From the Research
Nodules on the medial longitudinal arch of the foot are most commonly plantar fibromas, which are benign fibrous tissue growths, and the most effective treatment approach is a combination of conservative management and, in some cases, radiation therapy, as supported by the most recent study 1. The condition is characterized by the formation of nodules along the plantar fascia, which can be painful and affect ambulation.
- Conservative treatment options include:
- Custom orthotic devices to redistribute pressure away from the nodules
- Comfortable shoes with adequate arch support
- Over-the-counter pain medications like ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) for pain relief
- Physical therapy focusing on stretching exercises for the plantar fascia to reduce discomfort
- For persistent cases, other treatment options may be considered, such as:
- Corticosteroid injections (such as triamcinolone 40mg/ml) directly into the nodule to reduce inflammation and size
- Topical treatments with verapamil 15% gel or transdermal dexamethasone applied twice daily for 2-3 months
- Radiation therapy, which has shown promising results in treating plantar fibromas, especially in recurrent cases 1
- Surgery is typically reserved for severe cases that do not respond to conservative treatment, but recurrence rates can be high (up to 60%) 2, 3, 4. It is essential to note that the etiology of plantar fibromatosis is unknown, but it is believed to be related to abnormal fibroblast proliferation and collagen production, often triggered by repetitive microtrauma to the plantar fascia, which explains why proper foot support is crucial in both treatment and prevention 2, 3.