Plantar Fibroma

Overview

What is a plantar fibroma?

A plantar fibroma is a rare benign growth on your plantar fascia, the rubber band-like ligament that stretches from your heel to your toes. Plantar fibromas are small — usually less than an inch — and grow on the arch of your foot. You might not even notice one at first, but eventually a plantar fibroma can cause foot pain, especially when you’re wearing shoes.

Plantar fibromas are always benign, which means they’re never a symptom (or cause) of cancer.

If you get plantar fibromas frequently, you might be diagnosed with plantar fibromatosis, a condition that means you’ve shown a tendency to develop future plantar fibromas.

Who gets plantar fibromas?

Plantar fibromas can appear in anyone, and they have no confirmed cause, but you might be more likely to develop one if you are:

  • Older than 40: Older adults — especially those between 40 and 60 — seem more likely to develop plantar fibromas than younger people.
  • A man: Men are twice as likely to develop plantar fibromatosis than women.
  • Of European descent: People of European descent are more prone to plantar fibromas than other ethnicities.
  • Share a genetic predisposition: Studies suggest the tendency to develop plantar fibromas may be genetically inherited, meaning you might be more likely to if someone in your immediate family gets them.

You may also be at increased risk of developing plantar fibromas if you have other health conditions, including:

How common are plantar fibromas?

Plantar fibromas are rare. Fewer than 200,000 people in the U.S. each year develop one.

How does a plantar fibroma affect my body?

In many ways, a plantar fibroma has little to no effect on your body. You may never notice it all. But, as it grows, it can cause pain and pressure in your foot.

Even though plantar fibromas themselves are not dangerous, you should talk to your healthcare provider as soon as you notice any new growths on your foot or changes to its shape. Your provider will rule out other, more serious issues with a physical exam and imaging tests.

Plantar fibroma vs. plantar fasciitis: What's the difference?

Both plantar fibromas and plantar fasciitis affect your plantar fascia. Plantar fibromas are small growths on your plantar fascia. Plantar fasciitis is inflammation of the ligament itself. It’s also one of the most common causes of heel pain. Even though both conditions cause pain on the arch of your foot, the reason for your discomfort is different. No matter what’s causing it, talk to your healthcare provider about any new or unusual foot pain.

Symptoms and Causes

What are plantar fibroma symptoms?

The most common symptom of a plantar fibroma is pain on the bottom of your foot, usually in the arch. You’ll likely notice this pain for the first time when wearing shoes that put pressure on the plantar fibroma under your skin.

Depending on how big it is, a plantar fibroma can cause pressure on your foot. It might feel like there’s a stone in your shoe, but when you try to shake it out, there’s nothing there.

You might be able to see the plantar fibroma. It might look like there’s a tiny marble — less than an inch across — embedded in your skin. The skin on your foot’s arch will curve out around it, or slightly bulge in a way that’s unusual for the shape of your foot.

What causes a plantar fibroma?

There’s no clear reason people develop plantar fibromas or plantar fibromatosis. They appear without a known cause, and can affect anyone. The only indication you might develop one is if you have any of the conditions listed above, or a possible genetic predisposition.

Diagnosis and Tests

How is a plantar fibroma diagnosed?

A physical exam is usually all that’s needed to diagnose a plantar fibroma. Your healthcare provider will examine your foot, feel the growth and compare it to your other foot (if possible).

Your provider will check the mass on your plantar fascia to confirm it’s a fibroma and not something more dangerous. If they suspect other issues, you’ll need imaging tests.

What tests will be done to diagnose a plantar fibroma?

If you need additional tests, your provider will explain what they’re checking for. The most common tests you’ll need include:

  • Magnetic resonance imaging (MRI): An MRI will confirm the mass is a fibroma and not any other type of benign growth like a cyst.
  • X-ray or bone scan: These tests will show any issues or changes in the bones in your foot around the growth. Your provider will check for more serious conditions like a cancerous sarcoma.
  • Ultrasound: A musculoskeletal ultrasound is like an X-ray for soft tissue. Your provider can use it to take pictures of the area around the growth.

Management and Treatment

How is a plantar fibroma treated?

Treating a plantar fibroma is almost always focused on relieving your symptoms. The most common treatments include:

  • Over-the-counter medicines to reduce pain.
  • Orthotics (inserts for your shoes).
  • Stretching.
  • Verapamil (a cream you put on the bottom of your foot).
  • Cortisone injections.

People rarely need surgery to remove a plantar fibroma.

What medications/treatments are used?

Over-the-counter NSAIDs like aspirin or ibuprofen are typically all you’ll need to reduce the pain caused by a plantar fibroma. NSAIDs will also reduce inflammation around the fibroma, which could reduce the pressure it puts on your foot. You can take them as needed to reduce pain, but talk to your provider before starting, stopping or changing any regular use of medications. You shouldn’t take NSAIDs for longer than 10 days in a row without your provider’s approval.

Your provider might prescribe verapamil, a cream you apply to the bottom of your foot. Verapamil is usually used to manage blood pressure, but as a topical cream it can reduce inflammation and shrink the fibroma.

Complications/side effects of the treatment

NSAIDs can have serious side effects, including:

  • Bleeding.
  • Ulcers.
  • Stomach pain.
  • Bowel complications.

How to take care of myself/manage my symptoms?

If wearing shoes makes you uncomfortable, orthotics — removeable inserts — can relieve pressure and pain. You can buy generic, over-the-counter orthotics, or they can be custom-made for your feet. You may also need to wear different, more supportive shoes.

Your provider might recommend you stretch your foot, ankle and calf. This can relieve tension and pressure on your plantar fascia and lessen the severity of your plantar fibroma symptoms.

How soon after treatment will I feel better?

A combination of NSAIDs and changing your footwear should relieve your symptoms almost right away. In general, increasing your foot’s flexibility and wearing the right kind of shoes will reduce the symptoms of a plantar fibroma and prevent additional issues from developing.

NSAIDs should reduce your pain within a few hours of taking them. Orthotics will relieve pressure, but might take longer to make a noticeable difference. Stretching is a longer-term solution that you should work into your regular routine.

Plantar fibroma surgery

It’s very rare to need surgery to remove (excise) a plantar fibroma, but it is an option if your symptoms don’t clear up or aren’t manageable with more conservative treatments. Talk to your healthcare provider if you feel like the pain or discomfort from a plantar fibroma is affecting your quality of life.

Your surgeon will explain how much of your foot’s tissues they’ll remove. There are a few techniques they can use for a plantar fibroma surgery:

  • Local excision: Only the plantar fibroma itself is removed.
  • Wide excision: The plant fibroma and an area between 2 and 3 millimeters — less than one-tenth of an inch — around it is removed.
  • Plantar fasciectomy: The entire plantar fascia ligament is removed. This is extremely rare, in addition to how rarely people need plantar fibroma surgery in the first place.
  • Percutaneous fasciectomy: Similar to a full plantar fasciectomy. Your provider will use an ultrasound to guide them and remove only a portion of your plantar fascia near your heel.

Which type of surgery you will need depends on the severity of your symptoms, the size and exact location the plantar fibroma, and whether or not you’ve developed past plantar fibromas.

Recovery from surgery depends on which type of surgery you need. It can be anywhere from a few weeks to a few months, or as long as it takes for your plantar fascia and incision to heal fully. Your provider or surgeon will provide you with a customized recovery timeline based on your surgery.

Prevention

How can I reduce my risk?

Because they develop at random, there aren’t many identifiable risk factors for plantar fibromas. The good news is that they are always benign, which means even if you do develop one, it won't ever be cancerous.

How can I prevent a plantar fibroma?

There’s nothing you can do to prevent a plantar fibroma. However, wearing supportive shoes, exercising regularly and stretching your plantar fascia can help alleviate symptoms. The better your overall foot health is, the less a plantar fibroma will impact your day-to-day routine.

Outlook / Prognosis

What can I expect if I have a plantar fibroma?

Most people will not be impacted much by a plantar fibroma. Even if you have plantar fibromatosis and develop fibromas more often, the pain and discomfort are manageable at home with readily available medicines and treatments. If you develop a plantar fibroma, you’re likely to get more throughout your life.

How long does a plantar fibroma last?

There’s no known duration for a plantar fibroma. In many cases, they shrink or disappear on their own, sometimes as suddenly as they appear. If you have one, it’s much more likely to be a minor, temporary inconvenience than a major disruption.

When can I go back to work/school?

You shouldn’t need to miss any work or school if your pain and discomfort are manageable with NSAIDs and other at-home treatments.

If you need surgery to remove a plantar fibroma, your surgeon will explain the procedure and everything you need to know to recover.

Outlook for plantar fibromas

Plantar fibromas can be annoying and uncomfortable, but they’re not life-threatening and won't spread. Once you’ve confirmed that you have a plantar fibroma and not any other kind of growth in your foot, you should focus on treating your symptoms.

If you’re not experiencing pain or other symptoms, you should be able to do all the activities and exercises you normally do, including running and playing sports. However, if you notice new pain or pressure after running or working out, make sure to talk to your provider.

Living With

How do I take care of myself?

If you have plantar fibromas, finding a symptom management routine is typically the best long term option. Because you can’t predict when they’ll appear, or how long they last, knowing how to keep any pain or discomfort under control is all you’ll need to do.

When should I see my healthcare provider?

Talk to your healthcare provider as soon as you notice any new growths or changes in the shape of your foot, or if you’re experiencing new pain. Never assume any mass on your foot — or anywhere else on your body — is harmless, especially if you’ve never noticed it before.

Your provider will help you understand if the growth on the arch of your foot is a plantar fibroma or something more serious. No matter what’s causing it, anything that affects your ability to walk needs to be examined.

What questions should I ask my doctor?

  • Is this a plantar fibroma or a different type of growth?
  • What tests or imaging will I need?
  • How should I manage my pain or other symptoms?
  • Do I need orthotics or different shoes?
  • Will I need surgery?
  • When will the fibroma go away?

A note from Cleveland Clinic

Plantar fibromas are rare. Even if you do develop one, your symptoms will be minor and the most common treatments involve over-the-counter medications. Even though they’re not dangerous, make sure you talk to your provider as soon as you notice any changes in your feet — especially if you find a new growth or mass under your skin.

Last reviewed by a Cleveland Clinic medical professional on 11/10/2021.

References

  • American Orthopaedic Foot & Ankle Society. What is a plantar fibroma? (https://www.footcaremd.org/conditions-treatments/heel/plantar-fibroma-and-plantar-fibromatosis) Accessed 11/10/2021.
  • Nduka JC, Lam K, Chandrasekar CR. Diagnosing plantar fibromas - Beware of sarcomas. (https://pubmed.ncbi.nlm.nih.gov/33268229/) Foot (Edinb). 2020 Sep 8:101736. Accessed 11/10/2021.
  • StatPearls. Plantar Fibromatosis. (https://www.statpearls.com/ArticleLibrary/viewarticle/89667) Accessed 11/10/2021.
  • Young JR, Sternbach S, Willinger M, Hutchinson ID, Rosenbaum AJ. The etiology, evaluation, and management of plantar fibromatosis. (https://pubmed.ncbi.nlm.nih.gov/30774465/) Orthop Res Rev. 2018 Dec 17;11:1-7. Accessed 11/10/2021.

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