What are the treatments for plantar fibroma?
Plantar fibromas affect males more often than females and tend to occur in people of middle age or older.
Less commonly, some people may develop several fibromas on their foot, a condition known as plantar fibromatosis.
Keep reading to learn more about the symptoms and treatments of a plantar fibroma.
What are the symptoms?
The causes of plantar fibroma are not known.
The primary symptom is a slow-growing lump (fibroma) in the arch of the foot. It typically measures less than 1 inch in size.
The lump may initially cause little to no pain or discomfort. But the fibroma can get bigger or other fibromas may appear nearby over time. Larger lumps are often painful.
The pain may get worse when:
- applying pressure to the lump
- wearing restrictive shoes
- walking barefoot
- standing for long periods
The cause of plantar fibroma is not known.
Could it be genetic?
Some research indicates that genetics may play a role. Plantar fibromas are more common among people of Northern European heritage and rarely affect people of Asian descent.
Is trauma a factor?
Some experts believe that physical trauma to the foot may be a factor in the development of a plantar fibroma.
Repetitive foot injuries can lead to tearing of the fascia in the arch, which encourages the growth of fibromas.
The American Orthopedic Foot and Ankle Society, however, discounts trauma as a factor in nodule growth.
Can lifestyle contribute?
Research has linked several medical conditions and lifestyle choices to the development of a plantar fibroma. However, the study adds that these conditions probably contribute to a plantar fibroma rather than cause it directly.
There is also an association between plantar fibroma and some medications and supplements including:
- anti-seizure medications, such as phenytoin
- beta-blockers for high blood pressure
- glucosamine and chondroitin
- vitamin C (in large doses)
Are there any complications?
Plantar fibromas can cause complications even though they are benign.
Walking and standing difficulties
if a fibroma grows very large or if multiple fibromas develop, it can affect the shape of the arch of the foot, leading to difficulty standing or walking around.
Sometimes a person will require surgery to remove the mass. As with any surgery, there is a risk of complications including infection. There is also a risk that the fibroma will return.
Plantar fibroma can be diagnosed by a doctor.
A doctor can diagnose a plantar fibroma by examining a person's foot. Additional tests may be necessary in some cases.
During the physical exam, the doctor will press on the fibroma and surrounding area. They will check for pain and assess the person's ability to stand and walk comfortably.
A doctor may order further tests, including an X-ray and magnetic resonance imaging (MRI) scan to rule out other foot conditions including:
- swollen tendons
- ruptured tendons
Is a biopsy necessary?
A biopsy is not usually required, except where the imaging scans indicate that the lump may be cancerous.
A biopsy involves removing a sample of the nodule tissue to check it under a microscope.
What are the treatment options?
Treatment aims to alleviate pain and reduce the size of the mass. Small plantar fibromas that do not cause symptoms may not require any treatment.
Treatment options for larger or painful fibromas include:
A topical gel treats plantar fibroma by stopping the growth of fibrosis tissue. Some gels claim that they can alleviate pain within a few months of use. Evidence for its effectiveness is limited.
Getting an injection of steroid drugs into the mass can reduce pain and inflammation, which may allow people to stand and walk with greater ease.
A corticosteroid shot is often considered a temporary solution because it does not stop the fibroma from growing.
Orthotic insoles and pads
Pain caused by a fibroma may be eased by wearing a shoe insole or pad. These orthotic inserts redistribute body weight throughout the foot to reduce pressure on the arch and fibroma.
Orthotics can be purchased over-the-counter (OTC) or custom made.
Stretching and strengthening exercises help by:
- reducing inflammation
- increasing circulation to the foot
- encouraging the growth of new cells
A physical therapist can develop a program of exercises for people with a plantar fibroma.
Physical therapy may help to reduce pain by increasing circulation.
Surgery may be necessary in some cases, particularly if a fibrous mass continues to grow in size or causes increasing pain and discomfort.
Surgical removal of a fibroma, however, can increase the risk of other foot conditions developing, these could include flat foot and hammertoe.
Surgery is usually only considered after other treatments have failed.
Recovery from surgery can take up to 8 weeks. There is a risk of fibroma recurrence following surgery, especially in cases of multiple nodules.
Home remedies for plantar fibroma focus on alleviating pain and discomfort. They include:
Applying an ice pack to the foot can lessen pain and swelling. To make a cold pack, wrap ice cubes in a thin cloth and place on the arch of the foot for up to 15 minutes. Repeat the treatment several times daily or as needed.
Raising the affected foot above heart level can reduce inflammation and swelling. This can be achieved by lying down and propping the feet up on pillows whenever possible.
Over-the-counter pain relief
OTC non-steroidal anti-inflammatory drugs (NSAIDs) are another option for people with foot pain. These medications include:
- ibuprofen (Advil, Motrin)
- acetaminophen (Tylenol)
- naproxen sodium (Aleve)
NSAIDs should not be taken long-term as overuse can cause serious side effects.
The outlook for people with plantar fibroma depends on several factors including:
- the size of the fibroma
- the number of nodules present
- the level of pain experienced
Small fibromas often do not cause symptoms. Larger growths can cause persistent pain and impact a person's ability to move.
Fibromas will not go away without treatment. Options include topical gels, injections, orthotics, exercises, and surgery. Home remedies, such as ice and elevation, can reduce pain.
Although fibroma recurrence is typically rare, people with multiple lumps are more likely to experience a return of the condition, even after successful treatment.