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How Hyaluronidase Works to Shrink Plantar Fibromas: A Podiatrist’s Insight

Plantar fibromas, also known as plantar fibromatosis or Ledderhose disease, are benign (non-cancerous) nodules that form in the arch of the foot along the plantar fascia. These fibromas can be very painful, especially when walking or standing for extended periods. Though surgical removal of plantar fibromas is a common treatment, it has a high recurrence rate. Recent advancements in non-surgical therapies have led to the use of hyaluronidase injections to shrink these fibromas effectively.

But how does hyaluronidase work? Let’s dive into the science behind this enzyme and its therapeutic role in shrinking plantar fibromas.

What Is Hyaluronidase?

Hyaluronidase is an enzyme that occurs naturally in the body. It works by breaking down hyaluronic acid, a major component of connective tissues. Hyaluronic acid is responsible for maintaining tissue hydration, flexibility, and resilience. However, in the case of certain conditions like plantar fibromatosis, the abnormal accumulation of connective tissue can cause fibromas to form.

By breaking down hyaluronic acid, hyaluronidase increases tissue permeability and helps reduce excess fibrous tissue, making it a valuable tool in treating fibromas.

How Does Hyaluronidase Work on Plantar Fibromas?

  1. Softening Fibrous Tissue: Fibromas are made up of dense, fibrous tissue that resists shrinking. Hyaluronidase targets this tissue by breaking down hyaluronic acid, which helps to "soften" the nodule and reduces its volume over time.

  2. Improving Tissue Flexibility: Plantar fibromas are often rigid, causing discomfort when walking or standing. Hyaluronidase helps to make the surrounding tissues more flexible by dissolving the binding material within the extracellular matrix. This action makes the tissue around the fibroma less stiff, which can alleviate some of the pain caused by pressure on the foot.

  3. Decreasing the Size of the Fibroma: The breakdown of hyaluronic acid leads to a gradual reduction in the size of the fibroma. This process can take several weeks or months and may require multiple injections to achieve the desired result. However, many patients report significant improvements in both the size of the fibroma and the associated pain.

  4. Enhancing Drug Penetration: In some cases, hyaluronidase can also enhance the delivery of other medications, such as corticosteroids, when used in combination. This combination therapy can provide even more effective treatment by reducing inflammation and promoting further shrinkage of the fibroma.

What to Expect from Hyaluronidase Injections

For patients considering hyaluronidase injections to treat plantar fibromas, here’s what to expect:

  • Multiple Sessions: Most patients will require a series of injections spaced out over several weeks or months.

  • Minimal Downtime: Since this is a non-surgical treatment, there’s minimal recovery time, allowing patients to resume normal activities sooner compared to surgical options.

  • Gradual Results: Unlike surgery, which removes the fibroma immediately, hyaluronidase works gradually, and patients should expect a slow but steady reduction in size over time.

Hyaluronidase offers an exciting non-surgical option for shrinking plantar fibromas. By breaking down the excess connective tissue that forms the fibroma, this enzyme helps reduce its size, improve tissue flexibility, and alleviate discomfort. For patients seeking a less invasive alternative to surgery, hyaluronidase injections may be an excellent choice.

If you’re dealing with plantar fibromatosis and looking for an alternative to surgery give us a call to see if hyaluronidase injections could work for you.