Plantar Fibroma Cysts: symptoms, causes and treatments

Updated 11/24/2020
Plantar Fribroma, University Foot and Ankle Institute

What's a Plantar Fibroma Cyst?

A plantar fibroma cyst is a fibrous knot in the arch of the foot, buried deep within the plantar fascia (the band of tissue from the heel to the bottom of your toes).

 

A plantar fibroma can develop in one or both feet and is non-malignant. 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).


Symptoms of a Plantar Fibroma Cyst

Symptoms may vary depending on the size and location of the cyst and include:

  • Firm lump in the arch of the foot.
  • Pain may or may not be present
  • Increased pain when wearing shoes that press on the arch or when standing and walking when barefoot.

 

Plantar Fibroma Causes

While the exact cause is unknown, some experts believe there’s a connection between trauma and plantar fibromas. An injury to the fascia may cause tears in the tissue promoting the growth of nodules.

 

Because the causes of plantar fibromas are not clear, there’s no known way to prevent its occurrence.

 

Diagnosing Plantar Fibromatosis

To diagnose a plantar fibroma cyst, your doctor examines the foot by pressing on the affected area. This touch examination may produce pain that extends the length of the foot. An MRI or biopsy may be performed to further evaluate the lump.

 

Plantar Fibroma Cyst Treatment Options

Depending on the severity of your plantar fibromatosis, your physician may follow one or more of these non-surgical options:

Steroid and Corticosteroid injections

These may help shrink the mass and relieve the pain. This reduction may be only temporary and the mass may return to its original size, and possibly multiply

 

Topical medication

Certain topical medications, such as Verapamil 15% transdermal gel, have been shown to reduce the size of plantar fibromas if applied consistently for several months. This is a non-invasive way to treat plantar fibromas.


Orthotic devices.

If the fibroma is stable, meaning it is not changing in size, custom orthotic devices (shoe inserts) may be made to relieve pain by distributing body weight away from the fibroma.


Anti Inflammatory Medications.

These meds such as Advil, Motrin, and aspirin can be helpful in alleviating pain and swelling. Please do not take these on an empty stomach as they can cause bleeding in your stomach or other issues. 

 

A plantar fibroma is scar tissue. It is a hereditary condition that will not go away with trigger point massage therapy. If the mass increases in size or pain, surgical treatment may be used to remove the fibroma.

 

Ledderhose Disease

Ledderhose is a type of plantar fibromatosis. Symptoms include the growth of hard and round or lumps on the soles of the feet. They may be painless at first but may cause pain when walking as they grow. It often affects both feet and progresses slowly.

 

Ledderhose occurs in men about 10 times more often than in women and is usually seen in middle-aged and elderly people.

 

Treatment options include:

  • soft shoe inserts to relieve pressure on the lumps (cut out the area around your lumps to create space for them).
  • Gentle stretches, massage, and icing, and nonsteroidal anti-inflammatory drugs can help with pain and swelling
  • physical therapy

 

If these treatments don’t work and the lump is very painful, your doctor might recommend a type of surgery to remove part or all of the thickened tissue from your foot. 

 

Surgical Treatment Options for Plantar Fibromatosis

Your surgeon will make an incision that extends from the heel to the ball of the foot. The fatty tissue layer on the bottom of the foot then exposes the thick fibrous plantar fascia. The plantar fascia, which includes the benign fibromas, extends from the bottom of the heel, through the arch, to the ball of the foot. The fibroma removal requires careful separation from deeper soft tissue structures and small nerves. Once the fibroma has been removed, the bottom of the foot is stitched closed.

 

A drain may be placed into the site to prevent blood and other fluids from collecting. This is removed from three to five days. You will be asked to use crutches for a minimum of three weeks. Post-operative care includes rest, ice, elevation, and cleaning the site.

 

Orthotics are generally recommended to support the arch of the foot, which has been weakened by the removal of the plantar fibroma. Although you may resume walking about one month after the surgery, normal activities, including sports, usually resume in about three months. There may be some residual tenderness in the area of the incision.

 

Due to the high incidence of recurrence with this condition, we strongly suggest that you follow-up with your surgeon.

 

UFAI the Best Choice for Plantar Fibromatosis Treatment

 

Accurate diagnosis of cysts and proper treatment selection is essential for a successful treatment. Our podiatrists have are experts at identifying all masses of the foot and ankle. We are proud to offer the very latest diagnosis and treatment technologies available, all in a professional, relaxed environment.

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