A plantar fibroma or plantar fibromatosis is a condensed, hard, and non malignant mass of fibrous tissue at the bottom of the foot and set in the plantar fascia, which is a band of tissue extending from the toes to the heel at the base of foot. It may occur in one or both the feet; by and large, it is benign.
The exact cause is not been evidently identified. It may be a single mass or a cluster of fibromas; that may be present in the plantar fascia. As the mass increases in size, there will be pain and discomfort on walking.
Diagnosis of a plantar fibroma is done through examination. Biopsy is not advised given that it may enlarge the fibroma. In case the pain associated with the mass is not too painful, the physician may advocate taking no action. In case, the pain is excruciating, treatment is started at once.
Causes And Symptoms Of Plantar Fibromas
The precise cause of a plantar fibroma is not yet known. Injury / trauma is probable cause; as is phenytoin.
People having hypothyroidism, diabetes, epilepsy, and liver cirrhosis are believed to have a higher risk of developing planar fibromas.
To diagnose the condition, the doctor will inspect the foot a. An MRI may be done to further assess the mass and help in making the diagnosis.
Plantar Fibromas Symptoms
The typical symptom of a plantar fibroma is an obvious mass in the arch of the foot which feels firm to touch. This mass may remain the same size or may enlarge over time, or other fibromas may develop eventually.
There may or may not be any pain or discomfort. When pain occurs, it is due to the shoes pushing against the mass in the arch, and it occurs when you walk or stand barefoot.
Treatment Options For Plantar Fibroma
Treatment of a plantar fibroma needs a multi disciplinary approach:
- Non surgical management allays the pain and discomfort of a plantar fibroma, even though it will not make the lump go away.
- Your doctor may recommend steroid injections. Corticosteroid injection in to the lump helps it to shrink and thus eases the pain significantly. This decrease may be only provisional, and the fibroma mass may slowly come back to its initial size.
- Orthotic devices can be of immense help. If the fibroma is stable, i.e. it is not changing in dimensions, shoe inserts help manage the discomfort and pain by distributing the person’s weight away from the plantar fibroma.
- Physical therapy offers considerable relief as well. The discomfort of a plantar fibroma is sometimes managed via physical therapy. Physiotherapy eases the pain and discomfort and prevents inflammation of the muscles.
- In case the mass increases in size or the pain worsens, the patient needs to be further assessed.
- Surgical treatment is considered in case the patient experiences constant unrelenting pain even after non surgical approaches for a long period of time. Surgical removal of the mass causes flattening of the arch or development of hammer-toes. Given that, there are high incidences of recurrences, continued and regular follow-ups with the foot and ankle surgeon is necessary.