Plantar Fibromatosis

Plantar fibromatosis is a tissue condition affecting the plantar fascia which is fibrotic and usually includes a single lesion or multiple nodules. The condition usually derives from the medial as well as the central fascial band of the aponeurosis and usually is non-cancerous. It comprises extra fibrotic or collagen tissue. This additional collagen is generally denoted as a fibroma. These fibromas are mostly slow-growing lesions that are typically asymptomatic.

Symptoms of Plantar Fibromatosis

Some most common symptoms associated with plantar fibromatosis include:

• Firm lump in the arch of the foot
• Lump can cause pain
• Pain is caused by the pressure of shoes
• Heels and soles of the feet hurt when first stepped on in the morning

Causes of Plantar Fibromatosis

The exact reason for plantar fibromatosis is not known, but there are several probable causes that the majority of doctors believe can play a part in the situation.

Trauma

Any trauma or injury to the plantar fascia is believed to be the principal reason for plantar fibromatosis. A puncture or perforation could have caused this trauma through the sole of the foot or from the impact which is repetitive from undertakings such as climbing or running. Also, it is believed that tightening and thickening of the plantar fascia created by plantar fasciitis could have led to tissue tears which have caused plantar fibromas to follow.

Genetics

Numerous individuals may be predisposed genetically to fibrotic tissue complaints such as plantar fibromatosis. Those from north European ancestry seem to have higher incidences of diseases that are fibrotic, while Asians are rarely affected. Those individuals with plantar fibromatosis might also consider a close relative or a parent with the condition. This condition is likewise associated with Dupuytren’s disease or Peyronie’s disease. Approximately 5% of individuals with Dupuytren’s disease similarly have plantar fibromatosis, and 3% of those with Dupuytren’s disease will also have Peyronie’s disease.

Plantar fibromatosis may affect individuals of any age, but this is a condition which is seen more often in the middle aged individuals as well as senior citizens. As many as 25% of these age groups have plantar fibromatosis which also will affect men ten times more than it will affect women.

Medications/Vitamins/Supplements

Drugs which are frequently used for the treatment of hypertension belonging to the drug class identified as beta-adrenergic blocking agents or beta-blockers have known to be a reason for fibrotic tissue disorders. Drugs which are anti-seizure for example phenytoin as well as certain supplements, for instance, glucosamine/chondroitin and huge doses of vitamin C supplements can also stimulate excessive collagen production.

Other Conditions

Those individuals with diseases such as diabetes, chronic liver disease, and some seizure diseases have a higher rate of plantar fibromatosis. While these diseases may not be a direct cause for this condition, it can designate the influence these conditions or drugs used to manage them have on the healing of wounds. Long-term alcohol abuse has also been linked with this condition.

Treatment

Numerous different treatments are available for plantar fibromatosis and usually are separated into two major classifications, non-invasive and invasive.

Non-invasive treatments

They include:

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

Invasive treatments

• Corticosteroid injections in the fibroma
• Surgery – This is presently the most common management technique for the healing of plantar fibromatosis. There are usually two procedures which are common. One comprises the exclusion of the fibroma only – this results in a recurrence rate that is high and the second includes the total exclusion of the plantar fascia that has a longer recovery time as well as leading to other foot problems.

Many doctors agree that the non-invasive method for handling plantar fibromatosis should be first considered given the exceptionally high rate of recurrence from surgery. Invasive treatments, as well as surgery, are typically set aside for the cases which are more severe.

Initial treatment which is conservation for this condition includes the avoidance of any direct pressure to the nodules of plantar fibromatosis. In most cases, the only pain found with this condition is when the nodule is irritated by any direct pressure from the floor or shoes. Soft arch supports and padding can be an aid to cushion and pad the plantar fibromatosis nodules.

Plantar Fibromatosis Pictures