Lump on the bottom of foot?

Have you noticed a lump or a bump on the bottom of your foot?
Do not be quick to worry, it is most likely a plantar fibromas.
You may ask, "What is the Plantar Fibroma?" Well, it is a knot (nodule) of soft tissue that resembles scar tissue (fibrous tissue) often found in the arch of the foot. It is sandwiched within a band of tissue called the plantar fascia. The plantar fascia is a ligamentous like band that extends from the heel bone into the soft tissues behind the toes on the bottom of the foot. A fibroma can develop in one or both feet. This growth is benign (non-malignant), and usually will not go away or get smaller without treatment. Causes for this condition are not clearly understood at this time.

Plantar fibromas are initially identified as noticeable bumps or lumps in the arch that feels firm to the touch. Sometimes they are painful to the touch. The lump can remain the same size or get larger over time, or additional lumps may develop. Sometimes they are painful and other times they are not. When pain is present, it is often caused by pressure from shoes pushing against the lump in the arch, although it can also arise when walking or standing barefoot. People who climb ladders often complain more of pain when they have this condition.

A plantar fibroma is often diagnosed by examination by a podiatrist. Visualization by a diagnostic ultrasound or an MRI is helpful by definitively diagnose plantar fibroma. Taking a portion of the bump (a biopsy) can be another way to diagnose the problem.

How are lumps on the bottom of the foot treated?
Non-surgical treatment may help relieve the pain of a plantar fibroma, although it will not make the mass disappear. The foot and ankle specialist may select one or more of the following non-surgical options:
Cortisone (steroid) injections into the lump can help reduce the size of the lump and in tern relieve the pain that occurs when walking. This treatment may be only temporary and the lump could slowly return to its original size.
Padding around the lump with felt or a custom padded shoe insert called an orthotic. If the fibroma does not change in size, an orthotic is a great way to treat the lumps long term.
Physical therapy. Therapeutic ultrasound along with conduting gel mixed with a steroid (ionophoresis) is another method of delivering cortisone into the mass without the use of a needle.
Some studies have shown that a medication called verapamil applied to the skin (topically) three times a day for 9 months can reduce t he size of the lumps.
If the lump increases in size or pain, the patient should be further evaluated by his or her foot and ankle specialist. Surgical treatment to remove the fibroma is considered if the patient continues to experience pain following non-surgical approaches. Due to the high recurrence rate of plantar fibromas, it is advised that the entire plantar fascia be removed when removing the lumps. It is in the best interest of the patient to seek out an experienced board certified foot and ankle surgeon to operate on these painful masses.
Surgical removal of the bumps and the plantar fascia can result in a flattening of the arch or development c0ntracted toes. For this reason, orthotic devices are advised post surgery to reduce complications from the operation.

Dr. Eric Silvers of McKinney Foot and Ankle Center in McKinney, Texas and Advanced Foot and Ankle in Prosper, Texas is a board certified foot and ankle specialist. He is trained to treat plantar fibromas both conservatively and surgically. To make an appointment to see Dr. Silvers, please call 972-542-2155 or visit our website at www.mckinneyfootcenter.com.