Recently, I have been seeing quite a few patients that present to the office with a complaint of “a knot in the bottom of my foot.” Most of the time, they say that they just get occasional discomfort associated with the area. Many of these “knots” on the bottom of patients feet are plantar fibromas. A plantar fibroma is a fibrous lump that occurs on the bottom of the feet and is typically embedded in the plantar fascia (ligament that runs from the heel out to the ball of the foot) The cause of these knots are not always known but some thoughts include trauma, genetics (can be associated with certain diseases) as well as certain medications. (B-Blockers, Dilantin, glucosamine/ chondroitin)
Most people present with minimal pain and the pain they are experiencing is primarily with walking long distances. They are almost always seen within the arch of the foot and sometimes the nodule increases in size over time. Diagnosis typically includes evaluation by a podiatrist (usually a firm nodule within the plantar fascia). X-rays can be ordered to look for calcification of the lesion which can occur in certain tumors. The only way to be 100% sure that the nodule is not cancerous is by completing a biopsy. Sometimes an in office needle biopsy can be completed to look for malignant cells and other times an operating room biopsy is needed. An MRI can also be ordered to look at the area in more detail.
Once the lump is definitively diagnosed as a plantar fibroma, treatment options can include orthotics to help distribute weight around the lesion, steroid injections into the nodule as well as certain medications that can be use topically to try and decrease the size of the nodule. If none of the above help, surgical options can be discussed. Removal of the lesion in its entirety on the bottom of the foot would be the procedure of choice. Unfortunately, plantar fibromas have a relatively high recurrence rate and thus some normal tissue is typically removed from around the lesion to try and decrease chance for recurrence.
If you or anyone you know has a lump/knot on the bottom of their foot, call Quality Foot Care today at 215-230-9707 for an evaluation and discussion with one of our board certified podiatrists.