Plantar Fibroma Cysts

What are the symptoms of a plantar fibroma cyst? 

Early-stage plantar fibroma may have no symptoms. As it progresses, you might find it difficult to wear shoes that press on the affected area, experience tenderness when walking or standing for extended periods, or have a limited range of motion.

You might also notice a firm lump about the size of a pea or marble along the arch of your foot. The nodule may enlarge over time, or you could develop more of them.

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 at higher risk of developing plantar fibroma. It’s also more common among people of Northern European descent.
• Trauma or injury: Repetitive stress can lead to the development 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, review of medical history, and, in some cases, imaging studies. Dr. Baravarian starts with a review of your medical history and symptoms, followed by a physical examination. 

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

Dr. Bob also has access to imaging technologies, such as X-rays, magnetic resonance imaging (MRI), and CT scans, that let him see the bones and soft tissues of the foot. This helps him rule out other foot and ankle issues as the cause of your pain.

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

What are the plantar fibroma treatment options?

The treatment of plantar fibromas (or plantar fibromatosis) depends on the severity of symptoms and how much they affect daily life. In many cases, nonsurgical options focus on relieving pain and discomfort. 

Dr. Bob always prefers conservative treatments when possible. If we’ve confirmed that your foot lumps are caused by a plantar fibroma and ruled out malignancies, he might adopt a wait-and-see approach. 

Instead of immediate intervention, we’ll use orthotic insoles or shoe inserts to relieve pressure on the fibroma and help reduce your pain. Physical therapy has also been shown to improve flexibility and strength in the foot, helping protect your plantar fascia from future issues or fibromas.

For more serious cases, Dr. Bob might use steroid injections to decrease inflammation and pain. However, corticosteroids can cause other side effects and are not a long-term fix.

If conservative treatments aren’t giving enough relief, he has other medical procedures he can consider, such as:

• Extracorporeal Shock Wave Therapy (ESWT): ESWT uses shock waves to promote healing in the affected area. It is a non-invasive treatment that may be considered when conservative methods do not work.
• Radiation therapy decreases the size of the lesion and relieves symptoms. However, this method is less frequently used and may carry potential risks and side effects.
• Hyaluronidase injections: Hyaluronidase is an enzyme that breaks down hyaluronic acid, a key building block of dense connective tissue. When injected into or around a plantar fibroma, it softens and reduces the fibrous nodule by degrading the extracellular matrix that provides its structure. Think of it as essentially loosening the knot of tissue that’s causing your discomfort.

Surgery for plantar fibromas 

In severe cases, Dr. Bob may perform plantar fibroma excision (surgical removal). Removing the soft-tissue masses from the plantar fascia can weaken the tendon, so orthotics and physical therapy are important for supporting and strengthening the tendon after surgery.

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

Although the recurrence rate after surgery is lower, plantar fibroma still has a high chance of coming back. Your surgeon will set up a regular follow-up schedule to monitor your feet.

Dr. Bob is the best choice for plantar fibroma treatment in Los Angeles

You don’t have to suffer from foot pain. Many innovations in podiatric medicine are available today, and Dr. Baravarian, a board-certified podiatric surgeon, is at the forefront. With decades of experience, his success rates are among the highest in the country. Foot and ankle pain is not normal. Ignoring it can lead to worsening conditions that are harder to treat. 

Dr. Bob is well known as one of the nation’s most technologically advanced foot and ankle surgeons. While other practices say they know about “the latest and greatest,” he has been researching, running clinical trials, and performing these techniques for decades. 

Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.