Do you have fibrous lump or nodule tissue on the sole of your foot that causes you pain especially when walking or wearing shoes.
Plantar fibromas are considered uncommon to rare, although they are always diagnosed.
In this article, I explain to you, relying on my knowledge as a diagnostic radiographer and research studies, how to recognise plantar fibromas, what causes it and what you can do to improve or relieve pain.
Happy reading!😀 Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏
Last updated: Oct, 2025. Written by Juliet Semakula a diagnostic radiographer
Disclaimer: Amazon affiliate links, complete disclosure in the legal section.
▶️Is a plantar fibroma or ledderhose a tumour? If not, can it turn into cancer?
I have had people wonder whether plantar fibroma is a tumour or cancerous. And whether it can go away on its own.
The answer to this is NO, A plantar fibroma also known as ledderhose is a non-cancerous, fibrous lump or nodule that forms in the plantar fascia below the foot.
| It is a benign growth in medical terms this means something that is not cancerous, does not spread to other parts of the body, and is generally not harmful or life-threatening. |
A plantar fibroma usually won’t go away on its own. It may grow over time and require surgical or non-surgical treatment to alleviate pain
An example of a 48-year-old woman foot with a large plantar fibroma (Image from Carroll 2018)
▶️What can be mistaken for plantar fibroma? And how can you be sure it’s a plantar fibroma?
Plantar fibromas can be mistaken for:
⚫Ganglion cysts.
⚫Benign or malignant tumours.
The only way you can be sure it’s a plantar fibroma is by having a physical examination by a health care professional.
When you see a doctor, the following examinations may be done to determine whether it is indeed a plantar fibroma.
⚫Physical examination: the lump under your foot will be felt to determine how big, deep and mobile it is, whether its firm or just inflamed.
If it’s a firm nodule and non-mobile, approximately 0.5 – 3.0 cm in diameter, then this most of time confirms it is a plantar fibroma.
⚫Imaging such as Magnetic resonance (MRI) and ultrasound can be performed because they are good at visualising the lump size and extent.
MRI imaging demonstrating a plantar fascia fibroma (Young,2018)
⚫Biopsy in some case can be performed to rule out other conditions such as malignancy though this is very rare for plantar fibromas.
Plantar fibromas are known to be non-cancerous nodules but to confirm a diagnosis is crucial to help rule out differential diagnoses such as cysts, nerve or fatty tumours, swollen tendons, and infections.
▶️What are the most common causes of plantar fibroma?
Plantar fibromatosis (Ledderhose disease) is a rare, benign, hyperproliferative fibrous tissue disorder resulting in the formation of nodules along the plantar fascia.
According to research studies the exact cause isn’t fully understood. But the most common cause of plantar fibroma is associated with:
♦️Genetic predisposition: A family history of the condition may indicate an inherited predisposition.
♦️ Repetitive trauma or stress to the plantar fascia can be a factor leading to plantar fibroma.
♦️General conditions like diabetes, epilepsy, and Dupuytren’s contracture can affect wound healing and affect fingers causing plantar fibroma.
♦️Certain medications.
♦️Alcohol abuse is also associated with an increased risk.
▶️What are the first signs of plantar fibromatosis?
Understanding the signs can provide some clarity. Here is a list of symptoms that may be experienced when you have plantar fibromas
♦️Slow growing nodules on the medial and central bands of the plantar fascia, which may become painless or painful as it enlarges. This can negatively affect your walking mobility due to pressure from shoes.
♦️It will appear as a single lump or multiple lumps, which can appear as a small marble-sized bump that causes a slight bulge in the arch.
♦️Some people have swelling around the nodule and skin breakdown.
♦️Pain mainly occurs after you have had a long walk.
Wearing restrictive shoes, direct pressure on the mass, walking barefoot, and standing for long periods of time may worsen your discomfort.
▶️How do you treat Plantar fibroma?
Usually, no treatment is necessary if no symptoms are present, and surgery is rarely required.
Over the years treatment has historically involved symptomatic management using a multitude of conservative treatment strategies.
Here is a list of an overview of commonly suggested treatments by professionals.
🟠Rest the affected foot will help minimise pressure on the nodule.
🟠Applying Ice tubes to help with the swelling.
🟠Wearing comfortable shoes with orthoses to release pressure under the foot.
🟠Wearing compression stockings to help with the swelling.
🟠Massage: A physical therapist can help you perform manual massage or guide you on self-massage techniques, such as rolling your foot on a tennis ball to apply pressure to the arch and loosen the tissue.
Fuiano,2019.
These measures may improve symptoms but do not prevent the progression of the plantar fibromas.
Other therapies used are:
There is a varying level of evidence supporting the use of these therapies mostly in small-scale trials.
🟠Steroid injections: these are normally used to help shrink the size of the nodules or fibromas at the same time decreasing pain.
According to studies that have followed up people for 3 years who have used these injections to treat plantar fibromas (Young,2018).
Steroid injections are known to decrease inflammation and growth rate of the size of the nodule which resulted in smaller, less painful nodules.
For this reason, many patients choose to have multiple rounds of injections for continued symptomatic management
Current recommendations in some health care centres, for intralesional steroid injections call for a total of 3–5 injections administered approximately 4–6 weeks
Young,2018
🟠Verapamil is a calcium blocker used to inhibit collagen production and increase the activity of collagenase which in turn reduces function of fibroblasts and myofibroblasts.
However, there is little published data assessing the verapamil efficacy.
🟠Radiation therapy using Ionizing radiation is believed to reduce the proliferative activity of fibroblasts via disruption of TGF-β production by those cells (Young,2018)
One recent study demonstrated that after treatment with radiation, one-third of patients with plantar fibromas had complete remission of their nodules and slightly more than half of the patients had partial decrease
Nearly two-thirds of patients reported pain remission and walking improvement as well.
94% of patients reported minimal harmfulness and a high rate of satisfaction with radiation treatment (Schuster,2025)
🟠Extracorporeal shock wave therapy is thought that it plays a role in tendon metabolism by stimulating the biosynthesis of the extracellular matrix in tenocytes
🟠Tamoxifen oestrogen increases the contractile properties of certain cell types. For this reason, antioestrogen therapy has been proposed as a treatment for plantar fibromas.
🟠Collagenase Clostridium histolyticum is a mixture of two collagenases that has been shown to decrease contractions in Peyronie’s and Dupuytren’s and is currently being studied as a treatment option for plantar fibromas.
A recent study tested its effectiveness by injecting it into a nodule once a month for 3 months, this failed to improve nodule size, softening, or pain with ambulation (Hammoudeh,2014)
How to choose from this list should depend on the individual case? Your doctor will guide you on what is the best treatment to use.
▶️What about plantar fibroma surgery?
In general, surgery is suggested if the pain becomes too severe and when you have failed with conservative treatments.
A large incision for greater exposure is needed to evaluate any extension of the lesion to surrounding tissues.
The surgical procedure steps are:
⏭️The surgery is performed under local anaesthesia, sometimes with sedation.
⏭️ A small incision is made on the bottom of the foot, directly over the fibroma.
⏭️The surgeon carefully removes the plantar fibroma and some surrounding plantar fascia tissue to minimize the risk of recurrence.
⏭️The incision is then closed with sutures.
Image showing a wide excision and a wound closure after surgery.
Image showing wide excision of the lesion and meticulous wound closure and protection from weight bearing is needed to minimize the risk of wound complications. Image from Carroll 2018)
Healed incision 19 months after surgery and external beam radiation.
Some people who have had surgery to remove their plantar fibroma after years the plantar fibromatosis often tends to recur after operative removal.
According to a study that contained 27 patients who had plantar fibromatosis operation.
Recurrences were reported in 25% of patients after total fasciectomy and in 100% after local resection (van der Veer,2008)
So, it’s important to do complete excision of the lesion without leaving pathological tissue to minimize the risk of recurrence
▶️What are the complications of plantar fibroma surgery?
As with every surgery you always expect potential complications after surgery.
When you have had plantar fibroma surgery you may experience these complications (rare)
♦️High risk of the fibroma returning (recurrence).
♦️Nerve damage causing numbness or chronic pain.
♦️Painful scarring.
♦️Infection of the wound.
♦️Swelling around the foot.
♦️Potential for the arch of the foot to weaken or collapse.
Always consult your doctor when you experience any of these problems after the operation.Untreated plantar fibromatosis may lead to chronic pain due to continued lesion growth.
▶️Are orthotics useful for plantar fibroma.
The use of orthopaedic insoles has been known to reduce pain during walking. They are often used alongside other non-surgical treatments such as NSAIDs, steroid injections, stretching, and physical therapy (Veith,2013)
Yes, orthotics are useful for managing plantar fibroma by:
🟠Relieving pressure: Orthotics or pads are designed to offload pressure from the fibroma; they will help you take the pressure off the sensitive area when walking or standing.
🟠Orthotics help to distribute weight away from the painful knot in the foot, thereby reducing discomfort.
🟠They provide better support for the plantar foot, helping to cushion the impact on the plantar fascia and reduce pain caused by the lump.
There are so many different insoles and pads on the market you can get from any orthopaedic stores or pharmacy or see on Amazon.
You can also consult a professional: A foot and ankle surgeon can help select the right type of orthotic for your specific needs.
▶️How painful is plantar fibroma?
For people who have had plantar fibroma they do describe pain as:
🟠 Pain ranging from none to significant discomfort, with pain often caused by pressure on the lump from walking, standing, or wearing shoes.
🟠The pain can feel like a sharp, localized sensation in the arch and may radiate down into the toes, especially when the nodule is enlarged or inflamed.
🟠Many people first discover the lump incidentally, with pain developing later as it grows or irritates surrounding tissues.
Consult a podiatrist if a lump is growing larger or causing pain, or if you have trouble walking due to the pain to rule out other conditions.
▶️Is walking bad for plantar fibroma?
The exact effect of plantar fibroma (Ledderhose)disease on plantar pressure distribution during walking is unknown
A study that was done by (de Haan,2023) to explore the dynamic plantar foot pressure distribution in patients with painful plantar fibroma disease during walking.
Had this conclusion:
The plantar fibroma nodules are often located in the medial midfoot and observation this region is often offloaded during walking.
For patients with painful plantar fibroma the load on the entire heel and hallux regions is increased and the load on the entire medial midfoot region is decreased, during walking.
So painful plantar fibroma has a different plantar pressure distribution during walking.
What we learn from the study:
To help improve painless walking when you have plantar fibroma is to be able to get custom insoles and shoe adaptations which might be used for proper evaluation.
Yes, people diagnosed with the condition state that walking can be painful, especially if you do long periods of walking, standing, or activities that put direct pressure on the lump.
▶️What causes walking to be problematic
🟠Pressure and Friction: Walking and standing can apply pressure to the plantar fibroma, which is a firm nodule in the arch of the foot. This pressure can cause pain and discomfort.
🟠 Worsening Symptoms: Over time, activities like long walks can lead to increased pain in the sole of the foot.
🟠Footwear: Walking barefoot or in shoes with inflexible insoles can put more direct pressure on the fibroma, making it more painful.
▶️What can you do without compromising your activities?
⚪Try to wear supportive shoes with good arch support and cushioning to reduce pressure on the fibroma.
⚪Use custom orthotics because they help provide additional support and redistribute pressure, making walking more comfortable.
⚪Avoid triggering activities such as long walks and periods of standing if they increase your pain. Listen to Your Body: If an activity causes new or increased pain, you are likely doing too much and should back off.
⚪It is important to talk to a doctor or podiatrist for proper diagnosis and treatment options, such as physical therapy or injections.
We have come to the end of this article wishing a quick recovery, 🙋any questions in the comments sections.
Here are other articles you may also be interested to read.
⚫ What is the best pain relief for plantar fasciitis?
⚫Can you walk on a fractured heel?
⚫Should I go to urgent care if I stepped on glass?
⚫What is tarsal tunnel syndrome, treatment options.
📚Sources:
Carroll P, Henshaw RM, Garwood C, Raspovic K, Kumar D. Plantar Fibromatosis: Pathophysiology, Surgical and Nonsurgical Therapies: An Evidence-Based Review. Foot & Ankle Specialist. 2018;11(2):168-176. doi:10.1177/1938640017751184
Young JR, Sternbach S, Willinger M, Hutchinson ID, Rosenbaum AJ. The etiology, evaluation, and management of plantar fibromatosis. Orthop Res Rev. 2018 Dec 17;11:1-7. doi: 10.2147/ORR.S154289. PMID: 30774465; PMCID: PMC6367723.
Schuster J, Saraiya S, Tennyson N, Nedelka M, Mukhopadhyay N, Weiss E. Patient-reported outcomes after electron radiation treatment for early-stage palmar and plantar fibromatosis. Pract Radiat Oncol. 2015 Nov-Dec;5(6):e651-8. doi: 10.1016/j.prro.2015.06.010. Epub 2015 Jul 2. PMID: 26421835.
Hammoudeh ZS. Collagenase Clostridium histolyticum injection for plantar fibromatosis (Ledderhose disease). Plast Reconstr Surg. 2014 Sep;134(3):497e-499e. doi: 10.1097/PRS.0000000000000433. PMID: 25158740.
Fuiano M, Mosca M, Caravelli S, Massimi S, Benedetti MG, Di Caprio F, Mosca S, Zaffagnini S. Current concepts about treatment options of plantar fibromatosis: A systematic review of the literature. Foot Ankle Surg. 2019 Oct;25(5):559-564. doi: 10.1016/j.fas.2018.06.001. Epub 2018 Jun 11. PMID: 30321942.
Veith NT, Tschernig T, Histing T, Madry H. Plantar fibromatosis–topical review. Foot Ankle Int. 2013 Dec;34(12):1742-6. doi: 10.1177/1071100713505535. Epub 2013 Sep 16. PMID: 24043350.
van der Veer WM, Hamburg SM, de Gast A, Niessen FB. Recurrence of plantar fibromatosis after plantar fasciectomy: single-center long-term results. Plast Reconstr Surg. 2008 Aug;122(2):486-491. doi: 10.1097/PRS.0b013e31817d61ab. PMID: 18626366.
de Haan A, Hijmans JM, van der Vegt AE, van der Laan HP, van Nes JGH, Werker PMN, Langendijk JA, Steenbakkers RJHM. Effect of painful Ledderhose disease on dynamic plantar foot pressure distribution during walking: a case-control study. Foot (Edinb). 2023 Sep;56:101990. doi: 10.1016/j.foot.2023.101990. Epub 2023 Mar 1. PMID: 36905795.