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Plantar Fibroma: Causes, Symptoms,  Treatment

 

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What are plantar fibromas?
Causes
 Risk factors
 Signs and symptoms
 Diagnosis
 Treatment
 Living with a fibroma
 Consulting a podiatrist
 Your first podiatry appt
 FAQs

Noticing a plantar fibroma can feel quite concerning, appearing as a round mass in the bottom of the foot. Here’s what you should know.

What Are Plantar Fibromas?

A plantar fibroma is a fibrous ‘knot’ that develops in the bottom of the foot - hence the term ‘plantar’, which refers to the sole of the foot. Specifically, the notable bulge arises in the arch, on a thick band of tissue called the plantar fascia, which connects the heel to the toes and helps support the foot and arch. 

While a fibroma is typically benign (non-cancerous), it can cause discomfort and impact your comfort throughout the day. The level of the discomfort you experience can be linked to the size of the fibroma, which can vary greatly and may slowly change over time.

What Causes Plantar Fibromas?

While a plantar fibroma may feel as if it has just popped up from seemingly nowhere, there are several causative factors implicated in its development, including:

• Genetic factors: those with a family history of plantar fibromas or related foot conditions may have a higher susceptibility. While the specific genetic markers involved are not yet fully understood in the research, there is evidence to suggest that certain families may carry a predisposition to developing fibrous nodules in the plantar fascia, linked to the way that collagen is produced in the body, as well as other elements of the structure within their connective tissues.
  

• Trauma and injury: repetitive trauma and injury to the plantar fascia have also been identified as triggers for the development of plantar fibromas. The plantar fascia can become strained and damaged with excessive or repetitive stress. Activities that involve high impact on the feet, such as running, jumping, or standing for long periods can contribute to microtrauma in the plantar fascia. Over time, this cumulative trauma can lead to both a condition called plantar fasciitis, as well as the formation of fibrous nodules in response to the body's attempt to repair the damaged tissue.
  

• Other medical conditions: plantar fibromas have been associated with certain medical conditions, although the exact relationship of these associations is poorly understood. Conditions such as Ledderhose disease, a disorder characterised by nodules on the feet, and Dupuytren's contracture, which affects the hands, are considered related to the development of fibromas.
  

Plantar Fibromas: Who Is At Higher Risk?

Several risk factors increase the likelihood of developing plantar fibromas:

• Age: plantar fibromas are more common in adults, particularly those between the ages of 30 and 60 years.
  
• Gender: while the condition can affect both men and women, some studies suggest a slightly higher prevalence in men.
  
• Foot structure: those with certain foot structures, such as high arches or flat feet, may be at an increased risk of a plantar fibroma.
  
• Occupation: roles that involve prolonged standing or activities that put excessive strain on the feet may elevate the risk of a fibroma.
  
• Footwear: wearing shoes that lack proper support to the feet and arches, or that exert excess pressure on the arches, may contribute to the development of fibromas.

Plantar Fibroma Signs And Symptoms

Many people do not experience foot pain related to their fibroma, despite having a palpable and visible lump or nodule present. As the fibroma grows larger and takes on more pressure, tenderness may develop when walking, and make it difficult to wear certain shoes. Look for:

• Round nodules present in the arch of the foot that are firm, and typically stay less than 3 cm across in size.
  
• Discomfort or tenderness with larger nodules, particularly when standing, walking, or wearing certain shoes.
  

Diagnosing A Plantar Fibroma

Our podiatrists are able to confidently diagnose your plantar fibroma based on getting to know your medical history, paired with an examination of your feet and the nodule itself, looking at its size, location, and other characteristics. It’s always important to exclude other causes of nodules in the foot such as from cysts or tumours. If necessary, we may use medical imaging to help better visualise the fibroma as well as helping to rule out other foot conditions. As having the right diagnosis is crucial for having the right treatment plan, it's important to have fibromas professionally diagnosed.

Treatment Options

The goal of your treatment for a fibroma is to alleviate any uncomfortable or painful symptoms you may have, while keeping your foot functioning well and remaining supported. To achieve this, we may use:

• Footwear modifications: if your fibroma is fairly prominent and pressing into an area against your shoes that is causing you pain or discomfort, then we may be able to make custom modifications to your shoes that will help alleviate the pressure while keeping your feet well supported.
  
• Custom foot orthotics: our orthotics are prescribed and designed uniquely for your feet, paying careful consideration to the location and size of your fibroma. Your orthotics may feature good arch support with a cushioning-filled ‘cut out’ or drop-down area that redistributes pressure away from the fibroma, so you can stay comfortable on your feet when walking and exercising.
  
• MLS laser: if your fibroma is causing you significant pain and discomfort, we may recommend treatment with the MLS laser - a proven, painless and safe way to help manage a range of pains while reducing any inflammation.
  
• Shockwave therapy: shockwave is a non-invasive treatment that helps with reducing pain, promoting new blood vessel and collagen formation, increasing blood flow, resetting the inflammatory cycle and more. In some cases, shockwave may be indicated in supporting pain reduction and encouraging the reduction in size of the fibroma.
  
• Physical therapy: in some cases, working on your flexibility, muscle strength, or managing any muscle imbalances in your lower leg, foot or ankle can help reduce your pain and improve your daily comfort.
  
• Foot mobilisation: as a hands-on therapy for stiff joints that supports optimal movement of the feet, foot mobilisation therapy may help you if stiffness or tightness is exacerbating the symptoms of your fibroma or resulting in more pressure on the area.
  
• Footwear recommendations: your shoes play an important role in supporting your daily comfort and quality of life. Our podiatrists can recommend the best shoes for your specific foot type to offer you the best support and comfort, working together with your orthotics.
  

We usually have good success with the above treatments. If this care approach doesn’t create the level of relief needed, we may refer you for corticosteroid injections, which may work to help with the pain associated with the fibroma. Surgery is typically only considered as a last resort.

Living With A Plantar Fibroma

Developing a plantar fibroma can feel daunting, but with the right care, most people can still keep doing all the things they love and living a normal and comfortable daily life, even with the fibroma present. Always make sure to wear comfortable and supportive footwear both inside and outside of the house, regularly inspect and care for your feet (keeping them clean and moisturised), and regularly participate in low-impact exercises to help maintain your overall foot health without exacerbating your symptoms.

Consulting A Podiatrist

You should consult your podiatrist if you’re getting pain or discomfort from your fibroma, are finding it difficult to walk or wear shoes comfortably, you’re noticing changes in your foot structure, or if your fibroma is causing any disruption to your daily life.

What to Expect During a Podiatry Appointment

Your appointment starts with discussing your medical history, getting to know the history of your fibroma, as well as any other foot-related concerns and symptoms. We then conduct a comprehensive clinical examination, including assessing the fibroma itself as well as any issues with the range of motion in your feet and other factors that may be affecting your daily comfort. If needed, we’ll give you a referral for medical imaging to rule out other causes for the mass in your foot and any symptoms it's producing. We’ll discuss all of your findings with you, and together we’ll go through your treatment options and create a management plan that will best meet your needs. Another big part of what we do is focused on education and ensuring you’re well equipped with the information you need to best manage your fibroma - and your foot health in general.

Plantar Fibromas FAQs

Can plantar fibromas be prevented?

While nothing can prevent a plantar fibroma with certainty, there are steps you can take to help minimise your risk. Choosing footwear with good arch support, avoiding tight or ill-fitting shoes, and incorporating regular stretching exercises into your routine can all help contribute to your foot health. Maintaining a healthy weight and addressing any foot discomfort promptly also help.

Are there home remedies for alleviating fibroma pain?

Yes - start by wearing supportive footwear with cushioning and adequate arch support, as these will help reduce pressure on the fibromas. If the area around the fibroma becomes inflamed or irritated, you can apply ice to the area. Gentle stretching exercises may also help to improve flexibility and reduce pain. If your discomfort becomes severe, you can use over-the-counter pain relieving medication, if safe for you to do so.

What does fibroma surgery involve?

While typically left as a last resort for stubborn and painful fibromas, surgical treatment often involves the excision (removal) of the fibrous nodules, while preserving as much healthy tissue as possible. Following your procedure, a period of rehabilitation is necessary, involving physical therapy to restore foot function and mobility. The recovery period varies but can last up to six months - or even a year.