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What is a Plantar Fibroma?
A plantar fibroma is a fibrous
knot (nodule) in the arch of the
foot. It is embedded within the
plantar fascia, a band of tissue that
extends from the heel to the toes on
the bottom of the foot.A plantar
fibroma can develop in one or both
feet, is benign (non-malignant),
and usually will not go away or get
smaller without treatment.
Definitive causes for this condition
have not been clearly identified.
Signs and Symptoms
The characteristic sign of a plantar
fibroma is a noticeable lump in the
arch that feels firm to the touch. This
mass can remain the same size or get
larger over time, or additional
fibromas may develop.
People who have a plantar
fibroma may or may not have pain.
When pain does occur, it is often
caused by shoes pushing against
the lump in the arch, although it
can also arise when walking or
standing barefoot
Diagnosis
To diagnose a plantar fibroma, the
foot and ankle surgeon will examine
the foot and press on the affected
area. Sometimes this can produce
pain that extends down to the toes.
An MRI or biopsy may be performed
to further evaluate the lump and aid
in diagnosis.
Treatment Options
Non-surgical treatment may help
relieve the pain of a plantar fibroma,
although it will not make the mass
disappear. The foot and ankle
surgeon may select one or more of
the following non-surgical options:
• Steroid injections. Injecting
corticosteroid medication into
the mass may help shrink it and
thereby relieve the pain that
occurs when walking. This
reduction may be only temporary
and the fibroma could slowly
return to its original size.
• Orthotic devices. If the fibroma
is stable, meaning it is not
changing in size, custom
orthotic devices (shoe inserts)
may relieve the pain by
distributing the patient’s weight
away from the fibroma.
• Physical therapy. The pain is
sometimes treated through
physical therapy methods
that deliver anti-inflammatory
medication into the fibroma
without the need for injection.
If the mass increases in size or
pain, the patient should be further
evaluated. Surgical treatment to
remove the fibroma is considered if
the patient continues to experience
pain following non-surgical
approaches.
Surgical removal of a plantar
fibroma may result in a flattening
of the arch or development of
hammertoes. Orthotic devices
may be prescribed to provide
support to the foot. Due to the high
incidence of recurrence with this
condition, continued follow-up
with the foot and ankle surgeon
is recommended.
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