“ Health Problems „
Plantar Fibroma and my experience:
This is a relatively unknown disease that can be painful and debilitating; here I am going to tell you my story and as yet unsuccessful attempts to alleviate the problem.
Growing up I was sure I had a little bump in the arch of my foot but there was no pain, no growth and nothing to be concerned about, then two years ago out of nowhere like the little menace that it is it started to grow and started to become really painful. I headed off to the doctors as it was starting to interrupt with my daily life and this was not good enough. My GP has a look at the lump and annoyingly decided that it needed to be prodded which of course just made it more painful, he then informed me of what I already expected that it was probably a plantar fibroma. A plantar fibroma is a benign tumour that forms in the arch of your foot. I think a good way of thinking of it is basically that you have a marble stuck in the middle of the arch of your foot and it is like stepping on that all day.
Being a research scientist I was intrigued to see what I could find out about this nasty little thing, so I did some online searches using both just Google but also Pubmed to look for research articles on the condition. Now this was a few years ago so I can't remember all of the details but basically I found that Physio can't help, surgery can't help as it just grows back most of the time, steroid injections might help but might make it worse and that there are several other types of treatment but that are not available in the UK. So after my research I was quite surprised when the doctor referred me for Physio.... I waited for an appointment and then I waited some more, I was in so much pain that I decided, as my parents said they'd pay, for me to go to a private Physio. I went along and explained what I had, she was very experienced and very helpful, but said that in all of her years she had only come across one other case and that there is no known way for physio to help the condition. Being skint I needed to see the NHS physio before being put through to the foot specialist, luckily I got one pretty quickly after the above as I said I was happy to see a student physio, they told me the same thing as the private one and sent me on my way. I did learn from the private physio that it would be best to invest in a good pair of running trainers and wear them all the time and this did help decrease the pain to some degree.
I was getting pretty stressed at this point, my foot was killing me, there wasn't and if I am honest still isn't really a step in the day where I don't feel it, and many times I can just be lying in bed and it will twinge and I'll be in a lot of pain for 30 seconds or so. Anyway I was finally going to see the foot specialist to get answers. I went along and they said pretty much what I already knew, if I was to have surgery (let's face it if you hear tumour you do think surgery) the chances of it growing back are very very high and in all likelihood it is going to come back faster and harder and meaner and it really is a last resort, they were nice however and said that maybe at this point the best option would be to try an ultrasound guided steroid injection into the fibroma.
A few months later with little progress in any way I was lying on a bed waiting for the injection, I had been told that I would require local anaesthetic otherwise the injection would be incredibly painful, well the local was really really painful but the steroid injection just felt like some liquid surrounding the lump. I was told to avoid sport for a few weeks but otherwise I should be ok, well I stupidly decided to head off to the lab, not realising that I was only pain free because of the local, a few hours later that wore off and I was in a lot of pain and couldn't walk and had to be picked up and taken home.
Around the same time as this I started to do a lot of cycling, with my weight being a potential issue and pretty much any other form of exercise out of the question due to the foot pain and it was working I began to lose weight. Now whether it was the weight loss or whether it was the steroid injection that helped I don't know but over the coming months the pain began to subside, I was able to thrash everyone at badminton again but still in the knowledge that the lump was there it was just more in the background.
Things were good for nearly a year and then it all started again, I started to get increasing pain in my foot, increasing twinges and more and more depressed about it. A few things had changed over that year, I was no longer living with my parents but was living with my fiancé, whilst this is of course amazing it does mean I don't really have easy access to cycling and it turned out I had to be rereferred to the specialist as I had been discharged, then my referral wasn't received and I have an appointment in December.
The pain now is at a point where I can't give a 20minute presentation without requiring a seat, not only that but the condition has progressed to the point where if I have had a busy day on my feet I cannot bend the toes on my left foot up as the tendon in the bottom of my foot where the lump is located becomes too tight.
The problem with this thing is that I now don't walk properly, my foot is twisted so that I walk on the outside of my foot to stop weight from going through the lump, whilst this is a good thing it causes other pains as this is not how we evolved to walk. I think as a result of this and increased weight bearing on the other leg I now have Achilles tendonopathy (or tendonitis depending on who you see) which means I now have problems in both legs, luckily the Physio can help with the ankle and it seems to be working (but that's another story).
Along the course of this journey I have learnt a lot of things and really wanted to share my experience in case there is someone else out there with this who thinks they are the only one or who might have some helpful advice.
The science stuff:
I thought I would put a little bit about the science at the end, mainly because this is my area of expertise, as previously mentioned I work in a research lab on cancer research and therefore have access to a lot more resources and articles than most people with this nasty condition. As usual for stuff on dooyoo this is just my experience and my opinion and I am not a medical doctor so it's just my opinion.
What is a plantar Fibroma?
A plantar fibroma is a thickening of the plantar fascia that results in nodules in the arch of the foot, these are normally high in collagen and it is thought that over-expression of collagen causes a build-up and that this is the main content of the lump.
How do Planter Fibromas occur?
It is not really known how they occur but it is thought that they can be hereditary but another theory is that it is a response of the body to damage, in order to recover from some damage or trauma it tries to repair but over repairs and just keeps on repairing until too much tissue is present and this forms the lump. However in very rare cases the lump can be caused by cancer so it is worth getting it checked out.
Why do they grow back?
As far as I was aware it was not until earlier this year that it was really explained as to why these things are so pesky and grow back after surgical removal. Wang et al , see here http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0024050, showed that tissue from fibromas have stems cells present, this means that they are able to proliferate and make more tissue and they also showed that stems cells are not present in normal healthy tissue where fibromas are not present. They also showed a drug that can be used to stop progression of the disease, this hopefully suggests that their research might led to development of a cure or at least some kind of treatment to help anyone unfortunate enough to have it.
Are there any related conditions?
I thought I would also like to include a bit of information saying that there are a couple of other disease linked to this, one is present in the wrist and results in basically the same condition but of course with much less pain due to most people not bearing weight on their hands but all your weight does go through your feet and this is the main cause of the pain.
Plantar Fibroma is a, sometimes painful, condition that causes growth of lump(s) in your feet, as these develop they can be incredibly painful and cause stiffening of the toes. There is research going on in this area and hopefully some sort of help will come soon.
Plantar fascial fibromatosis, also known as Ledderhose's disease, Morbus Ledderhose, plantar fibromatosis, and plantar aponeurosis, is a relatively uncommon non-malignant thickening of the feet's deep connective tissue, or fascia. In the beginning, where nodules or cords start growing along tendons of the foot, the disease is minor, can be painful.