Plantar Fibroma – Bump on the Bottom of the Foot

Since so many people suffer with plantar fasciitis many people have heard of the plantar fascia.  I like to describe it as the support for our arch and it is fairly prominent along the bottom of the foot when we lift the big toe (hallux).  Today I write about a fibrous lesion of the plantar fascia that can spontaneously form but is often associated with an injury.  Most patients present to my podiatry practice simply stating that there is a new bump on the bottom of their foot.

Plantar fibromas are benign tissue tumors or growths on the plantar, or bottom surface of the foot. Unlike plantar warts, which grow on the skin, these grow deep inside on a thick fibrous band of ligaments, called the plantar fascia. The presence of the tumor can cause pain or pressure on other parts of the foot structure that can lead to other foot problems.

 Nonsurgical measures used in treating plantar fibromas often fail to provide adequate relief of symptoms. However, there is a new approach using topical Verapamil that I find very interesting.  At the same time, surgical correction can lead to further complications, such as plantar nerve entrapment or larger and recurrent fibromas that may be worse than the original problem.

Therefore, in my practice we take the conservative approach first and try to support the foot without irritating the fibroma itself.  “Bumps” on the bottom of the foot are not normal and should be properly diagnosed and addressed.  Hopefully, this post eases concerns that surgery is the only option.  Let’s talk about it!

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4 Responses to Plantar Fibroma – Bump on the Bottom of the Foot

  1. Amanda November 9, 2011 at 10:12 am #

    Dr. Sowell;

    I woke up one morning to find a reddish semi-hard “bump” on the inside of my left foot – near the sole , at the arch. It is about the size of a dime. I was very concerned, so I visited my local podiatrist who flexed my toes and then declared I had a plantar fibroma. How is he is so sure? I am concerned becuase it does hurt (not badly, but it does). He told me to wear a device on my foor and we will re-evaluate in 1 month. Do I need a biopsy or an ultrasound? If we don’t operate, will this be here forever? Are these common? Thank you so much, Amanda

  2. Mark E. Sowell, DPM November 9, 2011 at 12:22 pm #

    Amanda, Plantar fibromas are fairly common and are most often diagnosed clinically. They can be varified with additional studies if questions still remain. Typically, they stay about the same in size over time but they can get larger and smaller depending on irritations. Arch support is often used to reduce the tension on the plantar fascia and hopefully reduce any additional injury. Patience is the name of the game with plantar fibromas but you should learn more about them while you wait to see how the new supports do.

  3. Amanda November 9, 2011 at 1:02 pm #

    Thank you for your valuable reply. I really appreciate it Two (or 3) more quick questions:

    1. Do they ever “go away’ ? My dr seemed to think mine might go away or get smaller on its own

    2. How common are they in women? Everything I am readiing on line seems to say they are much more common in men. Is it common for it to just show up? There was nothing on my foot before?

    3. How would you know when to do an ultrasound? If it gets bigger? I am just concerned about it being something bad and not getting it tested. The podiatrist said he could tell what it was by the location and the way it felt with the toe muscles?

    Thanks again for your time. My dr. is very experienced, but an older gentlemen and I think he is gettiing tired of everyone’s same questions over and over!

    Amanda

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