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It's the end of the day and you're happy to be able to finally sit down. You kick off your shoes and socks and start massaging your feet. It feels good until you notice something in your arch. It feels like a bump or knot. What is that? My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, TX. What you're feeling is likely a plantar fibroma. Don't worry. It's benign, but it may become painful.
A plantar fibroma is the most common type of tumor found on the sole of the foot. Most people don't know they have it because there are no symptoms, but over time, planter fibromas can become painful. The most common type is a nodular fibroma.
These bumps tend to be flat and round, about half an inch wide. Sometimes they're soft and bumpy. Other times they feel firm and smooth. In every case, a plantar fibroma is benign. The exact cause of a plantar fibroma is unknown. Because it's not exactly clear why one develops, there's no known method to prevent it from occurring. A few theories exist.
One suggests that a genetic component exists, while others suggest that traumatic injury could trigger the development of a plantar fibroma. Most cases occur during adolescence or early adulthood. Over time, plantar fibromas may increase in size. This will make it more likely to become painful. That's due to the pressure on the fibroma when you're standing on it. It may feel like you have a bump beneath your foot.
When you come to the office with a bump on your arch, in most cases I can make a diagnosis by examination and with a simple x-ray. If I'm unsure about it, I may examine the area with an ultrasound or send you for an MRI. That will help me identify exactly what we're dealing with.
If the fibroma is not painful, you may elect not to treat it at all. If it is uncomfortable, there are a number of ways to treat it. To start with, you could use a topical anti-inflammatory medication such as Voltaren gel. This will reduce the inflammation and relieve the pain. I may recommend another preparation called Transdermal verapamil. This is a compounded topical form of a heart and blood pressure medication. Used topically, it can reduce the size of the fibroma and relieve any discomfort you might have. Why does this work? We're not completely sure, but it does work well.
In some cases, I may give you a cortisone injection to reduce the inflammation and the pain from the fibroma. I usually reserve this for rare situations where there is a lot of pain. We'll then follow up with transdermal verapamil to reduce the size of the fibroma. In situations where the fibroma is large and very painful. Again, very uncommon. We may elect to remove the fibroma surgically. I'm not a huge fan of taking care of these surgically. If one of the causes is trauma, well surgically removing it is traumatic. We often see the return of the fibroma after surgery. If the pain is debilitating, the surgery is worthwhile. Otherwise, I stick with conservative methods.
A common question I get asked is if a plantar fibroma and plantar fasciitis are related. Both plantar fibromas and plantar fasciitis can cause pain in the arch of your foot. You may think you're having a problem with either condition, but there's actually a big difference between the two. As we previously discussed, a plantar fibroma is a benign tumor that grows under your skin on the bottom of your foot. A plantar fibroma usually doesn't hurt, but can sometimes trigger some symptoms like swelling, tenderness, or stiffness.
Meanwhile, plantar fasciitis is an inflammation of the ligament that tends to occur because of repetitive stress overuse. This type of injury typically happens to runners and athletes who spend a lot of time standing up on hard surfaces. Eventually, the ligament becomes inflamed. So, a plantar fibroma and plantar fasciitis are two very different conditions. The only similarity is that they both involve and affect the planter fascia ligament.
#PlantarFibroma #bumpinmyarch #plantarfasciitis
00:00 Introduction
01:14 What is a plantar fibroma?
01:30 Causes of a plantar fibroma
02:10 Diagnosing a plantar fibroma
02:30 Treatment for a plantar fibroma
03:58 Plantar fibroma vs. plantar fasciiitis
05:23 How to connect with Houston podiatrist Dr. Andrew Schneider