If you’ve located a painful bump along the bottom of the foot, between the forefoot and heel pad, it may be a plantar fibroma. A plantar fibroma is a painful knot of fibrous tissue that sometimes develops inside the plantar fascia – the long band of tissues connecting the heel to the toes along the bottom of the foot.
A plantar fibroma grows slowly and can measure less than an inch in size. It can appear in one or both feet. It is a benign (non-cancerous) growth, developing from cells in ligament tissue. Plantar fibromas will NOT go away on their own, and only resolve with appropriate medical treatment.
Plantar fibromas are most prevalent among Caucasians, especially among middle-aged men.
Causes of Plantar Fibroma
There is no definitively known cause of plantar fibromas. However, possible causes include:
- Footwear – Wearing shoes with raised heels and toe spring (raised toe box) can stretch the plantar fascia. This can create an imbalance in the tissue that may contribute to various deformities. Plantar fibromas can develop in this situation.
- Injury – Injury to the plantar fascia, including puncture wounds or crush injuries, may lead to the growth of a plantar fibroma during the healing process.
- Medications – Taking certain medications like beta adrenergin blocking agents (beta-blockers) can cause fibrotic tissue disorders such as plantar fibroma. Also, anti-seizure drugs like phenytoin and large doses of supplemental vitamin C can cause the production of excess collagen.
- Excessive alcohol consumption – Heavy drinking may be a factor in the development of plantar fibromas.
- Genetics – Plantar fibromas are more frequently found in people whose parents or close relatives have had a history with the issue.
- Pre-Existing Health Conditions – There appears to be a link between diseases including diabetes, epilepsy, and thyroid issues, and an increased likelihood of suffering from plantar fibromas.
Symptoms of Plantar Fibroma
In the early stages, plantar fibromas may be painless, but as they grow, they can put pressure on sensitive structures such as nerves and blood vessels inside the foot. This can make standing, walking and running for long periods very painful. They can also cause a change in gait as the individual attempts to avoid bearing weight directly at the location of the fibroma.
The growth can cause a soft curvature in the contour of the bottom of the foot, which can be sensitive to direct pressure and the use of footwear. The person will be able to feel the nodule under the skin of the foot.
Treatment of Plantar Fibromas
There are two types of treatment for plantar fibroma: non-surgical treatment and surgical treatment.
Non-surgical treatments are designed to lessen the pain and discomfort in the foot, without removing the source of the problem. Below are some of the common non-surgical approaches you can apply:
- Wearing shoes that have no high heel or toe spring. Flat shoes are especially recommended. This will help to distribute the weight of the body across the entire surface and structure of the foot. Toe spacers may also aid in spreading weight more effectively.
- Corticosteroid injections to the fibroma.
- Foot stretching exercises.
Plantar Fibroma Surgery
If the non-surgical treatments suggested above don’t provide relief, surgery is an option. Surgical removal of the fibroma is usually successful in the long term, with a low rate of recurrence.
If you’ve noticed the growth of a nodule between the heel pad and forefoot, it may be a plantar fibroma. Depending on the stage of its growth, it may be causing no pain, or severe pain. At Houston Foot and Ankle Care, we can hep you manage the discomfort with conservative treatments. Or, if you’ve been unable to see an improvement, podiatric surgeonGabriel Maislos, DPM, FACFAS, can surgically remove the nodule to address the root cause.
Call (713) 541-3199 if you experience:
- pain while standing or walking
- sensitive or painful bump on the bottom of the foot
- inability to wear certain shoes without triggering pain in the plantar fascia area