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Understanding Plantar Fibroma

Introduction:

Plantar fibroma, also known as Ledderhose disease, is a benign condition that affects the plantar fascia, a thick band of tissue located on the bottom of the foot. This condition is characterized by the development of fibrous nodules or lumps in the arch of the foot. While plantar fibroma is not life-threatening, it can cause discomfort and affect a person’s ability to walk or engage in physical activities. In this comprehensive guide, we will explore the symptoms, causes, and various treatment options available for plantar fibroma.

Symptoms:

The most common symptom of plantar fibroma is the presence of a firm, non-tender lump or nodule in the arch of the foot. These nodules are usually small in size but can grow larger over time. They may feel like a pebble or a marble under the skin. In some cases, multiple nodules may develop, causing a cluster of lumps. The presence of plantar fibroma can lead to pain and discomfort, especially when walking or standing for long periods. Some individuals may also experience a decrease in foot flexibility.

Causes:

The exact cause of plantar fibroma is still unknown. However, certain factors have been associated with an increased risk of developing this condition. These include:

  1. Genetic Predisposition: Plantar fibroma tends to run in families, suggesting a genetic component to its development.
  2. Trauma: Previous foot injuries or repetitive trauma to the plantar fascia may contribute to the formation of fibrous nodules.
  3. Abnormal Foot Mechanics: Individuals with flat feet or high arches may be more prone to developing plantar fibroma.
  4. Age and Gender: Plantar fibroma is more commonly seen in middle-aged individuals, and it appears to affect men more frequently than women.

Treatment Options:

The treatment of plantar fibroma depends on the severity of symptoms and the impact on daily activities. Here are some common treatment options:

  1. Conservative Measures: Non-surgical approaches such as orthotic devices, physical therapy, and stretching exercises can help alleviate pain and improve foot function.
  2. Medications: Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be recommended to manage pain and inflammation. Although NSAIDs do reduce inflammation to temporarily relieve pain, they are responsible for 30% of hospital admissions for adverse drug side effects, mainly due to bleeding, heart attack, stroke, and kidney damage. In addition, from the first day of use, all NSAIDs increase the risk of gastrointestinal (GI) bleeding, myocardial infarction, and stroke.
  3. Steroid Injections: In some cases, corticosteroid injections may be administered directly into the fibrous nodules to reduce inflammation and relieve symptoms. Side effects of cortisone, which is commonly injected for joint pain, includes thinning of the skin, easy bruising, weight gain, puffiness of the face, elevation of blood pressure, cataract formation, thinning of the bones, and a rare but serious form of damage to large joints (avascular necrosis). Due to risks, patients may only get this treatment once every several months.
  4. Extracorporeal Shockwave Therapy (ESWT): This non-invasive procedure uses high-energy sound waves to break down the fibrous tissue and promote healing.
  5. Surgical Intervention: If conservative treatments fail to provide relief, surgical removal of the plantar fibroma may be considered. However, surgery carries risks and should be discussed thoroughly with a healthcare professional.

Conclusion:

Plantar fibroma is a condition that can cause major discomfort and have a negative impact on quality of life. By understanding the symptoms, causes, and treatment options available, individuals can make informed decisions about managing their condition. It is advisable to consult with a healthcare professional for a precise diagnosis and personalized treatment plan to address foot pain effectively. With proper care and management, individuals with plantar fibroma can find relief and regain their mobility.

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