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Exploring Treatment Options for Plantar Fibromas

As a podiatrist, my primary goal is to help my patients regain their comfort when walking and standing, especially when faced with conditions like plantar fibromas. Plantar fibromas, those firm nodules that can develop on the bottom of the feet, can often lead to discomfort and pain making it crucial to explore effective treatment options. Several conservative therapies aim to alleviate discomfort, improve mobility, and enhance overall quality of life. Remember, every patient's situation is unique, and the best treatment plan will be tailored to your specific needs and preferences.

Treatments for Plantar Fibromas

Verapamil Topically:  Verapamil is a medication usually used to treat heart conditions, but doctors have found that applying it topically (on the skin) can also be effective for managing plantar fibromas. When applied directly to the affected area, verapamil helps to break down the excess collagen that forms the fibromas. This can help reduce the size and discomfort of the lumps over time. The topical application is generally painless and can be a less invasive option compared to some other treatments.  It is best to start this treatment when the lesions are small.  You need to consistently apply the medication for it to be effective and may take up to 6 months to see results.

Steroid Injections: Steroid injections involve injecting a corticosteroid medication directly into the fibroma. These injections work to reduce inflammation and temporarily shrink the size of the lump. While steroid injections can provide relief from pain and discomfort, it's important to note that the effects may be temporary, and multiple injections might be needed over time. This option is commonly used when the fibroma is causing significant pain and hindering daily activities.

Enzyme Injections: Enzyme injections involve injecting specific enzymes into the fibroma. These enzymes help break down the excess collagen that makes up the lump. The goal is to gradually decrease the size of the fibroma and relieve symptoms. Enzyme injections are a relatively newer treatment option and might be considered when other treatments such as topical verapamil and steroid injections haven't provided the desired results.  Injections are typically done 3 weeks apart. Patients may need between 2 to 6 injections to achieve the desired results.

Orthotics: Orthotics are specially designed shoe inserts that can help redistribute pressure on the foot and provide better support. For people with plantar fibromas, orthotics can help alleviate discomfort by reducing the pressure on the lumps and providing better cushioning. They can also help improve foot mechanics, which might contribute to the development of fibromas in the first place. Orthotics are a conservative treatment option that is used in combination with other treatments.

Tenex Procedure: The Tenex procedure is a minimally invasive treatment that involves using ultrasound technology to guide a tiny instrument into the fibroma. This instrument uses high-frequency vibrations to break down the fibrous tissue. The broken-down tissue is then removed through a small incision. The Tenex procedure aims to remove the fibroma while minimizing damage to surrounding healthy tissue. This procedure is considered when other treatments have not been successful or when the fibroma is particularly large.

Each of these treatment options has its benefits and considerations, and the choice of treatment will depend on factors such as the size of the fibroma, the level of discomfort it causes, and the individual's overall health. We typically recommend combination therapy; orthotics, and topicals to start and injections for more painful lesions.  The sooner you start treatment the better the outcomes. It's important to consult a healthcare professional, preferably a podiatrist, to determine the most suitable treatment approach for your specific situation.

You don’t have to suffer with a plantar fibroma.  Let us develop a treatment regimen to help manage and alleviate your foot pain so you can get back to doing the things you love pain-free. Contact us or give us a call at 207-774-0028 today to schedule an appointment.