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Best treatment for small plantar fibroma?

Discussion in 'Ask your questions here' started by lky123, Sep 8, 2010.

  1. lky123

    lky123 New Member

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    I have what seems to be a small plantar fibroma (5 x 4mm) just superficial to the distal plantar fascia (from the ultrasound report; i'm no expert.) It doesn't bother me too much yet (had it for four weeks) but without looking at it a podiatrist recommended surgery. Seeing this is not the advice I've read on the net, I'd be interested in other opinions. Also does anyone know if Verapamil gel is a good treatment, as I've been reading some good reports on the net about it. Thanks in advance!

    Also from the report: "A well circumscribed, hypoechoic solid soft tissue mass measuring 5 x 4mm in diameter is present just superficial to the distal plantar fascia. It is avascular. It is separate to the fascia itself.

    Conclusion: the appearances are non-specific, but most consistent with a small fibroma.
  2. FootDoc

    FootDoc New Member

    Good luck may be the best treatment for plantar fibromatosis. Surgical excision has a high degree of recurrence and/or problems occasioned by the plantar incision and/or nerve entrapment. I have not personally used verapamil gel, but other than for its price and probable non-coverage by insurance, it may be worth a try as the other choices are limited and uncertain in their effectiveness. Some users of verapamil gel have reported varying degrees of success and others have not. Some have merely claimed no increase in size, although increases in size are not a certainty even without treatment.
    Last edited: Sep 8, 2010
  3. lky123

    lky123 New Member

    Thanks for that Foot Doc. My podiatrist had never heard of Verapamil so I might have trouble getting a prescription anyway (I'm in Australia.) How common do you find these plantar fibromas to be?
  4. FootDoc

    FootDoc New Member

    Reasonably common. Many with these have them in the palmar fascia also where they can result in a more serious condition called Dupuytren's contracture.
  5. lky123

    lky123 New Member

    I don't seem to have much in the way of treatment options, since I gather surgery is mostly only recommended in serious cases. Do you find that any
    of these just go away by themselves?
  6. FootDoc

    FootDoc New Member

    I have not seen that occur, but I don't follow such patients for life to know whether or not the lumps have resolved on their own.
  7. Unregistered

    Unregistered Guest

    I have had plantar fibroma in both feet most of my life first surgery at 12 years old. they do not go away on their own. as far as I have been told there is not very many treatments for this. my pain is terrible at times. 2 surgeries on each foot and they came back each time. stretching helps but as far as I know not much else helps
  8. lky123

    lky123 New Member

    I'd forgotten about this thread...
    I'd had the fibroma for about seven weeks and asked my podiatrist if they ever just went away on their own. "They never go away on their own" he told me quite confidently. Two weeks later it went away on it's own. (That was three months ago.)
    So there you go... :)
  9. Unregistered

    Unregistered Guest

    I have a rather large plantar fibroma. I've had it for some time now and recently it has become extremely painful. I'm seeing a podiatrist on Monday desperate for some relief. I can only assume that the pain is now present because of the increase in size. Will injections help to decease the size of this thing?
  10. Biomech

    Biomech New Member

    Plantar fibromas generally do not just go. I would be inclined to think that it was not a fibroma in that instance but there are no absolutes and I could be wrong

    Conservative management froms the mainstay of treatment. Exision tends to lead to recurrence but depending on your luck, it may not recur for a few years. It might, however, come back in a few months

    Accommodate the fibroma with a well contoured orthosis with localised relief infilled with padding. Sometimes, if the fibroma is very large, the depth required for relief is outside of that that can be accommodated in the footwear. Surgery should be a last option and that means that you have used very accommodative footwear and insoles.

    Good luck
  11. Unregistered

    Unregistered Guest

    Not sure if this will work for everyone but it has for me. I have had plantar fibromatosis for about 10 years now. I am 42 years old. I went to two different podiatrist and heard the same thing from both and was very frustrated. I would get even more frustrated when I would go online and read about it in forums like this.
    My whole life I have been in fairly good shape but started putting on weight about 11 years ago. I didnt get fat but was out of shape and was getting no excersise what so ever. A little over two years ago, I started back excersing,eating right and going to a chiropractor because of some lower back issues I was having. Part of my excersise routine was to do alot of streatching not only my back but my legs as well. I have always been tall and lanky and never real flexible. I noticed after about 6 months that my lumps in my arches were getting smaller. I dont know if it was loosing 35 lbs., going to the chiropractor and getting adjusted or a combination of all three. I am guessing that it is the streatching. The lump in my left foot is pretty much gone and the one in my right has shrunk considerably enough were I can get on the tread mill every day and not be in pain. I havn't been to the chiropractor in about a year because I could no longer afford going with insurance not covering it.
    I would say to any of you that if you have not been streatching to try it. Do it for 15 minuits in the morning and 15 minuits at night.Make sure you streatch your lower back and legs as much as you can. Also, if you are over weight see what loosing weight does. You can find videos or routines on line. You can e-mail me if you have any questions.
  12. Unregistered

    Unregistered Guest

    Re: plantar fibromas

    No cure that I know of. :-( Having had 2 surgeries in '92 & '94 on my right foot to remove 2 lumps, more have grown back replacing the others. A year ago, my left foot grew one in the same spot, the arch & Kaiser shot me with steroids, which made it grow from pea-size to baseball size within one year. They refused to do the surgery, saying it's too life threatening & I could end up paralyzed, etc., so I went to the Foot & Ankel Institute for a consultation & they said it's NOT life threatening, nor will I end up paralyzed (even I knew that) & they could do each surgical procedure for $3800+. I have 4 problems (1 bunion & pf lumps pr/foot), so you do the math. This is a painful & crushing problem to live with as I can't fit women's shoes anymore, barely fit mens & can't get an ofc job wearing men's boots. Needless to say, I don't have a man/bf either; it's ruining my life. Despite this painful hindrance, hiking is still my fav hobby. Not sure if being active all my life has anything to do with this or if it's just hereditary, as my grandmother had them too. What to do, what to do...
  13. densor56

    densor56 Guest

    I had them in both my feet, first right had surgury, doc did a good job.2 years later had left done doc didn't do a good job , now 2 years later they are back in both of my feet, left is worse. I was never told they would grow back until after second surgury. I had a cortizone shot in the left foot at a doc's office, very painfull and the cysts didn't shrink. then I went to a pain specialist, they put me partial out and gave me 3 cortizone shots in each foot, they shrunk the cysts, but I now get muscle spasms in my feet, but I can aleast stand on my feet.
    Last edited: Apr 26, 2011
  14. richard

    richard Guest

    ask your gp for steroid injections around the lump, i have finished a course of 3 injections, each one 3 months apart, the difference is huge. my plantar was painful, right on the arch of my foot, causing pain when walking and wearing some shoes, now it has more than halved in size and no pain! i have to wait another 9 months before i can go back for more sessions.
    hope this is a help to other sufferers.
  15. Nick

    Nick Guest

    Hi Everyone,

    I have a fibroma on my right foot for over two years now and in my case the pain has become more manageable with better footwear for my arches, constant stretching and a hell of a lot of rubbing and deep massages.

    From reading some of the testimonials in this forum it seems as though the manner in which the fibroma can affect someone ranges from mild to extreme. I believe my fibroma was caused from trauma to the plantar facitis whilst i was training for a marathon. My training came to an end when I thought that I "pulled" the tendon under my foot. The pain was really severe for a couple of months and when it finally reached a manageable level I tried to play soccer with some buddies and when I was taking off my football socks realized that there was this bump the size of a small olive on the tendon itself.

    The next day I went to a doctor and she told me what it was. She recommended that I do not consider surgery as there is no guarantee that it would not come back as well as it can even cause more problems. She also told me that I can go ahead and play soccer and continue running due to the location of the fibroma. At first I thought she was nuts, because I could have barely passed the ball when I was on the field. But, today I am running and playing soccer every week and the pain is almost non existent. Although at times after an intense game I may experience a sort of throbbing burning type of pain, but after some time it goes away.

    So in short, if it is a small fibroma I wont worry about it! :)
  16. Alexandra

    Alexandra Guest

    Re: plantar fibromas

    Mine is going away. I find that it goes away if I wear shoes that don't irritate it. I found that Aravon shoes for women have a removable footbed. If you take that out, you can figure out where your bump is, then from the bottom, using a hot knife (heated on top of the stove) I cut out a corresponding amount of the rubber sole, leaving the top surface intact. Does that make sense. It looks fine from the top but the rubber underneath has been cut out in a circle so that there is no pressure on the bump. It totally works and looks okay. I also went to a massage person who pushed really hard on it and it seemed to be much better after that. It's now a sort of thin flat bump and I really think it's going to be gone in another 6 months. It was pretty big before, and I could hardly walk. So don't give up hope. Find a nice think rubber sole insert for your hiking boots and get a pointy knife really hot, use an exhaust fan, and cut away. To locate where to cut, put something on the bump and press on the sole in exactly the right place that it will be when you have the shoe on. Then take a sewing needle and push it through to the other side. That's the middle of your circle to cut out. Good luck.
  17. "The Ripper"

    "The Ripper" Guest

    I'm sure that there are few podiatrists who would recommend this to you, but on several occasions I have removed small, pea sized fibromas from the soles of my feet myself. These fibromas grow under the skin, often on the ball of the foot or on the heal.

    Few podiatrists would recommend this self procedure to you, because this is how podiatrists make their living, and the advice I provide below, would probably be considered to be inconsistent with "professional advice" within the field of medicine.



    Now here is the procedure.

    Take a pair of sterilized, pointed scissors and cut through the surface skin around the entire fibroma. Have some tissue ready because this procedure will cause bleeding in the following stages. Also have a large bandage ready to use.

    After cutting through the skin completely around the entire circumference of the fibroma, now use the scissors to begin to pry up on the fibroma, away from the foot. Work around the fibroma until it is approximately half removed or until you can eventually grab onto the fibroma using a tissue between your fingers. The area will begin to bleed. Grab onto the fibroma using the tissue, and RIP the fibroma out of your foot. This is not particularly painful, but it will bleed profusely at first.

    Often the fibroma will have a core root that extends a few millimetres into the foot. Try to clear the blood away and check to see if you can see any white remnants of the fibroma which can be removed with the scissors from the deepest area of the excision.

    After the blood flow slows, bandage the area of the foot. After 24 hours, remove the bandage and allow air to the area of the foot when sleeping or not walking. For the first 48 to 72 hours, apply a bandage when walking. Walking may or may not be painful during the first day after the procedure.

    When you initially remove the bandage after 24 hours, you will see a hole in the skin that extends into the foot. The edges of the cut skin may appear white and swollen, as if soaked in water, from being bandaged. The white edges of the cut skin may be surrounded by mild inflammation. I do not use any medication, but suit yourself. The important part is to keep the area clean before the skin is healed and renewed so that infection is avoided.

    The hole in the skin will heal quickly over the next 48 to 72 hours, eventually filling the hole and having a dark thin scab over the newly forming skin. At this point, after 72 hours, when the likelihood of infection becomes low, the bandage can cease to be used.

    This area of the foot should completely heal within 2 weeks and the fibroma will appear to be gone. Monitor the area over the next 3-4 months. If the fibroma is going to grow back, you should see and feel it in about 3-4 months.

    Repeat the procedure as needed, whenever the fibroma has re-grown to bothersome size. If you are persistent one or more procedures should permanently eliminate the fibroma.

    If any of what I have described does not appeal to you, I recommend that you see a podiatrist to have your fibroma surgically removed, with the knowledge that the fibroma may return, even after surgery by a podiatrist, requiring a second or third trip to the podiatrist.

    Good luck to you DIY guys!!
    Last edited: Jul 13, 2011
  18. Unregistered

    Unregistered Guest

    Ya THINK??
  19. Unregistered

    Unregistered Guest

    Corticosteriod injections are the way to go. Kenacort (triamcinolone) is the best one, because it's tissue wasting effect, normally a negative side effect, is beneficial in this case.

    Injected with needling, in the dense fibroma, with local anaesthetic for dilution (and kindness) will shrink the fibromas.

    If the fibromas are very large, and the fascia is tight, sometimes a plantar fascia release is warranted. These can be done in a day surgery, with immediate ambulation.


  20. Unregistered

    Unregistered Guest

    I work 12 hr shifts, production assembly, in steel toes, on concrete floors. (Best described as "steel toe aerobics"). In Jan. 2011, I began to experience sharp pain in my right foot, mostly when I was resting or sleeping. I found multiple knots in the arch of that foot, about the size of pencil erasers. Being hard headed, I ignored it until about May 2011, at that point I couldn't handle the pain anymore. 2 of the knots had reached the size of 2 liter bottle caps. I went to a podiatrist and we counted 8 knots on my right and 2 on my left arch. The 2 big knots were on my right foot.
    Listen to me....
    DO NOT have these surgically removed, because it can cripple you for life. There are doctors who practice this and I'm telling you right now, I know two ppl, who are crippled from that procedure. I take steroid injections and use self-therapy(deep penetrating salves) and currently on light duty, to combat this and it is working. The knots are almost gone. Unfortunately, I'll never be rid of fibromas, because of what my job requires, it can easily return. It has changed my life, as I am battling for a new position (off of my feet) at work just because of the knots and the pain can be unbearable. Currently, my recovery has put me on track to be off light duty in a few weeks.
    I feel for anyone with this condition.
    If anyone has any questions about proper treatment, please email me at berserker40@hotmail.com
    I would be glad to help, because Pp, and your family.

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