What is the Difference Between Plantar Fasciitis and Plantar Fibromatosis

Plantar fasciitis and plantar fibromatosis are two connective tissue disorders affecting the plantar fascia, which is a strong connective tissue that connects the heel to the base of the toes. Connective tissue diseases are conditions that affect parts of the body that connect the structures of the body together.

The key difference between plantar fasciitis and plantar fibromatosis is their cause. Plantar fasciitis is the inflammation of the plantar fascia, while plantar fibromatosis is a benign tumor of the foot plantar fascia.

CONTENTS

1. Overview and Key Difference
2. What is Plantar Fasciitis  
3. What is Plantar Fibromatosis
4. Similarities – Plantar Fasciitis and Plantar Fibromatosis
5. Plantar Fasciitis vs Plantar Fibromatosis in Tabular Form
6. Summary – Plantar Fasciitis vs Plantar Fibromatosis
7. FAQ – Plantar Fasciitis and Plantar Fibromatosis

What is Plantar Fasciitis?

Plantar fasciitis is the inflammation of the plantar fascia, which is a tough, fibrous band of tissue in the foot. Planar fascia supports the arch of the foot and foot mechanics during walking. Plantar fasciitis can be caused by being on the feet all day for work, playing sports, exercising or working hard surfaces, wearing shoes that do not support the feet well enough, walking or standing barefoot while at home, and other medical conditions like rheumatoid arthritis. The common symptoms of plantar fasciitis include heel pain, pain in the arch of the foot, stiffness, swelling around the heel, and a tight Achilles tendon.

Plantar fasciitis can be diagnosed through physical examination, X-ray, ultrasound, and MRI. Furthermore, plantar fasciitis can be treated through taking NASIDs, resting, icing the foot, wearing the supportive shoes, orthotics or shoe inserts, immobilization, massaging and stretching, corticosteroids, plasma rich platelet therapy, extracorporeal pulse activation technology (EPAT), and percutaneous needle tenotomy.

What is Plantar Fibromatosis?

Plantar fibromatosis is a benign fibroblastic proliferation of the plantar fascia. It is also known as Ledderhose disease. Symptoms of this condition include pain and swelling in the foot, a small collection of bumps on the bottom of the foot, difficulty walking, and curly toes. The actual cause of plantar fibromatosis is not known. But this condition is common in people who have Dupuytren’s disease, Peyronie’s disease, knuckle pads, frozen shoulder, epilepsy, and alcohol use disorder.

Plantar fibromatosis can be diagnosed through questionnaires, physical examination, ultrasound, MRI scan, and biopsy. Furthermore, treatment options for plantar fibromatosis are orthotics, massaging, stretching, applying ice, taking NSAIDs, intralesional steroids, taking verapamil and tamoxifen, radiation therapy, extracorporeal shock wave therapy, collagenase injection, and surgery.

Similarities Between Plantar Fasciitis and Plantar Fibromatosis

1. Plantar fasciitis and plantar fibromatosis are two connective disorders.
2. Both conditions involve problems in the plantar fascia.
3. Both conditions can be diagnosed through physical examination and imaging testing.
4. They can be treated through specific medications and therapies.

Difference Between Plantar Fasciitis and Plantar Fibromatosis

Definition

1. Plantar fasciitis is the inflammation of the plantar fascia.
2. Plantar fibromatosis is a non-malignant thickening of plantar fascia.

Causes

1. Plantar fasciitis is caused by repeated stretching and tearing of the facia can irritate or inflame the plantar fascia.
2. The exact cause of plantar fibromatosis is not known. But it affects people with other connective tissue diseases, including Dupuytren’s contracture, knuckle pads, and Peyronie’s disease.

Symptoms

1. Symptoms of plantar fasciitis include pain on the bottom of the foot, pain along the sole of the foot, flat feet or high arches, mild foot swelling or redness, stiffness or tightness of the arch in the bottom of the foot, and stiffness with the Achilles tendon.
2. Symptoms of plantar fibromatosis include mass on the bottom of the foot, pain in the ankle joints, tightening of the skin and pins and needle sensation.

Diagnosis

1. Plantar fasciitis is diagnosed by medical history, physical examination, X-ray, and MRI.
2. Plantar fibromatosis is diagnosed by physical examination, MRI, ultrasound, and biopsy.

Treatment

1. Plantar fasciitis is treated by pain relievers, physical therapy, night splints, orthotics, walking boots, canes, crutches, steroid injections, extracorporeal shock wave therapy, ultrasonic tissue repair, and surgery.
2. Plantar fibromatosis is treated by NSAIDs, physical therapy, corticosteroid injections, radiation therapy, and surgery (fasciectomy).

The following table summarizes the difference between plantar fasciitis and plantar fibromatosis.

Summary – Plantar Fasciitis vs Plantar Fibromatosis

Plantar fasciitis and plantar fibromatosis are two connective disorders due to a problem in planar fascia. Plantar fasciitis is a condition due to the inflammation of the plantar fascia while plantar fibromatosis is a condition due to the benign tumor of the plantar fascia. This is the key difference between plantar fasciitis and plantar fibromatosis.

FAQ: Plantar Fasciitis and Plantar Fibromatosis

1. What is the main cause of plantar fasciitis?

• Plantar fasciitis is the inflammation of the thick tissue on the bottom of the foot. The tissue is called plantar fascia. Plantar fasciitis occurs mainly when people overstretch or overuse this thick band of tissue.

2. Is there a cure for plantar fasciitis?

• Plantar fasciitis can be cured through resting, icing, massaging, altering the activity levels, wearing the appropriate footwear, stretching exercise, strengthening exercises, taking medications such as NSAIDs, extracorporeal shock wave therapy, ultrasonic tissue repair, and surgery.

3. Does plantar fibromatosis need to be removed?

• If the mass increases in size or pain increases, surgical treatment to remove the fibromatosis is considered. However, surgical removal of a plantar fibroma may cause a flattening of the arch or development of hammertoes.

4. What happens if plantar fibromatosis is left untreated?

• Plantar fibromatosis creates a lump on the arch of the foot, which can cause pain. The pain intensifies more when people step on it, or by wearing certain types of shoes.

5. What are the stages of plantar fibromatosis?

• Plantar fibromatosis has the following stages: proliferative phase where it increases the fibroblast activity, active or involution phase where fibroblast maturation, myofibroblast differentiation, and increased collagen production occur and residual phase where collagen and fibroblast maturation start to wane.

Reference:

1.”Plantar Fasciitis.” Johns Hopkins Medicine.
2.“Plantar Fibromatosis.” Physiopedia.

Image Courtesy:

1. “Pain under your heel” By InjuryMap – Free Human Anatomy Images and Pictures. (CC BY-SA 4.0) via Commons Wikimedia
2. “Morbus Ledderhose I” By Herecomesdoc – Own work (CC BY-SA 3.0) via Commons Wikimedia