@swimming When I needed new orthotics after hip replacement, my long time podiatrist who was a wizard at making & adjusting them had retired. My first new ones were actually painful, kind of like you are describing.

Then, when I was having rehab therapy for other hip related issues, the physical therapist sent me to a prosthetics clinic, where they made orthotics for people with complex problems. They were able to make & fine-tune new orthotics for me. (I own 2 different types now.) I do not have "fat pat atrophy", but I do have arthritis & bone spurs in my feet. My favorite orthotics are made from carbon fiber (like Kevlar) and cushioned with a thick memory foam. I wear them in boots, athletic & hiking shoes and they really help.

Can you find a prosthetic clinic near you?
Sue