Pain in the heel frequently occurs and there are a number of reasons for this. Plantar fasciitis is certainly the most frequent condition and is generally simple to diagnose. However, there are many other causes that are not as frequent and are more difficult to diagnose. One of the less frequent conditions is a problem referred to as heel fat pad atrophy. There is a covering of fat underneath the heel which acts as a cushion and shock absorber when we are walking or running. Generally there's adequate fat there to provide that shock absorption, however in some individuals it atrophies or wastes away and it may no longer protect the heel with that shock absorption. Exactly why it happens is not completely obvious, there is however some atrophy of that fat pad with getting older and some just appear to atrophy greater than others quicker. The primary signs of fat pad atrophy are increasing pain with weight bearing underneath the heel. It is also essential to exclude other reasons because they may exist simultaneously.
The main way to deal with heel pad atrophy is to replace the fat that has wasted away. The easiest way is to use pads in the footwear beneath the heel, preferably made from a silicone gel which has a similar consistency as the natural fat, because they technically replace the pad which is atrophied. This ordinarily works with almost all cases of this and this is all that has to be done. The only problem with this approach is that you need to use the pads and you can’t do that when barefoot or in sandals very easily. The only other option is a surgical procedure called augmentation where some fat is surgically inserted under the heel. The injected fat can come from another area of the body or might be artificially made in the laboratory. The long term outcomes of this type of method are not yet known, however early results from the procedure appear good.