Plantar Fibroma – Causes, Symptoms & Treatment
A small nodule that grows within the plantar fascia is know as plantar fibroma.
Plantar fibromatosis is a benign nodular growth means it is a non-cancerous growth and it does not resolve without proper treatment.
Usually it grows about a inch in size or less.
It may cause pain when you walk or stand on your feet and severity of pain depends upon its location and size.
It is also known as Plantar fascial fibromatosis, Ledderhose disease and morbus ledderhose.
In 1894, George Ledderhose identified this disease for the first time in history.
We will see the common causes, sign, symptoms and treatment for these fibroma.
What is plantar fibromatosis?
To better understand this condition, we need to learn the basics of anatomy of foot arch.
Plantar fascia is a thick band of firbrous tissues that runs from heel to the bones of toes and positioned at bottom of foot.
It provides stability to foot arch by supporting the bones that build foot arch.
In cases of plantar fibroma, small thickening starts to appear in the middle portion of plantar fascia.
This nodules are termed as plantar fibromatosis. These can be occur as singular nodule or multiple nodules forming a cluster.
Also known as Ledderhose disease, this condition leads to pain while standing & walking.
It is more prevalent in men than women. It can be found in both feet but most of the time it affects one foot.
Plantar fibromas should never be confused with inflammation of fascia, which is known as plantar fasciitis.
During initial phase plantar fibromas does not create any significant symptoms, but as their size grows it produce discomfort in foot.
common symptom of these fibromatosis includes –
- Firm Nodules (it looks like bump on bottom of foot)
- Toe stiffness
The most common symptom of plantar fibromatosis is a visible & firm nodule under the skin of bottom of foot.
Many time patient call them as a bump on bottom of foot.
Usually it found at middle part of foot and measures less than a inch in size.
These nodules is called as fibromas and it originates from the fibrous tissues of plantar fascia. Many time patient can have multiple nodules in arch of foot.
These nodules does not fade away by its own unless you remove them surgically and can be seen by dorsiflexing (pulling toes upward) your foot.
Usually plantar fibromatosis is a painless situations.
But these nodules start to giving pain when external pressure is directly applied to them i.e. from running, standing or walking.
In sever cases, these condition may lead to thickening of plantar fascia.
Thickening of fascia may cause contractures and makes walking more difficult.
Though primary cause of this condition yet to be discovered, trauma or micro-tears in plantar fascia might be the leading cause of Ledderhose disease.
Repeated trauma may lead to tears in plantar fascia which may result in forming fibromas.
The pin point cause of this condition is not clear but patient usually shows one or more of the following causes.
Genetics plays important role in this condition.
If you have family history this condition, then you might be predisposed to get it.
Male are commonly affected by this condition.
It has been observed that it is more common in Caucasians, so Caucasians male are more prone to get Ledderhose disease.
Diabetes, Thyroid problems, Liver disease, Peyronie’s disease and Epilepsy are considered to linked with Ledderhose disease.
Repetitive foot trauma at the bottom of foot causes inflammation and micro tears in plantar fascia.
Tears in fascia can develop into fibromas.
It better to have comfortable shoe for your feet to avoid possible injury to plantar fascia while running, walking or standing for hours on your feet.
Chronic alcoholism is supposed to be a risk factor for plantar fibromatosis.
Usually this condition is diagnosed with clinical examination, it may confuse physician with other similar looking conditions like inclusion body fibromatosis, post traumatic neuroma, epithelial sarcoma and fibrosarcoma.
Doctor may advice to undergo MRI to easily diagnose and identify the size, shape and exact location of fibromatosis.
Do not forget to inform your doctor about other symptoms like pain, difficulties in walking etc. as well as he might ask about your past medical history, medication that you are currently taking, family history etc.
Treatment usually depend upon whether nodules are painful or not, its size & location.
If nodules are not causing any pain then physician may advice to observe them for few days to see if pain arise and whether its size increase or not.
If they are small in size and does not causing unbearable pain then treatment includes reliving direct pressure on nodules by using foot orthotics like shoes insoles & specially designed padding.
Use of 15% verapmil gel shown some good results reducing size of nodules.
Physician will also advice you to perform some simple stretches for plantar fascia.
If pain are unbearable and nodules start to grow in size leading to difficulty in walking then surgical intervention is required.
If all conservative treatments fail to provide relief then fibromas can be removed by surgical procedure. But they might grow back after some time.
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