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Fat pad atrophy / Plantar fat pad

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What is fat pad atrophy?

The soles of your feet, especially under the balls of the feet, the heels and the toes, take a lot of stress when we stand, walk or run. People usually have a fatty layer under the skin on the soles of the feet which provides cushioning.

The ageing process, some medical conditions such as Rheumatoid Arthritis and Diabetes, and your foot shape or mechanics can lead to atrophy, thinning or migration (movement) of the fatty padding so that it is no longer offering you cushioning and shock absorption. This can be made a lot worse if you are on your feet a lot, carrying extra weight, or wear thin soled footwear, high heels, or work on hard floors.

Many patients say that they feel like they are walking on stones or pebbles and the feet get sore and tired and throb and ache.

There are many conditions that can cause pain under the feet, and fat pad atrophy is just one, however it can often go hand in hand with other conditions such as metatarsophalangeal joint capsulitis or plantar heel pain / “plantar fasciitis”

It may also be called “metatarsalgia” if it is under the ball of the foot.

How can I help myself?

Generally, wearing thicker, more cushioning soled footwear such as running trainers, or wearing cushioned liners/insoles in your footwear may help. Avoiding hard surfaces or repetitive stress on the feet and also wearing thicker socks may also help.

When to see a Podiatrist?

It is a good idea to see a Podiatrist for an assessment and to confirm the problem is just fat pad atrophy. They may be able to modify your footwear or insoles, or even make you foot orthoses to offload high pressure areas too, and they could treat any skin problems related to the fat pad atrophy or migration such as corns. 

Some Podiatrists also offer dermal filler injections which can fill the area where the fat pad should be, with a substance such as Hyaluronic acid. This can provide relief from symptoms for a period of time.

If you book an appointment, it is a good idea to take the footwear you wear day to day so that the podiatrist can see this and advise.

Fat pad atrophy
Big toe joint problems