Your feet take on your entire body weight and more, every single day. It’s impossible to prevent placing pressure on them, so the best thing to do is to take the best possible care of them.
Unfortunately, in some cases, foot conditions can develop for seemingly no reason at all, even if you do take good care of your feet. Plantar fibroma is one of those conditions that can affect almost anyone.
Let’s have a look at plantar fibroma, its causes, treatment, and prevention.
What is Plantar Fibroma?
Plantar fibroma is a foot condition that starts as a small lump between the skin and the first layers of soft tissue in the arch—the plantar fascia. This runs along the bottom of your foot, connecting your heel to your toes.
The plantar fibroma will continue to grow and it can get as big as one inch in size. Fortunately, these types of nodules are benign—non-cancerous—and in most cases are often painless, but they can cause discomfort.
You can develop a plantar fibroma in one or both of your feet. It’s also possible to develop several fibromas on their feet, which is known as plantar fibromatosis—also known as Ledderhose disease.
Unfortunately, plantar fibroma won’t get smaller or go away without treatment or in severe cases, surgery.
Plantar Fibroma Symptoms
The main symptom of plantar fibroma is a lump that’s developed about half way between the heel and the ball of the foot, often right in the middle of the arch. The lump will feel firm to the touch and may be painful when pressure is applied to it.
When you first notice the plantar fibroma, it will be fairly small—about the size of a small pebble or pea—just beneath the skin.
As the lump grows, you may start to notice that your underfoot feels tight, or that your foot feels stiff when you take your first step in the morning.
The longer you’re on your feet, the more your foot may start to hurt, throb, or feel as though you’re walking on a golf ball.
You may experience pain when walking barefoot, when you’ve been standing for an extended time, or experience a mild pain or discomfort when wearing shoes.
The pain and discomfort isn’t caused directly by the plantar fibroma, but from the lump placing pressure on the nerves, muscles, tendons, and ligaments around it.
Who Is Likely to Suffer From Plantar Fibroma?
Anyone can develop plantar fibroma, but there may be several factors that could increase your risk of developing a nodule.
Research has shown that you may be at an increased risk of developing plantar fibroma if you have a close relative that has a history of plantar fibroma.
While both men and women can develop plantar fibroma, it’s more common for men to develop the condition. It also tends to affect people who are between 40 and 60 years of age and who are of European descent.
There are several medical conditions that can contribute to you developing plantar fibroma and these include:
- Liver cirrhosis
Some medications that are used to treat high blood pressure or seizures may contribute to you developing a nodule.
You may be at an increased risk of developing plantar fibroma if you consume excessive amounts of alcohol.
Unfortunately, there’s no clear reason why people develop plantar fibroma. But doctors believe that there are several factors that can contribute to developing the condition.
Some of the most common considerations include:
- Genetic predisposition
- Injury to the plantar fascia
- Poor flexibility
- Lifestyle choices like consuming excessive amounts of alcohol
- Medications that encourage the excess production of collagen and tissue
Treating Plantar Fibroma at Home
One of the best ways to treat plantar fibroma at home is to massage and stretch your calves, feet, and Achilles tendon.
This will help reduce the pressure that’s placed on the Achilles and the plantar fascia, as well as increase flexibility of the soft tissue, which will alleviate the symptoms.
You can use myofascial release balls, a foam roller, frozen bottle of water, or even a tennis ball to help massage your foot.
Your doctor may recommend that you use gel or foam pads or insoles in your shoes to help support your arch and redistribute body weight. This can make wearing shoes and spending time on your feet more comfortable.
To help alleviate pain, discomfort, and inflammation you can use over-the-counter pain medication like Ibuprofen.
How Is Plantar Fibroma Treated Medically?
1. Plantar Fibroma Injections
Your doctor may recommend a corticosteroid injection to help reduce the size of the nodule, alleviate pain, and reduce the inflammation.
The corticosteroid provides almost instantaneous relief and the size of the nodule will begin to decrease within a few days of the injection.
The injection can be effective in easing your pain for up to 6 weeks, and it can keep the inflammation down for a bit longer as well.
In some cases, this may only provide temporary relief and the plantar fibroma may eventually return to its original size.
2. Plantar Fibroma Exercises
Stretching and strengthening exercises of the calves, achilles, and feet have proven to be very effective in the treatment of plantar fibroma.
The benefits of including them in your daily routine is that they help strengthen the plantar fascia and surrounding soft tissues, increase blood circulation to the foot, and encourage the growth of new cells.
You’ll find that the arch of your foot is better supported, that the tension through the plantar fascia is reduced, and that your flexibility improves. It will also help alleviate discomfort, pain, and inflammation in the affected foot.
3. Plantar Fibroma Orthotics
Your doctor may recommend the use of orthotics or insoles for plantar fibroma if you’re in the early stages of the development of the nodule, or if the fibroma isn’t getting bigger.
Orthotics will then help to reduce the pressure that’s placed on the nodules, support the arch for the foot, and ensure that your foot stays in its correct alignment.
They will also help to distribute your body weight evenly and away from the nodules—especially if the nodule is stable—reducing the amount of tension that’s placed on your plantar fascia, and alleviating pain.
Your podiatrist will either recommend an orthotic or they’ll provide you with custom orthotics that will take into account the size and position of your nodule on your foot.
It’s important to note that once a nodule has reached a certain size, orthotics may not work and could actually place more pressure on the fibroma.
4. Physical Therapy
Your doctor may recommend that you see a physical therapist, who will put a treatment plan together for you.
This could include a combination of ultrasound or shockwave therapy, as well as stretching and strengthening exercises.
Ultrasound or shockwave therapy uses sound waves to help break down adhesions, reduce the size of the nodule, and stimulate blood circulation to the foot to encourage healing.
In most cases, people will start to notice a difference in the size of the nodule, their discomfort, and their pain levels after 3 to 4 sessions.
Research has shown that radiotherapy is an effective treatment for decreasing the size of the nodules. However, you should note that this is low-dose radiation, and not the high-dose treatment used to treat cancer.
Although there aren’t a lot of studies available, outcomes do show that low-dose radiotherapy—30 Gy, administered over a number of sessions—has been effective at reducing the size of the nodules and the pain associated with plantar fibroma.
Radiotherapy has been shown to improve foot function, reduce pain, and prevent progression of the condition.
6. Plantar Fibroma Surgery
Surgery is the last treatment option and is often considered when the symptoms are severe or when all other treatment options aren’t effective.
In most cases, the surgery is performed under a local anesthetic and you’ll still be able to go home on the same day. The doctor will remove the nodule as well as a part of the surrounding plantar fascia to help prevent recurrence.
You may have to use crutches to keep your weight off of your foot for the first few weeks, and possibly wear a splint or boot while your foot heals.
With that being said, there’s still a risk that you could develop another plantar fibroma in the future.
As there is no specific known cause for plantar fibroma, understanding how to prevent it can be difficult. However, you should take steps to improve your foot health and support your feet as much as possible to reduce the chances of developing plantar fibroma.
This can include things like making sure you’re wearing the right kind of shoes for plantar fibroma for your gait and ensuring that they support the plantar fascia.
Other ways to prevent plantar fibroma include: exercising regularly, incorporating plantar fascia stretches and exercises to keep it strong and supple. You should also be maintaining a healthy weight to prevent excess strain on the feet.