Hard Nodule on the Bottom of My Foot

What Is the hard nodule on the bottom of my foot? 90%+ of the this is a plantar fibroma. This is a thickening somewhat related to plantar fasciitis.



What is the hard nodule on the bottom of my foot?


The hard nodule on the bottom of your foot is something referred to as a plantar fibroma. This is also known as plantar fascial fibromatosis.


This fibroma is a benign fibrous tissue tumor or growth, it can occur anywhere else in the body. For example, these also occur in the uterus and they are called uterine fibroids. On the bottom of the foot, this is called a plantar fibroma. The term “benign” means that it is not cancerous. But to be 100% safe sometimes a sample is needed to make 100% sure. It is very difficult to sometimes get rid of a plantar fibroma.


These plantar fibromas are deep within the tissue, they are part of ethic fibrous band called the plantar fascia. This is different than a war for example, which will grow in the skin and not deep under the skin. A fibroma is a bump on the bottom of the foot that will make it hurt to walk. This is a thick concentration of connective tissue that can feel like a “pebble” or even larger or even many off them.


Unfortunately this disorder will not go away on its own or in get smaller without any treatment. The clear definitive cause for this condition has not been clearly identified.



This hard nodule is deep below the skin, it is usually not dangerous.

What other names does this hard nodule go by?

Around the world there is many different names that this is known by many different names around world. The most common name is a plantar fibroma or plantar fascial fibromatosis. The other names are listed below.


  • Benign foot tumor.
  • Foot fibroma.
  • Plantar fascia fibromatosis.
  • Letter hose disease (Dupuytren’s contracture of the feet)
  • Hard lump on the bottom of the foot.
  • Knot in the arch of the foot.
  • A painful lump under the foot.
  • Lump in arch of the foot.
  • A Ganglion cyst on the bottom of the foot (more evaluation does have to be done to evaluate assistant verse this. A plantar fibroma is not a true cyst.)

These nodules are almost never dangerous as they are just thickening of the connective tissue and not a dangerous cancer of any type. They are extremely slow growing and have probably been developing for months or years before you have even noticed them, and they likely will continue growing slowly if they grow at all.


Hard Nodule on the Bottom of My Foot Symptoms:


  • Not painful itself, but painful on walking.
  • The nodule is basically nothing more than a benign pebble stuck under your skin that can be removed.
  • Can irritate you while walking on it.
  • The single biggest sign of a plantar fibroma is the fact that it is an noticeable lump or bump an arch of the foot.
  • The fibroma can remain the same size or even get larger as time goes on.
  • It may turn into many additional surrounding fibromas.
  • Some people who have a plantar fibroma may have pain, whereas other people may not have any pain at all.
  • When pain does occur, it is usually as it is pressing against the hard surface.
  • This can be your shoe, or the floor This bump will likely make it hurt to walk on a hard floor.



What Caused This Nodule on the Bottom of My Foot?
  • Usually family history – it is a genetic connective tissue disorder.
  • Can be associated with nodules in the palms and penis.
  • Can be associated with Diabetes Mellitus



Diagnosis of a plantar fibroma:

  • To confirm the plantar fibroma, your podiatrist or foot specialist will examine the foot.
  • Sometimes by evaluating manually and with an x-ray, we had most of the information we need that it is likely a plantar fibroma.
  • Sometimes if there is any question, or if the situation is very painful and resistant, an MRI or even a biopsy may be performed to make sure that this is in fact the correct diagnosis.
  • The odds are very low that this is something dangerous, but nothing is ever 100% medicine.
  • The only way to 100% confirm the and nodule is in fact a plantar fibroma, is to get a soft tissue biopsy of this lesion.


Home treatment of the plantar fibroma:

  • In our clinic we have had a lot of success treating this non-surgically. In fact the good news is 95% of people tend to get better without any surgery at all.
  • The podiatrists at our office have success with the following methods:


Steroid injections:


  • If you are having significant pain and you need to get feeling better in a hurry, a storage injection could be a good solution. The main downside of a steroid injection is that it can be painful!
  • The benefits of a steroid injection is that almost immediately within about 10 seconds you start getting some relief, the downside is that studies show that a steroid injection may be temporary, and is not a permanent solution in some cases.


Orthotics for a plantar fibroma:


  • This is my personal favorite treatment option, if you like with a modified orthotic with a cut out for the fibroma, we can make the pain go away 90% of the time.
  • As enough time goes by the fibroma should start to relieve by itself with the pain decreasing to the site.
  • The goal of the orthotic is to redistribute the pain away from the patients nodule on the bottom of their foot, and as there is less stress, there is then less inflammation and pain.


Shockwave therapy in the office:



  • We have had a lot of success utilizing shockwave therapy in the office, although this is something where there is not a ton of evidence just yet.
  • With medicine we generally do want to have published studies to confirm treatment option, and as a result shockwave therapy does not have a lot of evidence for insurance approval is a procedure just yet.
  • But while utilizing this on a plantar factual nodule, we have found the risk to be almost nothing, you can walk almost right away, and as time goes on these nodules can start to disappear.
  • Anecdotally we have had a lot of success, I would even say over 75% of the time the start to improve.
  • If the nodule is too large, you will not have this solved with shockwave therapy alone.



Surgical treatment options for the plantar fibroma:


  • Surgical treatment for the removal of this plantar fibroma can be considered if it continues to grow.
  • The removal of the plantar fibroma is an in-hospital surgical procedure. The downside is that there is a high incidence of recurrence with this condition.
  • The best bet is to work with your podiatrist and foot and ankle specialist to see what types of treatment options are recommended.
  • Even after the surgery is performed it is still recommended that you a good foot orthotic to keep pressure off the site. Even with surgical resection there’s still a chance that this could still have some recurrence.
  • It takes about three months to resume normal activity after surgery like this.


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Plantar Fibroma excision surgery recovery time:


Weeks 1 to 2:

  • For the first two weeks you will have a dressing in place, sutures are generally still in place during this time.
  • We will go over your biopsy results at this point, we will confirm that nothing dangerous is going on through this site.
  • At the end of two weeks we tend to remove the sutures, if it is a bigger incision site and is only healing, it may be three.


Weeks 3 to 4:


  • At weeks 3 to 4 if you incision site is well healed, we can transition you into a walking boot, you will wear this walking boot for weeks three through about six.


Week 6+:


  • At about six weeks or incision sites are well healed, and you can get out of the walking yearbook.
  • At this point people generally tolerated good supportive soft orthotic to take pressure off the site.