orthbiologic treatment

Fat Pad Atrophy

Fat Pad Atrophy is Now Treatable With Regenerative Medicine

orthobiologic Treatment

Fat Pad Loss: Age And Cortisone Injections

You may lose the fat pads on the balls of your feet with age. 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.


Many patietns come to see us with Fat Pad Atrophy after having received corticosteroid injections for their Morton’s neuroma. Cortisone interferes with the body’s natural healing processes resulting in tissue and fat pad breakdown. Fat pad atrophy is fat tissue breakdown that does not repair or reverse with time. This results in foot bones that are closer to the floor, not as protected, and in more pain. This can also occur normally due to the aging process. In high arched people, chronic stress over the fat pad can also cause it to shift forward and degenerate. Acute injury, diabetes or smoking can also cause or contribute to Fat Pad Atrophy.

Patients with Fat Pain Atrophy complain of pain under the heel while walking barefoot on a hard surface or pain under the metatarsal heads when walking on a hard surface. It feels like a dull ache in the center of the heel and it may be possible to feel the heel bone with your fingers through the fat pad. If it feels like hardly any cushion, atrophy is more likely than fasciitis. Frequently the pain in your heel is worse the more you walk on it.


Until recently, we had nothing to offer. We now have a Regenerative Medicine solution 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. 

We extract a small amount of fat from your abdomen or buttocks and after minimally processing, we inject into your fat pads using ultrasound guidance as necessary. This can have a long term, positive effect to repair the fat atrophy and restore comfort and function. The aim of using this procedure is to support your body’s self-healing processes and reverse disease leading to symptom relief and recovery of function.

We first examine and evaluate your feet and confirm the diagnosis and make sure that you are a suitable candidate. Then  we do a mini liposuction taking a very small amount of your own fat from your buttocks in a painless procedure under local anesthesia. We then process your fat here on site. Once we have the fat processed, we inject the fat into your fad pad area under ultrasound guidance as needed.  The whole process takes about 1-2 hours.

Recovery can take a week and we recommend you then ease back into your routine but avoid long walks and runs (and anything that creates excessive foot pad pressure) for 4 weeks. Custom Orthotics can help the healing and recovery.

Janet D Pearl

Our Medical Director

Janet D. Pearl MD MSc

Orthotics, especially custom made orthotics, can help your recovery. Surgery is also an option but only as a very last resort.

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