What Is Plantar Fibroma and How Is It Treated?

Medically reviewed by William Morrison, MD on January 4, 2018Written by Valencia Higuera on June 26, 2017

Is this cause for concern?

A plantar fibroma is a noncancerous or benign growth in the arch of your foot. It develops in the plantar fascia, which is thick, fibrous tissue at the bottom of your feet. This tissue covers the area from your heel to your toes and stabilizes your foot arch.

This nodule, which grows slowly over time, can develop on one foot or both feet. It’s typically less than an inch in size.

A single lesion is referred to as a plantar fibroma. A condition called plantar fibromatosis can develop if the lesion starts to enlarge and others develop on the plantar aspect, or sole, of your foot. This rare condition is also known as Ledderhose disease.

Although anyone can develop a plantar fibroma, it typically occurs in middle age. Men are also more likely to be affected.

Keep reading to learn more.

How to identify plantar fibroma

A plantar fibroma growth typically appears on the bottom of your foot, namely in the middle of the arch.

In the early stages, these growths cause little discomfort. They often appear as little more than small bumps. You may not notice the nodule unless it begins to grow in size.

You may begin to experience pain or discomfort if the nodule becomes larger or if external pressure is applied to the affected area. This includes friction from wearing shoes, walking for an extended period, and standing barefoot.

Plantar fibromas are benign. On occasion, they will regress on their own. If you’re experiencing discomfort or develop a bump on your foot, see your doctor.

What causes plantar fibroma to develop

The exact cause of a plantar fibroma is unknown, although some experts suspect a genetic component. For example, there is a higher rate of fibrotic conditions in people of Northern European descent.

Some researchers also believe there’s a connection between trauma and plantar fibromas. An injury may cause tears in the fascia of the bottom of your feet, promoting the growth of nodules.

Certain medications and supplements may also encourage the growth of excess collagen and fibrous tissue, but this hasn’t been proven. These include:

  • certain beta-blockers to treat high blood pressure
  • anti-seizure medications
  • vitamin C
  • glucosamine

You may also be more likely to develop plantar fibroma if you have:

  • chronic liver disease
  • diabetes
  • seizure disorders

The connection between these conditions and plantar fibroma is unclear.

Because it isn’t clear what exactly causes plantar fibroma or why, there’s no known way to prevent its occurrence.

Diagnosing plantar fibroma

If you suspect plantar fibroma, see your doctor. This condition doesn’t heal on its own, and medical intervention may be necessary to relieve any pain caused by the nodule.

At your appointment, your doctor will conduct a physical examination of your foot. This includes pressing the nodule.

Although it’s possible to diagnose a plantar fibroma based on the appearance of the nodule, your doctor may recommend additional testing.

Imaging tests can confirm a plantar fibroma and rule out other conditions, such as cysts, granulomas, and malignancies.

Possible imaging tests include:

  • X-ray
  • MRI scan
  • bone scan (if it’s thought a tumor has spread to the bone)

Sometimes doctors perform a biopsy of the lesion for further investigation. This involves removing a sample of the tissue and examining the sample under a microscope.

Treatment options

The goal of treatment is to reduce any pain and discomfort and decrease the size of the nodule. Treatment is based on the severity of the nodule, so your individual treatment plan may vary. A typical plan will include one or more of the following:

Topical treatment

Transdermal verapamil 15 percent gel inhibits the growth of fibrosis tissue in the laboratory. When used correctly, it’s claimed that this gel can remodel the affected tissue within 6 to 12 months. However, the scientific evidence for this claim is very limited. Any pain or discomfort usually subsides within 3 months of use if this medication is helpful to a particular user.

The manufacturer of the drug states that skipping or missing doses can slow the rate of recovery, so be sure to follow your doctor’s directions. After the tissue has been remodeled, recurrence is unlikely.

Corticosteroid injection

A corticosteroid is an anti-inflammatory medication. Injecting a steroid into the nodule can reduce pain and inflammation. If the inflammation lessens, it may become easier to walk, stand, and wear shoes.

Although steroid injections are effective in relieving any inflammatory process, the nodule may continue to grow.

Orthotics

Orthotics may be beneficial if the growth is small and hasn’t changed in size. This nonsurgical treatment involves the use of gel or foam pads and insoles to redistribute body weight and relieve pain associated with a plantar fibroma. Although their usefulness is questionable, there is no risk to trying them.

As a result, wearing shoes and standing may become more comfortable. If over-the-counter insoles aren’t improving your symptoms, talk to your doctor about custom options. However, the usefulness of custom orthotics has also been questioned.

Physical therapy

Physical therapy helps break tissue accumulation in the foot. Your physical therapist will help you develop a routine of strength training and stretching exercises that can help increase blood circulation and stimulate cell growth. Increased circulation can also reduce inflammation and relieve pain caused by a plantar fibroma. There are no published studies that show that physical therapy has a significant beneficial effect in the treatment of plantar fibromas, however.

Surgery

In severe cases, your doctor may suggest surgical removal of the fibroma. This procedure can flatten your foot arch and increase your risk of hammer toe, so this procedure is only used as a last resort. On average, recovery can take one to two months.

Outlook

A plantar fibroma affects people differently. Some develop a small growth that doesn’t cause discomfort, whereas others experience persistent pain that doesn’t respond to conventional therapies.

Treatment with steroid injections, physical therapy, gels, orthotics, or surgery may provide short-term or long-term relief. However, growths may recur if you’re predisposed to plantar fibromas.

CMS Id: 123739