Pain in the heel is common and there are many different reasons for this. Plantar fasciitis is certainly the most common problem and is usually simple to diagnose. However, there are numerous other reasons that aren't as frequent and are more difficult to diagnose. One of the less frequent conditions is a disorder referred to as heel fat pad atrophy. There is a covering of fat under the heel which provides a cushion and shock absorber when we are running or walking. Ordinarily there's plenty of fat there to provide that cushioning, but in some individuals it atrophies or wastes away and it can no longer guard the heel with that shock reduction. Precisely why it occurs isn't entirely obvious, there is however some atrophy of that fat pad with growing older and some just appear to atrophy a lot more than others at a faster rate. The key symptoms of this problem are increasing pain with weight bearing under the heel. It is also essential to rule out other conditions since they may exist concurrently.
The main approach to deal with heel pad atrophy is to replace the fat which has wasted away. The simplest way is to wear pads in the shoe underneath the heel, ideally made from a silicone gel that has a similar consistency as the natural fat, because they technically replace the pad which is missing. This generally handles nearly all cases of this and that is all that has to be done. A possible problem with this approach is that you need to wear the pads and you can’t do that when barefoot or in sandals very easily. The only other choice is surgery called augmentation in which some fat is surgically implanted beneath the heel. The injected fat can come from another area of the body or might be synthetically made in the laboratory. The long term results of this sort of approach are not yet known, however early results from the surgery appear good.
