Pain in the heel frequently occurs and there are many different reasons for that. Plantar fasciitis is certainly the most common condition and is generally easy to diagnose. However, there are plenty of other reasons that aren't as common and are much harder to diagnose. Among the less common causes is a problem referred to as heel fat pad atrophy. There is a covering of fat under the heel which acts as a cushion and shock absorber while we are running or walking. Normally there's adequate fat there to provide that protection, however in some people it atrophies or wastes away and it may no longer guard the heel with that shock absorption. Precisely why it happens is not completely clear, there is however some atrophy of that fat pad with growing older and some just appear to atrophy a lot more than others quicker. The key signs of this heel pad atrophy are usually increasing pain with standing and walking beneath the heel. Additionally it is crucial that you eliminate other causes since they could exist simultaneously.
The primary way to manage heel pad atrophy is to replace the fat which has wasted away. The easiest way is to wear pads in the shoe underneath the heel, preferably made of a silicone gel which has a similar consistency as the natural fat, as they theoretically replace the pad that is wasted. This usually handles nearly all cases of this and this is all that has to be done. A possible problem with this approach is you have to wear the pads and you can’t do this when barefoot or in sandals very easily. The only other option is a surgical procedure called augmentation in which some fat is surgically inserted underneath the heel. The injected fat can come from another area of the body or may be synthetically made in the laboratory. The long term outcomes of this type of method are not yet known, however early results from the procedure appear great.