Plantar fibromatosis occurs when there is fibrous overgrowth of connective tissue resulting in tumours. These tumours are called fibromas and are usually not cancerous. Patients with plantar fibromatosis develop masses, or nodules, on the bottom of their feet which are usually painful. These nodules do not go away on their own and patients must seek medical attention to treat the problem.
Symptoms and Causes
Symptoms of plantar fibromatosis include pain and firm nodules. These nodules are compromised of fibrotic tissue or excess collagen, and are located in the arch of the foot just under the skin. They can be painful, especially when walking or standing. Plantar fibromatosis has no exact cause, but potential causes include foot trauma, diabetes, alcohol abuse and genetics. The condition may also be caused by high blood pressure medicines, anti-seizure medicines and consuming large amounts of vitamin C.
Plantar fibromatosis can affect anyone of any age, but it is a condition seen most often in middle aged people and senior citizens. As many as 25 per cent of these groups have plantar fibromatosis, which also affects men 10 times more often than women. People who are Caucasian or whose ancestry originates in northern Europe are more likely to be affected by plantar fibromatosis than other ethnic groups.
Treatment of plantar fibromatosis initially involves an effort to keep direct pressure off nodules. Many patients will only feel pain when the nodule is pressing or rubbing against a shoe or the floor. Foot doctors may advise patients with plantar fibromatosis to wear shoes with a soft inner sole, or to add padding to the inside of the shoe so the nodules will rest against a more cushioned surface.
Invasive treatments of plantar fibromatosis are typically reserved for those patients with severe cases of the condition. One treatment involves corticosteroids injected into the nodules. Patients may also undergo surgery, which is the most common invasive treatment for plantar fibromatosis. One surgical procedure involves removing the nodule and another procedure involves removing the plantar fascia, which is the ligament running along the bottom of the foot. The latter procedure has a longer recovery time and can lead to other foot problems.
Noninvasive treatment of plantar fibromatosis includes stretching exercises, physical therapy, padding and orthotics for shoes, and a medicine called Transdermal Verapamil. This medicine is a calcium channel blocker primarily used to lower blood pressure, but a gel form of the drug is being used in the treatment of plantar fibromatosis. Doctors prefer using these noninvasive treatment options because of the high rate of recurrent plantar fibromatosis after invasive surgery.