A plantar fibroma is a non-cancerous growth that occurs on the bottom of your foot.
On the bottom of your foot, you have a thick band of tissue that connects your heel to your toes. This band of tissue is called the plantar fascia. Sometimes, a small growth can occur in this tissue. This is called a plantar fibroma.
If there are several lesions, especially if they are on the sole of your foot, then you have a different condition called plantar fibromatosis. This is also called Ledderhose disease.
A plantar fibroma is usually very small, less than an inch around. You can have one on just one foot or on both feet. If the growth is very small, you may not even notice it. It is only when it grows larger that you may feel pain. There is no exact cause pinpointed that leads to the development of a plantar fibroma. Since there is no known cause, it is not possible to prevent them from occurring. A plantar fibroma is always benign, or non-cancerous. However, your doctor may decide to do a biopsy on it just to be on the safe side.
You may have had a plantar fibroma for years and been unaware of it. Many people do not notice them until they start to cause pain. By the time you feel pain, you may also be able to feel a sizable lump on the bottom of your foot. The pain may intensify when you wear shoes, as there is more pressure being put on the lump. Walking or standing for long periods will also increase the pain. Some people feel a lump but do not have pain. If the fibroma is not causing pain, it is up to you if you want to seek treatment for it. Patients who are experiencing difficulty walking due to the pain need to seek treatment.
A physician can normally diagnose a plantar fibroma with a history of the patient’s symptoms and a physical examination. Pressing on the lump may cause pain to radiate down into the toes. An MRI or x-ray may be ordered to get a better look at the entire foot and make sure that the physician is not missing a smaller lump, or the incidence of many lumps, which would then be a different condition. Your doctor may also decide to image both feet to ensure a lump is not beginning to form on the other foot.
You may decide to try non-surgical treatment first. Bear in mind that only surgery can actually remove the fibroma. While other treatments can diminish your pain, the fibroma will not disappear and may even grow bigger. Orthotics and physical therapy are two interventions used that do not include any medicine. Orthotics may give relief because the foot is better supported and the sole of the shoe is not pressing into the fibroma. Physical therapy breaks up the tissue, which can decrease inflammation.
There are two medicinal treatments available. The first is called verapamil 15 percent gel. This is a transdermal gel that is applied to the bottom of the foot. In lab tests, it was shown to slow the growth of fibrous tissue. If it’s used correctly, your pain should subside after three months of treatment. If you are using verapamil gel and your pain has not diminished in three months, speak to your doctor about re-evaluating your treatment plan.
Corticosteroid injections are commonly used to reduce pain for different kinds of ailments. These injections will reduce pain but will not cure the condition.
When less invasive procedures have not worked to reduce the pain from a plantar fibroma, then surgery is warranted. While the surgery is usually completely successful in removing the fibroma, it puts the patient at risk for developing hammertoes or flat arches. If this happens, orthotics may be useful to correct the foot’s position and alleviate pain. Recurrence is possible with a plantar fibroma, so your doctor will schedule follow-ups after the surgery.