Aloha Foot Centers

Kailua Kaneohe Foot & Ankle Specialists

Robert LaReaux, DPM
Sandra Au, DPM
Ken Tsubata, DPM

Plantar Fibromatosis

What Is Plantar Fibromatosis?

It is a fibrotic tissue disorder or wound healing disorder, which is non-cancerous and is characterized by the presence of excess collagen or fibrotic tissue. The most common symptoms of are firm nodular masses that can be felt just under the skin on the bottom of the foot and pain when standing or walking. Unlike the related condition Peyronie's disease, plantar fibromatosis nodules are not known to resolve on their own. Studies indicate that this condition is diagnosed most often in the middle-aged and elderly population, although it can affect people of all ages. It has been found that the incidence may be as high as 25% in the middle-aged and elderly population and that the condition affects men approximately 10 times more often than women**. Caucasians of northern European descents tend to be affected more than other ethic groups.

Symptoms

The two most common symptoms are firm nodules that can be felt just under the skin and pain that can be constant or increases when standing or walking. The lump often increase in size and density over time but not indefinitely.

Trauma to the plantar fascia is thought to be a primary cause. The trauma may be from a puncture through the bottom of the foot or from repetitive impact from activities such as running or climbing. It is also thought that thickening and tightening of the plantar fascia caused by plantar fasciitis may lead to tears in the tissue, contributing to the cause.

Many patients may be genetically predisposed to fibrotic tissue disorders with a parent or other close relative with this condition. People of northern European descent appear to have a higher incidence of fibrotic diseases, while they rarely affect Asians.

Medications often used for treating high blood pressure that belong to the drug class known as beta adrenergic blocking agents (beta-blockers) have been reported to cause this podiatric orthopedic tissue disorder.

 

Treatment Options

Many different treatments for plantar fibromatosis have been used and can be divided into two major categories, invasive and noninvasive.

Invasive treatments include:

  • Corticosteroid injections into the fibroma
  • Surgery - Surgery is currently the most common treatment for plantar fibromatosis. There are two common procedures. One involves the removal of the fibroma only which results in a high recurrence rate and the second involves the complete removal of the plantar fascia which has a long recovery time and can lead to other podiatric problems.

Non-invasive options include:

  • Transdermal Verapamil 15% Gel
  • Stretching
  • Orthotics
  • Padding
  • Physical therapy

Most doctors agree that a non-invasive approach to treating plantar fibromatosis should be considered first given the high rate of recurrence from surgery. Invasive treatments and surgery are usually reserved for the most severe cases.