What might cause the fat pad under the heel to atrophy?

Heel pain is common and there are many different causes of that. Plantar fasciitis is by far the most frequent condition and is often simple to diagnose. However, there are numerous other causes that are not as frequent and are much harder to diagnose. One of the less common conditions is a condition known as heel fat pad atrophy. There is a covering of fat beneath the heel that acts as a cushion and shock absorber when we are running or walking. Usually there's adequate fat there to provide that shock absorption, but in some individuals it atrophies or wastes away and it can no longer protect the heel with that shock absorption. The reason why it occurs is not entirely clear, but there is some atrophy of that fat pad with getting older and some just appear to atrophy a lot more than others at a faster rate. The primary symptoms of fat pad atrophy are usually increasing pain with weight bearing underneath the heel. It is also essential to exclude other reasons because they could exist concurrently.

The main strategy to take care of heel pad atrophy is to replace the fat that has wasted away. The simplest way is to use pads in the footwear under the heel, usually made of a silicone gel which has a similar consistency as the natural fat, since they theoretically substitute the pad which is atrophied. This normally works with the majority of cases of this and that is all that has to be done. The only problem with this approach is that you need to wear the pads and you can’t do this when without shoes or in sandals without difficulty. The only other choice is surgery called augmentation in which some fat is surgically inserted under the heel. The inserted fat can come from another area of the body or might be synthetically created in the laboratory. The longer term results of this sort of method aren't yet known, however early results from the procedure appear great.

What is fat pad atrophy?

Under the plantar surface of the rearfoot is a fat pad that naturally cushions us and guards the heel as we walk. When walking, there is a pressure equal to approximatly 2.5 times body weight on the rearfoot during heel strike, therefore it should be no surprise that we require that fat pad. Not having that fat pad there would most likely be inadequate shock reduction which could lead to several problems because of that inadequate shock absorption. The most common is just pain beneath the heel bone. The pain sensation will mostly show up on standing instead of so much on palpation. It isn't really a frequent reason for heel pain, but it is a significant reason as it can often be mistaken for plantar fasciitis and other reasons. Typically it is straightforward to identify as there is just not any cushioning under the rearfoot and you can easily feel the calcaneus.

The causes of fat pad atrophy are not completely obvious. The fat pad does waste away as we grow older normally and in some it simply wastes away more at a faster rate. Many people simply seem to develop this yet others usually do not. It's not linked to bodyweight problems. It might occur in some rheumatological disorders and runners because of the many years of pounding on the heel may perhaps be at a greater risk for fat pad atrophy. People with a higher arch foot (pes cavus) can also get a displacement of the fat pad which will make a similar problem to the atrophy.

The only method to manage fat pad atrophy is usually to replace the fat or substitute for the fat. This can be inserted in operatively or a cushioning heel pad in the footwear used that features a equivalent consistency to the atrophied fat pad. Cushioned footwear could also be used with or without extra cushioning. Operatively this can be an injectable fillers or perhaps an autograft utilizing your own fat cells.