What Is a Plantar Fibroma?
A plantar fibroma is a fibrous knot in the arch of the foot. It is usually located within the plantar fascia, a thick band of connective tissue, and is often considered a benign thickening. It is usually made of collagen fibers and can be firm to the touch. It can develop on one foot or both, and there may be a solitary nodule or a number of them. Plantar fibromas will typically not go away and usually get bigger over time.
The causes are not fully understood, but it can be inherited and related to certain countries of origin. They are more likely to appear alongside:
- Plantar Fasciitis
Patients with a plantar fibroma experience one or more of the following symptoms:
- Lump in arch
- Numbness or tingling in the arch
- Pain, especially with walking or standing barefoot
The symptoms are usually around the arch. Pain is not always present. In addition, the size can stay consistent or get bigger or more fibromas may develop.
The foot and ankle doctor will examine your foot and ankle and review any pertinent medical issues. Often times the mass can be felt in the arch. In our clinic, we often use an ultrasound to help identify the mass and map the location and size. Rarely, an MRI or X-ray may need to be performed to rule out other causes.
A variety of treatment options, often used in combination, are available to treat plantar fibromas. These include:
- Rest. Staying off the foot prevents further injury and encourages healing.
- Ice. Apply an ice pack to the affected area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Topical medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
- Physical therapy. Ultrasound therapy, exercises, and other physical therapy modalities may be prescribed to reduce symptoms.
- Injection therapy. Injections of a local anesthetic provide pain relief, and an injected corticosteroid may be useful in treating the inflammation.
- Custom Orthotic devices. Custom shoe inserts may be prescribed to help maintain the arch and limit excessive motion that can cause compression of the nerve.
When is Surgery Needed?
Sometimes surgery is the best option for treating plantar fibromas. The foot and ankle surgeon will determine if surgery is necessary and will select the appropriate procedure or procedures based on the cause of the condition.