In the early stages of a plantar fibroma, doctors advise the following nonsurgical treatment options. If the fibroma is severe enough, surgery may be needed.
A plantar fibroma is a benign (noncancerous) lump or nodule in the arch of the foot.
In the early stages of the condition, doctors advise conservative management with observation. Nonsurgical treatments may help relieve the pain of a plantar fibroma, but they will not remove the mass.
6 nonsurgical treatment options for a plantar fibroma
Doctors may suggest one or more of the nonsurgical options listed below:
- Home treatments:
- Massage the soles of your feet to promote healing.
- Staying off your feet prevents further injury and promotes healing.
- Most doctors will advise rolling a frozen bottle of water over the sole of the affected foot for relief.
- It is critical to stabilizing a plantar fascia to help prevent further fibroma exacerbation; doctors may advise people to wear padding and strapping on their shoes.
- You can take a topical or an oral anti-inflammatory drug to relieve discomfort. Ibuprofen and other nonsteroidal anti-inflammatory drugs can help reduce pain and inflammation.
- Topical gel:
- Doctors may recommend topical gel that inhibits the growth of fibrous tissue. The application of transdermal verapamil 15 percent gel (calcium channel blocker) is a non-invasive treatment option that has shown promising results.
- It has been demonstrated that it can penetrate the skin and remodel the tissue, allowing the collagen to shrink in size.
- Orthotic devices:
- Custom orthotic devices (shoe inserts) may relieve pain by distributing the person’s weight away from the fibroma if the fibroma is stable.
- Physical therapy:
- Doctors may advise physical therapy to stretch and strengthen the tissues and promote circulation. This reduces inflammation, prevents fibrous tissue accumulation, and promotes healing.
- Steroid injections:
- Injection of corticosteroid and/or collagenase into the mass may help the fibroma shrink. This reduction may be only temporary, and the fibroma may gradually return to its original size.
- Radiotherapy:
- To reduce the size of the nodules, doctors may recommend radiotherapy. Side effects of radiotherapy are minor (approximately 80 percent effective).
Surgery options for plantar fibroma
If the person’s pain persists despite nonsurgical treatment, doctors will consider surgical removal of the fibroma.
- Tenex, a minimally invasive surgery, has recently become popular.
- During this procedure, doctors make a small incision and insert a needle with high-frequency vibrations to break up and remove the damaged scar tissues.
- This does not require any stitching.
- In a common and more invasive procedure, the fibroma and surrounding plantar fascia are removed through large incisions that require preoperative and postoperative care.
- Surgical removal of a plantar fibroma may cause the arch to flatten or the development of hammertoes.
- Doctors may prescribe orthotic devices to provide post-surgery foot support.
Surgery should be considered only after all other options have been exhausted, and the fibroma has progressed beyond its early stages.
Because of the high recurrence rate of this condition, it is recommended that you see your doctor regularly. Topical Mitomycin C has recently been shown to reduce the recurrence rate of fibrous lesions.
Before pursuing any of these options, please confirm with your doctor that this is a plantar fibroma and not a cancerous lump.
What is a plantar fibroma?
A plantar fibroma is a fibrous knot (nodule) in the foot’s arch. It is embedded within the plantar fascia, a band of tissue on the bottom of the foot that runs from the heel to the toes.
A plantar fibroma can appear in one or both feet as a single mass or cluster.
Signs and symptoms of a plantar fibroma include:
- A plantar fibroma is distinguished by a noticeable lump in the arch of the foot that feels firm to the touch.
- There may or may not be any discomfort.
- If there is pain, it is more likely to be felt when the shoes press up against the lump in the arch, but it can be felt when walking or standing barefoot.
- A plantar fibroma can cause pain or pressure on other parts of the foot structure, leading to additional foot problems.
What causes a plantar fibroma?
Plantar fibromas do not have any definitive cause but are the result of an abnormal accumulation of collagen fibers in the plantar fascia.
Some of the factors that may affect its growth are as follows:
- Genetics
- Physical trauma to the foot
- Medical conditions such as chronic liver disease, diabetes, epilepsy, and long-term alcohol abuse
- Some medications and supplements such as anti-seizure medications, beta-blockers, glucosamine and chondroitin, and vitamin C
Can a plantar fibroma lead to disability?
There is little chance that a person will be able to stand for at least three to four weeks after having surgery to remove a plantar fibroma and plantar fascia.
The nodule is found among the tendons that provide support and structure to the foot. The person must heal completely, without putting any weight on the foot.
The person will be on crutches for the duration of their recovery and until a doctor allows them to walk again. It will most likely take two months for the individual to be able to fully walk on both feet again.
As a result, people who have undergone surgery to remove a plantar fibroma will be disabled for approximately two months. If the tumor or tumors are larger or more numerous, the person may be disabled for a longer period.
In severe cases, the person's walking ability may be affected for the rest of their life.
