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What are Plantar Fibroma | Find Your Stride | Edinburgh Podiatrist

Introduction

Plantar fibroma is a benign tumour that develops within the plantar fascia, which is a thick band of tissue that runs along the bottom of the foot. This condition is characterised by a nodule or a firm lump that can cause pain and discomfort, leading to difficulties in walking or participating in physical activities. In this blog post, we will delve into the prevalence and typical presentation of plantar fibroma, along with the available treatment options.



How common are they?

It is essential to understand the prevalence of plantar fibroma to gain insight into the frequency of occurrence. Although I've seen quite a few working in Orthopaedic clinics plantar fibromas are actually quite rare. For some perspective, the condition continues to appear on the National Institute of Health’s list of rare diseases affecting less than 200,000 people in the United States of America (1). This condition primarily occurs in adults between the ages of 30 and 60, with a slightly higher prevalence in males than females.


What are the symptoms?

Typically, the presentation of plantar fibroma involves the development of a small nodule or lump within the plantar fascia. This nodule is usually less than an inch in size, and it may be either single or multiple. Initially, it may be painless and go unnoticed, but as it grows, it can cause discomfort and tenderness. If the fibroma increases in size, it can make walking or standing painful and affect the biomechanics of the foot. The symptoms of plantar fibroma can vary depending on the location and size of the nodule. Some people experience a sharp or shooting pain, especially when pressure is applied to the affected area.


Getting a diagnosis

Diagnosing plantar fibroma typically involves a physical examination, medical history review, and imaging studies. During the physical examination, your podiatrist will usually palpate the affected area to identify any nodules or lumps within the plantar fascia. Medical history review is crucial to rule out other conditions that may present with similar symptoms. Imaging studies, such as ultrasound or magnetic resonance imaging (MRI), can provide a detailed view of the fibroma and aid in confirming the diagnosis.


What are the treatment options?

Regarding treatment options, there are several options available, and the choice depends on the severity of symptoms and the impact on daily activities. Non-surgical treatments may be considered as the first line of management. These include orthotics or shoe modifications to provide support and reduce pressure on the fibroma. Physical therapy can be beneficial, such as exercises to improve flexibility and strengthen the affected foot. Shockwave therapy and steroid injections can also be considered.


In cases where the fibroma is causing severe pain, significantly impairing functionality or the diagnosis isn't clear, surgical intervention may be necessary. Surgical treatment is usually avoided where possible but excisional biopsy (removing the lesion) for analysis is the option I've seen considered most. Recovery from surgery typically involves a period of immobilisation followed by physical therapy to facilitate healing and restore normal foot function. As with any surgical procedure, there are risks involved, and the success and outcome of the surgery may vary depending on individual circumstances.


Conclusion

In conclusion, plantar fibroma are seen quite regularly by podiatrists, they are characterised by a lump or nodule within the plantar fascia (beneath the foot). Plantar fibroma can cause pain, discomfort, and difficulty walking or participating in physical activities. Prevalence is slightly higher in males than females. Treatment options range from non-surgical interventions, such as orthotics and physical therapy, to surgical procedures for severe cases. A thorough evaluation by a podiatrist is recommended to determine the most suitable option for each individual.


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References

1. Ledderhose Disease. Gaithersburg: National institutes of health genetic and rare diseases information center; c2017-18. [Accessed April 23, 2018]. (updated 2018 April 1 cited 2018 April 23).

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