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Plantar Fibromatosis

Plantar Fibromatosis

What Causes Plantar Fibromatosis?

A plantar fibroma is a fibrous nodule that develops within the plantar fascia. The plantar fascia is a thick fibrous band of connective tissue which extends from the heel to the ball of the foot. The excess collagen is commonly referred to as a fibroma. Plantar fibroma’s are most commonly located in the arch of the foot. The condition presents most frequently in the middle-aged and elderly population, although it can affect people of all ages. Males tend to be more commonly affected than females. Only 25% of patients show symptoms on both feet. Plantar fibromas often increase in size and density over time without treatment – but not indefinitely. Plantar fibromas are not known to resolve on their own.

Signs and Symptoms

  • Firm nodules that can be felt just under the skin
  • Pain that can be constant or increases when standing or walking. The overlying skin is freely movable.

Summary of Causative Factors:

  • Increased weight gain
  • Increased age (> 50 years)
  • Sudden increase in physical activity
  • Flat feet with foot pronation
  • High arched feet
  • History of high impact activities(ie, running)
  • History of wearing poor footwear or walking barefoot
  • Work involving prolonged periods of standing and walking on your feet (i.e., hairdressers, butchers, laborers, retail assistants, nurses).
  • Tight calf muscles
  • Tight plantar fascia
  • Weakness of the intrinsic foot muscles

Treatment Options:

It is important to understand that there are no “quick fix” treatments for plantar fibromatosis. This is because remodeling tissue is a slow process. Asymptomatic cases may not require treatment. In the initial stages, when the nodule is single and/or smaller, it is recommended to avoid direct pressure to the nodule(s). Soft inner soles on footwear and padding may be helpful.

  • Orthoses & Padding: To reduce weight bearing pressures over the nodules.
  • Calf and Plantar Fascia Stretching: To stretch the plantar fascia and encourage re-alignment of the tangled collagen fibers.
  • Night Splint/Stretching sock: (As Above)
  • Electro-Corporeal Shock Wave Therapy
  • Corticosteroid injections: injected into the fibroma
  • Topical application of Verapamil 15% Gel: this is a painless, non-invasive treatment. It is a prescription medication which requires a script from your GP and a compound chemist to then make up a gel. The gel is applied directly to the skin twice a day, 12hours apart. You should expect to use the Verapamil Gel for 6-12 months to complete the treatment. Those who are experiencing pain or discomfort typically see this as the first symptom to be significantly improved, usually within 90 days. Once the fibroma has been remodeled, recurrence is unusual. Transdermal Verapamil 15% Gel is nota life-long treatment.
  • Surgery: A fibroma will only be surgically removed if unresponsive to conservative treatments and if discomfort hinders walking.

For further information about plantar fibromas, please contact Darwin Podiatry on 8941 9955 and make an appointment to see a Podiatrist today.

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