Pain in the heel frequently occurs and there are many different reasons for this. Plantar fasciitis is certainly the most frequent condition and is generally simple to diagnose. However, there are plenty of other reasons that aren’t as frequent and are much harder to diagnose. Among the less frequent cause is an ailment known as heel fat pad atrophy. There is a covering of fat under the heel that acts as a cushion and shock absorber while we are running or walking. Normally there’s plenty of fat there to provide that cushioning, but in some individuals, it atrophies or wastes away and it may no longer guard the heel with that shock absorption. Exactly why it occurs is not completely obvious, there is however some atrophy of that fat pad with growing older and some simply appear to atrophy more than others at a faster rate. The key signs of this problem are increasing pain with weight-bearing beneath the heel. It is also important to rule out other conditions because they may exist concurrently.
The main approach to take care of heel pad atrophy is to substitute the fat which has wasted away. The easiest way is to use pads in the shoe beneath the heel, usually made of a silicone gel that has the same consistency as the natural fat, because they theoretically substitute the pad which is missing. This generally works with almost all cases of this and that is all that needs to be done. A possible problem with this approach is you need to wear the pads and you can’t do that when without shoes or in sandals without difficulty. The only other choice is a surgical procedure called augmentation where some fat is surgically inserted underneath the heel. The injected fat can come from another area of the body or maybe artificially created in the laboratory. The long term results of this type of method are not yet known, but early results from the surgery appear great.