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Fat pad atrophy/Plantar fasciitis
Hello,
Ill try to make this brief. 8 years ago when I was 29 years old I was diagnosed with Fat pad atrophy by an orthopedic foot surgeon. I tried cushions and padding and she eventually put me in a cast. Nothing helped and she said I had to live with it. I saw another doctor who said I did not have fat pad atrophy (FPA) and I had plantar fasciitis. He had me stretch ect and nothing helped. He wanted to do steroid injections but I said no bc that can cause FPA. I gave up and went to a 3rd doctor who did nerve studies and an MRI. He said I neither had FPA or plantar fasciitis (PF) He dismissed me. Finally I went to pittsburgh and had a podiatrist/plastics do fat pad injections. They did an ultrasound and said they didnt think it was FPA but they did it anyway. 5000 later and it did not help. I cannot stand barefoot on hard surfaces or even carpet really. I have vionic flip flops that help (a little) but all tennis shoes and virtually all other shoes hurt. I am only 38 years old. I measured my own fat pad at work and it is 12mm via ultrasound without compression. My question is this. Has anyone been diagnosed with fat pad atrophy at such a young age of 29? I still dont know if thats my problem. If anyone has had theirs measured how thick is your fatpad? Has anyone with fat pad atrophy found any relief with anything at all? I am MISERABLE all the time unless I am sitting with my feet off the ground. Thanks Bryan
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I'm not much help. but I wish you well. https://www.columbusohiopodiatrist.com/blog/leneva-injections-fat-pad-augmentation
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1 ReactionI have had Plantar fasciitis. A PT told me to be put in a boot and order a certain sock to wear at night. It stretches the top of foot back. It helped.
I had shots in bottom of foot which didn't help. Next step would have been surgery. Glad a the sock worked. Bought it on Amazon. It is adjustable.
How do I order this sick? My fat pads have been gone for years and my feet kill me.
Helen
@htolan just google plantar fasciitis night time sock. Though plantar and lack of fat pads are two different things completely. My fat pads are gone - I can’t go barefoot. Wearing metatarsal pads can be helpful. There is so much on line. I’d google “cushion for bottom of foot” and see what you come up with. I have a metatarsal pad I wear, it’s purple and can be rinsed off to keep the stickiness. It can be helpful My orthotics both have metatarsal pads built into them. Good luck! Feet pain sucks
or tap https://valepodiatry.com/leneva-fat-pad-injection/
For you guys that say you.have no fat pads. How old are you and when did your symptoms start? Do your feet stop hurting when you wear the right shoes or padding or is it constant regardless of what younwear?
@htolan
i will look it up on Amazon for you
The only shoes I can wear are Hoka and Clark. I can't go barefoot even on carpet.
SELLER IS CEZUVR-US 21.86
Hope this helps.
Mindy
*The information stated below is well-established in orthopedic and podiatric literature*.
Bryan, I’m really sorry you’ve been dealing with this for so many years — especially with so many conflicting opinions. Foot pain like this can be incredibly disruptive, and it’s understandable that you’re frustrated.
A few thoughts that might help you sort this out:
1. Fat pad atrophy is uncommon at 29, but not impossible. It usually shows up later in life or after steroid injections, repetitive high-impact activity, or certain medical conditions. A 12 mm heel fat pad on ultrasound is actually within the normal range for many adults, which may be why some specialists doubted the diagnosis.
2. Plantar fasciitis, nerve issues, and fat pad problems can overlap. Sometimes chronic heel pain isn’t one single diagnosis. Nerve entrapment (like Baxter’s nerve), chronic inflammation, or even biomechanics (tight calves, foot posture) can mimic fat pad pain.
3. The fact that soft, supportive flip-flops help more than shoes suggests your pain may be related to pressure distribution or nerve irritation more than true fat pad thinning — but only someone examining you in person can say for sure.
4. Unfortunately, fat-pad “injections” (fillers) have mixed results. Some people get relief, but it’s not predictable, and it tends to be temporary.
5. People do find relief, but it often takes the right combination:
Custom orthotics designed for offloading rather than arch support
Heel cups specifically made for fat-pad problems (e.g., deep, soft silicone cups)
Avoiding hard floors barefoot at all times
Physical therapy focused on calf length, ankle mobility, and gait pattern
Evaluation for nerve-related heel pain if not already done
6. A specialist in complex heel pain (sports podiatrist, orthopedic foot/ankle surgeon, or PM&R physician) may be the best next step — someone who looks at mechanics, nerves, and soft tissue together rather than one narrow diagnosis.
You’re not alone in this — heel pain without clear imaging findings is surprisingly common, and it can get better once the right cause is found. I hope you get answers and, more importantly, some real relief soon.
Also, I forgot to say that I have found that 100% tart cherry juice has given me much relief. It's science...look it up..it reduces Uric Acid that accumulates in the feet.
I’m much younger than you, but mine started about your age. I have no fat pad on the ball of my right foot. I can’t even get in the shower without a Croc or Ctoc-like shoe. Stepping on a hard floor is excruciating. It’s unlike any pain you could describe. I asked about fat pad injections or replacements, but NOPE… wrong kind of fat. I still suffer; along with a million other things. My Doc Martens are comfortable and most Crocs (that are terrible for my feet). I have several Sketchers that are ok. I think Sketchers run big, so watch out for that. Amazon is great for returns. Good ly, and let me know if you find anything that helps. Sandy Surface