Heel pain frequently occurs and there are a number of reasons for that. Plantar fasciitis is by far the most frequent problem and is often easy to diagnose. However, there are numerous other causes that are not as common and are much harder to diagnose. One of the less frequent conditions is a ailment known as heel fat pad atrophy. There is a covering of fat under the heel that acts as a cushion and shock absorber when we are running or walking. Usually there is plenty of fat there to provide that protection, but in some individuals it atrophies or wastes away and it might no longer protect the heel with that shock reduction. Exactly why it happens isn't completely obvious, but there is some atrophy of that fat pad with getting older and some simply appear to atrophy greater than others at a faster rate. The main symptoms of fat pad atrophy are increasing pain with standing and walking under the heel. Additionally it is crucial that you rule out other causes because they could exist concurrently.

The main way to treat heel pad atrophy is to replace the fat which has wasted away. The simplest way is to wear 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 replace the pad that is missing. This normally deals with nearly all cases of this and that is all that needs to be done. A possible problem with this method is that you have to use the pads and you can’t do this when without shoes or in sandals without difficulty. The only other option is surgery called augmentation in which some fat is surgically implanted under the heel. The inserted fat can come from another part of the body or might be synthetically created in the laboratory. The longer term results of this sort of surgery aren't yet known, however early results from the procedure appear excellent.