Plantar Fibroma Cysts: symptoms, causes and treatments

Updated 1/9/2024
Plantar Fribroma, University Foot and Ankle Institute

What's a Plantar Fibroma Cyst?

A plantar fibroma is a knot of connective tissue in the arch of your foot, buried deep within the plantar fascia (the band of tissue that runs from the heel to the forefoot along the bottom of the foot). Also known as Ledderhose disease, a plantar fibroma nodule is made up of the same type of tissue that is found in ligaments.


A plantar fibroma is slow-growing and may develop on the sole of one or both feet. Luckily, these tumors are non-cancerous.


However, the mass usually will not go away without treatment. It's critically important that you have a proper evaluation of cysts that you discover to eliminate a more serious medical condition (such as cancer).


The condition is diagnosed most in the middle-aged and elderly population. Risk factors include diabetes, chronic liver disease, and epilepsy.

What are the symptoms of a plantar fibroma cyst? 

Early-stage plantar fibroma may have no symptoms. As it develops, you may have difficulty wearing shoes that put pressure on the affected area, experience tenderness when walking or standing for long periods, or limited range of motion.


You may also be able to feel the firm pea- or marble-sized lump of fibrous tissue along the arch of the foot. The nodule may grow over time, or more may develop.


What causes plantar fibroma?

While the exact cause of plantar fibroma is unknown, there are some factors we know can contribute, such as:


  • Genetics: If you have a family history of Ledderhose disease or Dupuytren’s contracture, you may be more susceptible to developing plantar fibroma. It’s also more prevalent in people of Northern European descent.
  • Trauma or injury: Repetitive stress may contribute to the formation of fibromas. This could include activities that involve excessive running or jumping.
  • Abnormal foot mechanics: People with flat feet or high arches may be more prone to developing plantar fibromas due to the increased stress on the plantar fascia.
  • Inflammation: Chronic inflammation within the plantar fascia may play a role in the development of fibromas. Conditions such as plantar fasciitis may increase the likelihood of fibroma formation.


How to diagnose plantar fibroma 

The diagnosis of plantar fibroma typically involves a combination of a clinical examination, medical history review, and, in some cases, imaging studies. At University Foot & Ankle Institute, our podiatrists start with a review of your medical history and symptoms and then perform a physical examination. 


Palpation of the sole of the foot allows our doctors to feel lumps or nodules that indicate plantar fibroma. A range of motion test also provides critical information for uncovering the cause of your foot pain.


Our doctors also have access to imaging technology such as X-rays, magnetic resonance imaging (MRI), and CT scans that allow them to see the bones and soft tissues of the foot. This allows them to rule out other foot and ankle issues as the cause of your pain.


To rule out malignant sarcomas (cancer), we can also take a sample from the fibroma for a biopsy. 


What are plantar fibroma treatment options?

The treatment of plantar fibromas (or plantar fibromatosis) can vary depending on the severity of symptoms and the impact on daily activities. In many cases, nonsurgical treatment is focused on managing pain and discomfort. 


At University Foot & Ankle Institute, we always opt for conservative treatment options when possible. If we’ve ruled out malignancies and confirmed plantar fibroma to be the cause of your foot lumps, we may take a wait-and-watch approach. Rather than directly intervening, we’ll use orthotic insoles or shoe inserts to take pressure off the fibroma and reduce your pain. Physical therapy has also been shown to be effective in improving flexibility and strength in the foot and protecting your plantar fascia from future damage or fibromas.


For more severe cases, we may turn to steroid injections to reduce inflammation and pain. However, corticosteroids can have other side effects and so are not a long-term solution.


If conservative treatments aren’t providing enough relief, we do have other medical procedures we can turn to, such as:


  • Extracorporeal Shock Wave Therapy (ESWT): ESWT uses shock waves to stimulate healing in the affected area. It is a non-invasive procedure that may be considered in cases where conservative measures are not effective.
  • Radiation Therapy: Radiation therapy reduces the size of the lesion and alleviates symptoms. However, this approach is less common and may have potential risks and side effects.


Surgery for plantar fibromas 

In extreme cases, we may turn to plantar fibroma excision (surgical removal). Removing the soft-tissue masses from the plantar fascia will weaken the tendon, so orthotics and physical therapy are essential for supporting and strengthening the tendon after surgery.


You’ll typically need to avoid weight-bearing for three weeks while the incision heals.


While the recurrence rate after surgery is lower, plantar fibroma does have a high incidence of recurrence. Your surgeon will establish a regular schedule for follow-ups to keep an eye on your feet.


University Foot & Ankle Institute (UFAI) is the best choice for plantar fibroma treatment

You don't have to live with foot pain. There is so much innovation in podiatric medicine today, and our board-certified orthopedic surgeons are at the forefront. With decades of combined experience and the highest success rates in the nation, we have effectively treated over 200,000 patients. Foot and ankle pain is not normal. And ignoring it will likely cause your condition to worsen and become harder to treat. 


UFAI is well known as one of the nation's most technologically advanced foot and ankle surgeon practices. While other practices say they know about "the latest and greatest," UFAI’s healthcare team has been researching, running clinical trials, and performing these techniques for decades. 


To schedule a consultation, please call (855) 872-5249 or make an appointment now.


University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area. Our foot doctors are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Manhattan Beach, Northridge, Downtown Los Angeles, Sherman Oaks, Westlake Village, Santa Barbara, and Valencia.


Plantar fibroma FAQs

Plantar fibroma FAQs


How serious is plantar fibroma?

Plantar fibroma can vary in seriousness. Small nodules may cause little discomfort, while larger or multiple nodules can lead to more significant pain and impact daily activities. The condition's severity often depends on the size of the fibroma, the level of discomfort it causes, and its response to treatment. It's advisable to seek medical advice for proper diagnosis and management, especially if it affects walking or standing.


Is it OK to massage plantar fibroma?

Massaging a plantar fibroma should be approached with caution. Gentle massage may help relieve tension in surrounding tissues, but direct or aggressive massage on the fibroma itself could potentially irritate it or cause it to grow. It's important to consult a healthcare professional before starting any massage therapy to ensure it's safe and suitable for your specific condition. Alternative treatments such as physical therapy, orthotics, or steroid injections might be recommended.


Is walking bad for plantar fibroma?

Walking is not necessarily bad for plantar fibroma, but it can sometimes exacerbate symptoms, especially if the fibroma is large or painful. It's important to wear supportive footwear and possibly use orthotic insoles to reduce strain on the foot


What will happen if you don't get rid of a plantar fibroma?

If a plantar fibroma is not treated, it may remain stable, grow slowly, or occasionally grow more rapidly. While it's not life-threatening, an untreated fibroma can lead to discomfort or pain, especially when walking or standing. Over time, this can affect mobility and quality of life. However, not all fibromas require active treatment, particularly if they are not causing significant symptoms. 


Is plantar fibroma hereditary?

Plantar fibroma is not clearly understood to be hereditary, but there may be a genetic component in some cases. While most instances of plantar fibroma occur sporadically, there have been instances where it appears in multiple family members, suggesting a possible genetic predisposition. However, environmental factors and individual health conditions also play significant roles.


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