Fat Pad Atrophy of the Foot

One of the complications of Morton’s neuroma surgery and Morton’s neuroma corticosteroid injections is Fat Pad Atrophy. It causes significant foot pain and metatarsalgia.

Fat Pad Atrophy: Understanding, Managing, and Treating Heel Pain

Fat pad atrophy is a common yet underdiagnosed condition that can cause significant discomfort in the heel or ball of the foot. Often mistaken for other foot ailments, it involves the thinning of the protective fat layer under the foot, leading to pain and sensitivity, especially on hard surfaces.

In many cases, the loss is due to the result of cortisone injections. Many people suffering with Morton’s neuroma foot pain or Metatarsalgia receive cortisone injections for the temporary relief of pain. However, these corticosteroid injections have a significant risk of resulting in fat pad atrophy, especially if they have been repeated a few times.

We can treat Fat Pad Atrophy with your own fat extracted from a mini liposuction done on your abdomen or buttocks, then processed and injected into your feet in an orthobiologic treatment.

fat pad atrophy

Contact us to explore effective treatments for fat pad atrophy.

What is Fat Pad Atrophy?

Fat pad atrophy occurs when the protective cushion of fat beneath your heel or ball of the foot begins to thin out. This thinning exposes the underlying bones to stress and impact, leading to discomfort and potential damage.

Key Highlights:

Symptoms of Fat Pad Atrophy

Identifying the symptoms early can help in managing and treating fat pad atrophy effectively.

Common Symptoms:

Note: The symptoms may resemble other foot conditions like plantar fasciitis. A professional diagnosis is recommended.

Causes of Fat Pad Atrophy

Several factors contribute to the development of fat pad atrophy, including:

Understanding these causes can help you adopt preventive measures. Learn more about prevention.

Contact us to explore effective treatments for fat pad atrophy.

Who is at Risk of Fat Pad Atrophy?

Fat pad atrophy doesn’t affect everyone equally. Let’s explore the groups that are most at risk:

1. Older Adults

As part of the natural aging process, the fat pads in the feet tend to shrink and lose their elasticity. This makes individuals over 50 more vulnerable to the condition, especially if they have an active lifestyle or spend a lot of time on their feet.

2. History of Multiple Corticosteroid Injections.

Corticosteroid injections are a common early treatment for metatarsalgia and Morton’s neuroma. These injections are frequently repeated.  Repeated Cortisone injections result in a breakdown of fat pad tissue which does not repair or reverse. 

3. Athletes and High-Impact Activity Participants

People who engage in sports like running, basketball, or dance place repetitive stress on their feet. Over time, this constant impact wears down the protective fat layers, leading to pain and discomfort.

4. Individuals Wearing Improper Footwear

Shoes that lack proper cushioning or force the foot into unnatural positions, such as high heels or narrow-toed shoes, can compress the fat pads and lead to their breakdown. Wearing supportive footwear is crucial for prevention.

5. People with Chronic Conditions

Certain health conditions increase the likelihood of fat pad atrophy, including:

6. Structural Foot Issues

Structural issues like flat feet, high arches, or bunions can disrupt the even distribution of pressure across the foot, putting excessive strain on specific areas and increasing the risk of fat pad thinning.

By understanding these risk factors, you can take proactive steps to protect your foot health.

Treatment Options for Fat Pad Atrophy

We offer a range of non-surgical and surgical treatments to manage fat pad atrophy effectively.

Simple Non-Surgical Treatments:

Advanced Treatments:

  • Fat Pad Augmentation: Until recently, we had nothing to offer. We now have a Regenerative Medicinesolution to build up your fat pads in your feet. Recent studies show that taking a small amount of your own fat from an area, like the buttock or thigh, and putting it back into the ball of your foot can have a long term, positive effect to repair the fat atrophy and restore comfort and function. This minimally invasive procedure can provide long-term relief.

Contact us to explore effective treatments for fat pad atrophy.

Prevention Tips

Preventing fat pad atrophy involves making lifestyle and footwear adjustments to reduce stress on the feet:

Learn more about how to protect your feet.

Scientific Insights and Studies

Recent studies highlight the effectiveness of fat pad augmentation in the treatment of Fat Pad Atrophy.

Lipofilling for functional reconstruction of the sole of the foot. Nicoletti G; et al;  Foot (Edinb). 2014 Mar;24(1):21-7.  doi: 10.1016/j.foot.2014.02.003. Epub 2014 Mar 6. Link to Article

Autologous Fat Grafting for Pedal Fat Pad Atrophy: A Prospective Randomized Clinical Trial; GusenoffJ et al; Reconstr Surg. 2016 Nov;138(5):1099-1108. Link to Article

Fat Grafting for Pedal Fat Pad Atrophy in a 2-Year, Prospective, Randomized, Crossover, Single-Center Clinical Trial; Minteer et al; Plast Reconstr Surg. 2018 Dec;142(6):862e-871e. Link to Article

A: Fat Pad Augmentation. We can treat Fat Pad Atrophy with your own fat extracted from a mini liposuction done on your abdomen or buttocks, then processed and injected into your feet in an orthobiologic treatment.

A: No, we only do one for the time. If you need both feet then then we do your second for at least one month after the 1st foot.

A: Walk only as needed for the first three days. Using crutches is preferable. Within the next two weeks, you can walk but keep your foot elevated whenever you can.

For the first 4 to 6 weeks:

  • no barefoot walking and only minimal walking.
  • Use a scooter if possible.
  • Cannot work or walk full-time on your foot.
  • Use towels placed on the shower floor or a shower pad when showering.

A: You should notice a change within the first six months, and this will continue to improve for two years thereafter.

A: While the condition does not reverse, symptoms can be managed in the short term with proper care and custom orthotics.

A: Fat pad atrophy causes pain under the heel, while plantar fasciitis typically causes pain in the arch and heel, especially after resting. Sometimes it can be very difficult to distinguish between the two and you should seek a provider who has a lot of experience in dealing with these two conditions to make an accurate diagnosis.

A: Surgery is rarely required and is usually reserved for very severe cases.

A: Shoes with thick, cushioned soles and proper arch support are ideal.

Have more questions? Contact us.

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