Plantar Fibromas

by Bessie
(Bradenton, FL, USA)

MRIs show multiple plantar fibromas bilaterally. Doc said he can remove them but I read nothing positive anywhere about foot surgery not leading to other painful issues. I have been under treatment for 3 other diagnosis and now that this doc told me to STOP wearing the inserts the other docs told me to wear my feet do not hurt as much. Still cannot walk or stand with comfort, but they do feel better. Please tell me what your thoughts are of successful surgery for this condition.

I have previously posted on Baxter Nerve for MRI vs EMG. Also posted about plantar faciitis which was diagnosed by good feet and agreed by an orthopedist. Another doc said I had tarsal tunnel but the last EMG doc said where the pain was isn't even the right part of foot for that diagnosis.
40 weeks of PT, injections, 2 Rx creams, 4 docs, 4 PT's in year. Just trying to prepare myself for doc appt. I want to have all questions ready for him to answer. I was also mistaken on one post about this being the Dr. Katz for cryosurgery. It is another Dr. Katz in Tampa. My latest doc is in Bradenton Florida.

RESPONSE

Hi Bessie,

In my 35+ years of practice I do not think I have ever seen a patient that has every foot condition that has ever been invented that can cause pain on the bottom of the foot.

Since I do not think you can have every condition ever invented, you need to get a primary diagnosis of what is the major cause of your pain.

If I am correct, I think you have mentioned that you have had previous MRI's on your feet. Usually the whole foot is looked at. I am surprised that these plantar fibromas were not previously identified.

The other problem, is that if you have multiple plantar fibromas, did you not feel any of these on the bottom of your feet?

Well....if your problem is now plantar fibroma and they actually hurt there are things you can do short of surgery.

First of all, make sure that they actually hurt, most plantar fibromas are non-painful, the lump on the bottom of the foot concerns the patient and that is what brings them in; not pain.

Secondly, I like the idea of orthotics for treatment of plantar fibromas. I do not know what your orthotics look like, but when I make orthotics for this condition, I use a very cushioned top cover like plastazote that is "cut out" around the fibroma to take pressure off of them. It usually works out fairly well.

Additionally, you could have cortisone injections into the fibromas in attempt to shrink them. There is also compounded medication that applied to the fibromas over a period of months has been shown to reduce their size.

You are right that surgical intervention does have a high incidence of complications and this becomes more so when there are multiple plantar fibromas. Sections of the plantar fascial ligament has to removed beyond the actual fibroma and if there are multiple lesions to remove, this can create a real mess.

I do not really know what to tell you because I cannot believe you have all these problems on the bottom of your feet. I will say this, if you are contemplating surgery, get another opinion first.

Marc Mitnick DPM
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