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​Plantar
Fibroma

Common Foot Problems

Plantar Fibroma

Plantar fibroma is characterized by a fibrous knot or nodule in the arch of the foot that is embedded within the plantar fascia. The plantar fascia is a band of tissue on the bottom of the foot that runs from the heel to the toes. A plantar fibroma is a benign (non-malignant) condition that may develop in one or both feet. Patients must be treated by Dr. Radovic in order for the nodule to decrease in size or resolve. Clear, definitive causes for this condition have yet to be identified.

A plantar fibroma is characterized by a firm, noticeable lump in the arch of the foot. This fibrous knot may or may not increase in size over time. Plantar fibromas can increase in number.

Patients may or may not experience pain from a plantar fibroma. Pain that does occur may be caused by walking, by standing barefoot or by shoes pressing against the lump in the arch.


Dr. Radovic will examine the foot and press against the fibrous knot when diagnosing a plantar fibroma. This pressure may sometimes cause pain that radiates down to the toes. Performing a biopsy or ordering an MRI may supplement evaluation and aid in diagnosis.

Conservative treatments may reduce the pain from a plantar fibroma, but will not resolve the nodule. Dr. Radovic may select one or a combination of these non-surgical treatments:

  • Steroid injections. Cortisone medications injected into the mass can help reduce its size and minimize the pain experienced when walking. Injections might provide only temporary relief from the fibroma, which could gradually return to its initial size.
  • Custom orthotic devices. A fibroma that is consistent in size may benefit from custom orthotic devices. Orthotics are shoe inserts that can relieve pain by distributing the patient’s weight away from the fibroma.
  • Physical therapy. Pain may be relieved from physical therapy methods that absorb anti-inflammatory medications into the nodule without injection.

Patients should return for evaluation if an increase in size or pain of the fibroma is observed. Dr. Radovic may recommend surgical treatments in cases of prolonged pain that does not respond to non-surgical treatments.

Flattening of the arch may result from the plantar fibroma being surgically removed. Dr. Radovic might prescribe orthotic devices to provide foot support. Patients are advised to continually follow up with Dr. Radovic, as plantar fibroma often reoccurs after surgery.

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Summary of Benefits

Summary of benefits of current treatment options for Plantar Fasciopathy:

PHASE 1 :

Stretching of calf and arch

High Level Evidence
Over-the counter arch supports 
Medium Level Evidence

Cryotherapy

Medium Level Evidence
Night splints
Medium Level

NSAIDS

Low Level (unless inflammatory arthropathy)
Physical Therapy (UltrasoundS & Iontophoresis)  
Low Level
PHASE 2 :

ESWT/Soundwave

High Level Evidence
Custom Orthoses
Medium Level Evidence
Cortico-steroid injection
Medium Level Evidence
Platelet Rich Plasma(PRP/ABI)
Low Level
SURGERY
Endoscopic Plantar Fasciotomy 
High and Medium Level Evidence
Open and Percutaneous Fasciotomy
Low Level
Gastrocnemius recession  
Low Level

TOPAZ 

Low Level
Experimental/Under-reported therapies
LASER, Acupuncture, Needling, massage

Adapted from: Saxena, A, Fullem, B “Plantar Fascial Injuries” in Foot and Ankle in Sports Medicine ( editors: David W. Altchek, M.D., Jonathan T. Deland, M.D., Christopher DiGiovanni, M.D.,Rock G. Positano, DPM, MSC, MPH, and Joshua Dines, M.D.) Lippincott 2012

Common Foot Problems
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Copyright 2019 Philip Radovic D.P.M., All Rights Reserved. Diplomate American Board of Podiatric Surgery

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