A plantar fibroma (plantar fibromatosis) is a condensed hardened non-cancerous mass of fibrous tissue occurring at the bottom of the foot. It can occur as a single mass or in a cluster and usually occurs within a ligament in the foot arch, called the plantar fascia. As the mass enlarges, it may cause pain and discomfort during walking.
The cause is not always known, but trauma and patients on phenytoin have been said to develop these masses. Also, patients who suffer from diabetes mellitus, epilepsy, hypothyroidism and liver cirrhosis are said to have higher incidences of occurrences.
Diagnosis of the plantar fibroma is usually by clinical examination and biopsy is not normally recommended as this can enlarge the fibroma. If the fibroma is removed, examination via microscope will usually be able to provide a more detailed diagnosis. If the mass is not painful, then no action is usually taken. However, if there is pain, then treatment will usually follow.
Treatment usually involves padding to reduce the pressure and pain in the area, and foot orthotics to provide relief in the plantar fascia area. It may also be useful to wear a night brace or splint to stretch the plantar fascia ligament and reduce the mass size. The use of cortisone injections are not normally useful or recommended and can be very painful. If these measures fail to provide pain relief, then surgical removal of the mass may need to be conducted. This should be considered as the last resort as it can give rise to many complications.
Plantar Fibroma Signs, Symptoms And Treatment
Surgical treatment requires removal of the mass with most of the healthy plantar fascia ligament, because, if you remove the mass without the whole plantar fascia ligament with it, re-growth of the mass is very common. This poses a potential problem of not having the ligament in use to maintain the arch of the foot. In addition, there is the risk that the incision made at the bottom of the foot, from the heel to the ball of the foot, can result in scar formation, which may be painful once healed. After any surgical removal of the plantar fibroma and the plantar fascia ligament, it is recommended that the patient remains non-weight bearing on the foot for at least four weeks.
After healing has taken place and the physician has authorized it, gentle calf muscle strengthening exercises and gentle weight bearing exercises should be conducted. A foot orthotic should also be worn to provide foot arch support and stability.
