is in the earlier stages, if the condition is more developed then it can still help reduce the size of the lump, however of course radiation is not good for your body in general as it can introduce mutations which can lead to cancer. However, in the UK on the NHS at least, the chances of receiving this for Ledderhose disease is very slim as it has not been approved for use on this and also due to very long waiting lists and priority, rightly so, being given to cancer patients. See here for more details. It is available privately and contact me if you want information as this is a procedure that I have had. 

Steroid / Cortizone injections – 

Having had one of these I can say that the administration of the local anaesthetic hurts a lot and then you have a weird sensation of the application of the steroid as you can feel it going in and around the lump but there is no pain or anything, however don’t go back to work afterwards as I did as the local will stop working after a few hours and if you are anything like me you won’t be able to walk and I would also think about taking the next day off as well to help it recover. However these can cause a reduction in size and slow progression an it helped me for about 6 months before everything returned. See here for more detail. 

Cryosurgery – 

Although only use a few times it has had some success. Basically the idea here is to freeze the diseased tissue using deep freezing with something like liquid nitrogen, to be honest having worked with liquid nitrogen this option scares me a little as the stuff used in the wrong way can easily be lethal, though I am sure in the quantities used it is perfectly safe. However there is the known side effect that it can produce hard scar tissue which then results in pain when walking meaning that the end result may not be too different to leaving it alone.  See here for more details.

Surgery – 

This is the one way to actually remove the lump and is sometimes basically the only option left once it is big enough and painful enough. Clearly with the load bearing that the foot has to undertake on a daily basis there are going to be side effects and additional some people have reported that post surgery nodules have grown back quicker and worse than before, meaning that this option needs to be treated as a last resort and with a certain degree of caution, I have seen posts of people saying do not consider this, just do not do it, so is it better to try this and maybe get better or continue as you are? See here for more details.

Verapamil – 

This is a calcium channel blocker that has been used in the treatment of other conditions and it is thought to work by blocking the release of collagen this changes steady state levels of production of collagen and break down by collagenases so that there is more break down to compared to production when means that the levels of collagen, thought to be the main part of the lump, are decreased and thus the size and pain produced are decrease. See here for more details.

Orthotics

These are basically shoe inserts that take the pressure off of the lump, if they work they are a great treatment as they are non-invasive. See here for detail.

Physiotherapy – 

I have seen online that this can be recommended, however I have been to 2 physios, 1 was NHS and 1 was private and both of them told me there was nothing that they could do to help with this and for me this was just a step in the pathway towards getting proper treatment.

I hope what I have put here helps someone, if you need more then browse the pages specific for those treatments.