plantar fasciitis and fat pad atrophyWhen most people think about pain in the heel they assume it's plantar fasciitis. And most of the time they would be right. Runners, people with flat feet, and those who are overweight are at high risk for developing heel pain. Ageing can also play a role.

But there's another condition that shows up that can mimic heel pain called Fat Pad Atrophy. The pad of the heel thins and can cause pain in some people. Fat Pad Atrophy typically develops and worsens as people age. It is also more common in people with diabetes, those who have had multiple injections of cortisone, and women after menopause.

Fat Pad Atrophy can be distinguished from plantar fasciitis by the location of the pain.  If the pain is located in the center of the heel it's probably Fat Pad Atrophy and if it's found where the arch and heel meet, it's more likely plantar fasciitis.

Treatment for Plantar Fasciitis

There are numerous modalities for treating plantar fasciitis including icing, cortisone injections, anti-inflammatory medications, use of splints to stretch the calf muscles, supportive shoes, physical therapy, and orthotics. Dr. Berg treats heel pain daily at our Heel Pain Center.

Treatment for Fat Pad Atrophy

Although you may be able to prevent recurrence of plantar fasciitis, you can't prevent the loss of fat from your heels. Padding the foot with heel cups or correcting the mechanics of the foot with orthotics can often alleviate the pain. Although the idea of transplanting fat to this area of the foot is a possibility it is currently only in clinical trials.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
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