Plantar Fibroma Treatment Michigan | Arch Lump Specialist

Related Conditions

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Plantar Fibroma Treatment Michigan

A plantar fibroma is a benign (non-cancerous) fibrous nodule embedded within the plantar fascia — the thick ligament running along the arch of the foot. It typically presents as a firm, pea-to-marble-sized lump in the inner arch, often causing discomfort or pain during walking and standing. Plantar fibromas are part of Ledderhose disease (plantar fibromatosis) — a condition similar to Dupuytren’s contracture of the hand. Dr. Tom Biernacki DPM at Balance Foot & Ankle provides plantar fibroma diagnosis and treatment in Michigan at our Howell, Brighton, and Bloomfield Hills locations.

Symptoms

• A firm, non-movable nodule in the arch of the foot
• Pain or pressure when walking, especially barefoot
• Multiple or enlarging nodules (more aggressive fibromatosis)
• Gradual growth over months to years
• No skin changes overlying the nodule

Diagnosis

Plantar fibroma is diagnosed clinically based on its firm consistency, location within the plantar fascia, and characteristic appearance. Diagnostic ultrasound confirms the diagnosis — fibromas appear as well-defined hypoechoic (dark) lesions within the plantar fascia, distinct from fat pad lesions or cysts. MRI provides definitive characterization and maps the extent of involvement for surgical planning. Biopsy is performed when malignancy cannot be excluded clinically.

Treatment

Conservative treatment offloads the fibroma and reduces pain without affecting the nodule itself. Custom orthotics with a plantar fascia groove cut out around the fibroma redistribute weight bearing away from the nodule. Shoe inserts with arch support reduce stretch on the plantar fascia. Most patients tolerate single, small fibromas well with conservative measures.

Corticosteroid injection under ultrasound guidance can temporarily reduce fibroma size and pain in some patients. Effects are typically not permanent, and repeat injections may be needed. Verapamil injection (a calcium channel blocker) is used by some practitioners as an alternative with potentially more durable results.

Collagenase injection (Xiaflex) — the same enzyme used for Dupuytren’s contracture in the hand — is an emerging non-surgical treatment for plantar fibromas currently in clinical trials and available at select centers.

Surgical excision is reserved for large, painful, rapidly growing fibromas that have failed conservative care. Dr. Biernacki excises the fibroma along with a margin of surrounding plantar fascia through a medial arch incision. Important: simple enucleation (shelling out the nodule alone) has a very high recurrence rate — wide local excision is required. Recovery involves non-weight-bearing for 2–3 weeks. Recurrence risk after wide excision is 25–50%.

Frequently Asked Questions

Schedule your plantar fibroma evaluation at Balance Foot & Ankle in Howell, Brighton, or Bloomfield Hills, Michigan.

Most Common Mistake We See

The most common mistake we see is: Waiting too long before seeking care. Fix: any foot pain lasting more than 4 weeks, or any sudden severe symptom, deserves a professional evaluation rather than more rest.

Warning Signs That Need Same-Day Care

Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)

If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot lumps and cysts, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Frequently Asked Questions

When should I see a podiatrist?

See a podiatrist if: foot or ankle pain has lasted more than 2–4 weeks without improvement, you’re changing your gait to avoid pain, you have an open wound or sore that isn’t healing, you notice nail discoloration or thickening, you have diabetes and any foot concern, or pain is severe enough to wake you at night. Most foot conditions are easier and cheaper to treat early — what starts as a minor issue can become a surgical problem with months of delay.

What is the difference between a podiatrist and an orthopedic surgeon?

Podiatrists (DPM — Doctor of Podiatric Medicine) specialize exclusively in the foot, ankle, and lower leg. Orthopedic surgeons (MD/DO) have broader musculoskeletal training but variable foot/ankle subspecialization. For foot and ankle-specific problems, a podiatrist often has more focused training and experience. For injuries involving the leg above the ankle, complex pediatric cases, or multi-level reconstruction, orthopedic consultation may be appropriate. We frequently co-manage patients with orthopedic colleagues.

How do I know if my foot pain is serious?

Signs that warrant same-day or next-day evaluation: severe pain that appeared suddenly without clear cause, swelling, redness, and warmth that appeared suddenly (possible gout, infection, or Charcot fracture), an open wound that looks infected (redness spreading, pus, warmth), inability to bear weight, or any foot problem in a diabetic patient. Pain that’s been present for weeks and is stable is important but not an emergency — schedule within 1–2 weeks.

Can foot problems cause back and knee pain?

Yes — this is a kinetic chain effect. Abnormal foot mechanics (overpronation, supination, leg length discrepancy) cause compensatory changes in knee, hip, and lumbar alignment. Roughly 30% of patients presenting to our clinic with knee pain have a treatable foot-level biomechanical cause. Correcting foot mechanics with orthotics or appropriate footwear often provides significant knee and back relief. If you have chronic knee or back pain and haven’t had your foot mechanics evaluated, it’s worth a consult.

Are orthotics worth it?

For the right conditions, yes — custom orthotics are among the most cost-effective interventions in podiatry. They’re most effective for: plantar fasciitis, flat feet with secondary knee/back pain, leg length discrepancy, metatarsalgia, posterior tibial tendon dysfunction, and diabetic foot pressure management. Quality OTC orthotics ($35–60) resolve symptoms for 60% of patients with mild-to-moderate conditions. Custom orthotics are appropriate when OTC options have failed or when the biomechanical problem is complex. We cast custom orthotics in-office.

How do I choose the right running shoes?

Start with your foot type (flat, neutral, high arch) and running pattern (overpronator, neutral, supinator). Flat feet and overpronators do best in stability or motion-control shoes. Neutral feet do well in neutral-cushioned shoes. High arches need maximum cushioning with flexible soles. Always buy running shoes at the end of the day (foot swelling peaks then), get properly fitted by a specialist, and replace every 300–500 miles. If you’ve been injured repeatedly, a gait analysis can identify the mechanical flaw driving your injury pattern.

What is the difference between a sprain and a fracture?

A sprain is a ligament injury (the tissue connecting bones); a fracture is a break in the bone itself. Both can occur with the same trauma (ankle roll, fall). The old test — ‘if you can walk, it’s not broken’ — is wrong; many fractures are initially weight-bearable. Key differences: a fracture typically produces localized bone tenderness along the bone itself, while a sprain is tender over the ligament. X-ray is the standard to differentiate. High-grade sprains without proper treatment can be as disabling as fractures.

How do I prevent foot and ankle injuries?

The four most impactful prevention strategies: (1) Supportive, appropriately fitted footwear for your foot type and activity. (2) Gradual activity progression — the 10% rule (never increase weekly mileage or intensity by more than 10%). (3) Regular calf and ankle mobility work. (4) Strengthening the posterior tibial tendon, peroneals, and intrinsic foot muscles. Most overuse injuries are preventable; most acute injuries are not — but ankle sprain recurrence (60–70% without rehab) is prevented by balance and proprioception training.