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Fat Pad Atrophy/Fat Pad Syndrome

Is a condition that refers to the loss of fat pads in the balls of the feet, which causes thinning of the protective cushioning that sits under the bones.

This is commonly seen in elderly people causing significant pain while walking, as the shock absorption from the fatty tissue is no longer there.

Without the fat pads the whole bodyweight shifts onto these bones with minimal to no protection.  Therefore the load under this area is unable to be spread out effectively leading to pain, inflammation and over time possible damage to the bones.

Although plantar fat pad atrophy effects both men and women equally, the choice of footwear makes women more susceptible to developing pain and callouses on the ball of the foot. Callus that is not treated may lead to ulceration of the underlying tissue.

Similarly, there is a fat pad under the heel bone, as we stand or walk, the body weight is transferred through the heels and ball of the foot, so both these areas need protection.

loss of fat pads on feet

Causes of Plantar Fat Pad Atrophy (Loss of Fat Pads on Feet):

  • Age is the most common cause, as fatty tissue is reduced in the foot, like it is around the rest of the body.
  • Collapsed long bones in the balls of the feet leading to increase pressure, wearing out the fat pad over time.
  • Wearing high heels, walking barefoot or in very thinned soled shoes may initiate or exacerbate the condition.
  • Extremely high arches are increase weight goes through the balls of the feet.
  • Excessive pronation (rolling in) as increased pressure is put on the balls of the feet.
  • Injury to the ball of the foot, multiple surgery incisions or fractures can lead to thinning and displacement of the fat pad.
  • Genetics are considered to be a cause behind excessive loss of fat pads on feet.
  • Rheumatoid arthritis, which causes clawing of the toes and more prominent bones in the balls of the feet.
  • There is often thinning and loss of fat pad on feet in people with diabetes especially if they have neuropathy (no feeling), which increases the risk of developing foot ulcers.


Symptoms of Plantar Fat Pad Atrophy (Loss of Fat Pads on Feet):

  • Experiencing pain in the ball of the foot, worse when barefoot, in heels or thinned soled shoes.
  • Pain which is greater when standing and relieved when sitting.
  • The feeling of having a small rock in the shoe.
  • Callouses may appear and become very thick on the ball of the foot.
  • When feeling the balls of the feet, you can feel the bones without much overlying fatty tissue.


Treatment for Fat Pad Atrophy (Loss of Fat Pads on Feet):

  • Avoid activities that require walking on tiptoes, squatting, walking down a slope or any action that puts pressure on the balls of the feet, this includes high heel wearing.
  • Wear low heels (an inch or less) and avoid barefoot walking.
  • Switch high impact weight bearing exercise to low impact alternatives, such as cycling, swimming and pool running.
  • Supportive orthotics with a soft top cover to evenly distribute weight to the soles of the feet, and provides adequate shock absorption and comfort.
  • Soft Paddings may also be beneficial and suggested by your podiatrist.
  • Wear supportive footwear that also provides cushioning to the feet.


Surgical Treatment

If conservative methods of treatment fail, surgery may be an option, although this is rarely the case.

Surgery will involve correcting any collapsed long bones in the balls of the feet and securing with a pin. Fillers may be used to replace the fat pad; however this is not common practice.


Fat Pad Syndrome

This is not a commonly encountered condition, but is frequently misdiagnoses. Fat Pad Syndrome will present pain located in the centre of the heel, which can feel like a deep bruise. This condition may also be associated with calcaneal apophysitis (inflammation of the heel bone).

The thick pad between the skin and the bone of the heel is called a ‘fat pad’ because it’s made up primarily of fatty tissue. This fat pad aids in the cushioning and shock absorption of the heel bone.

This fat pad is kept in place by fascia, if this structure becomes stretched or damaged the fat pad can spread out reducing the cushioning under the heel, resulting in Fat Pad Syndrome.


Causes of Fat Pad Syndrome:

  • Trauma from landing heel first on a hard surface (after a jump or fall).
  • Prolonged standing or walking on hard surfaces with inappropriate thinned soled footwear.
  • Age can cause the fat pad to flatten, reducing its ability to absorb shock and protect the heel bone.
  • Excessive heel strike with poor footwear can damage the fat pad.
  • Overweight, as this leads to increased pressure and shock going through the fat pad.


Symptoms of Fat Pad Syndrome:

  • Deep, dull ache that  feels like a bruise in the middle of the heel, when standing or walking.
  • Pain is aggravated by walking barefoot, or on hard surfaces.
  • Unlike plantar fasciitis, fat pad related pain is felt more at the outer side of the heel during heel strike.
  • MRI investigations will reveal changes in the fat pad showing signs of swelling.


Treatment for Fat Pad Syndrome:

  • Taping the heel to hold the fat pad in place, providing more protection to the bone. If symptoms subside your diagnosis of fat pad atrophy have been confirmed
  • Deep heel cups to hold the fat pad in place, ordered from your podiatrist.
  • Heel pads may also be used to add extra cushioning (foam or gel).
  • Anti-inflammatory medication and icing may help for flare ups.
  • Stretching and strengthening program customised by your podiatrist.
  • Supportive footwear with firm heel counters and midsoles, that provides heel cushioning.
  • Chronic cases may need to be treated with custom foot orthoses with a deepened heel cup to stabilize the bones of the feet and provide more restricted fat pad containment, heel protection and cushioning.


Proactive Podiatry will undertake an initial assessment to diagnose and identify the cause of your injury. The podiatrist will help reduce your pain, accelerate healing and increase cushioning to the heel so that you can get back to your activities of daily living with more confidence.

  • Calendar icon August 27, 2013
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  • Shirley

    After having bunion surgery I have developed metatarsalgia. I lost the fat pad on my foot. If I get the fat pad replaced, will that make the metartarsalgia go away?

    • Proactive Podiatry

      Hi Shirley,

      Thank you for your enquiry. If an external device such as an orthotic or soft insole, manufactured by a podiatrist is placed into the shoe this will act as a replacement fat pad and relieve you of your symptoms. A replacement fat pad surgically is rarely done and not very successful.
      I hope this helps you.


      Proactive Podaitry

      • Sean O’Hare

        Hello 🙂

        I am a 27 year old man, fit and active and have had trouble with my feet for 9 years. This would have all but disabled me if not for a strong will.

        First started with typical plantar fasciitis symptoms at age 19. Innesoles helped this somewhat.

        Then turned into a deep aching of the heel. (Sounds a bit like fat pad syndrome) have had my feet taped. That helped a bit. Have had fat pads looked at; doctor felt they were of goodness size.

        The last 4 years I have experienced tingling, burning and a lot of heat in my feet. The burning is especially when they are in contact with something.

        Alcohol makes it worse, as does hot weather. (Nearly unbearable)

        I have had MRI of feet/ankles, spine and head, x Ray, nerve conduction studies, physio, and blood tests for all sorts of genetic and autoimmune disorders. Nothing conclusive here. Have also tried lyrics and gaba something or other. No help there.

        To sum up, I have deep aching in my heels whilst standing, burning (mainly underneath my feet) – also at night while lying in bed my feet are often very hot and massage helps somewhat. Lastly, when I stand barefoot my forefeet feel as though they are building up pressure and want to explode sideways.

        Any info or ideas would be greatly appreciated.

        Ps, no significant pain can be felt under palpation and MRI showed only a few broken ligaments in the ankles and ‘perhaps’ a slight thickening of the plantar fascia.

        Best regards,


        • Sean O’Hare

          I see that auto correct has done a great job in my last comment 😉

          One last thing,

          I cannot bear bearing weight for more than 30 seconds at a time whilst standing still. Walking is slightly more bearable. Although, I can stand in ankle deep cool water for a lot longer without the same sensations…
          I find that quite weird.



          • Proactive Podiatry

            Hi Sean,

            Thank you for your reply. The reason you can stand in cool water for longer is because the pressure under your feet is much less. This is why the treatment off offloading the soles of your feet is very successful in treating fat pad issues.
            I hope this helps.

            Warmest Regards

            Proactive Podiatry

        • Proactive Podiatry

          Hi Sean,

          I am sorry to hear you are suffering so much pain in your feet. I am glad to hear you have undergone extensive diagnostic assessments to determine if there are any systemic conditions underlying that may be contributing to your symptoms.

          Without physically assessing you I am unable to give you specific advice. It does appear to be mechanical in nature and long term heel pain can result in irritation to the medial calcaneal nerve, fat pad disruption of the heel and swelling around the heel bone.
          Manual therapies such as foot Mobilisaiton, deep tissue massage, customised foot orthotics and footwear advice would be beneficial.

          I would advise seeing a Podiatrist who is experienced in the areas of Sports and biomechanics to assist you with this.

          Kind Regards
          Proactive Podiatry

  • john lascelles

    hello, i have lost my left metatarsal fat pad, is it possible to use graftjacket to replace my pad. i have seen an operation on a 77 year old woman, that used grafjacket to replace part of the sole of her foot. thank you.

    • Proactive Podiatry

      Hi John,

      Thank you for your comment. There have been cases, where the metatarsal fat pad has been replaced with graftjacket. However due to the high amount of sheer force and pressures that occur in the feet a prolonged period of total non-wb will be required post surgery. You will need to discuss specific surgical options with a Podiatric or Orthopaedic surgeon that your GP can refer you to.


      Proactive Podiatry

  • Beth Weiselberg

    Hi. I have fat pad atrophy in both feet. But it is the entire foot – the ball of the foot and the heel, I recently got new orthotics and that took away the pain in the ball of the foot but the condition still exists and is getting worse. I am 54 and very active but I have the feet of a 75 year old. They are flat, bony, and veiny.

    Should I have an MRI to determine the degree of fat pad atrophy? My New York City internist and podiatrist don’t see the need for an MRI. (a podiatrist out of NY State asked if I’d had an MRI done) so obviously the answer varies according to what school of thought the podiatrist subscribes to.


    • Proactive Podiatry

      Hi Beth,

      Thank you for your enquiry. Unfortunately with fat pad atrophy you can not slow the process down, you can only manage it conservatively or replace the fat pad in certain areas with a new graftjacket substitute. MRI’s can be a very expensive procedure so would only be suitable if clinically necessary. The fat pad can be palpated and assessed physically for areas of wear and therefore an MRI would not be required.

      The main conservative treatment modalities are orthotic therapy with a soft top cover of poron or extra cushioning under the heel and balls of the feet to put in supportive footwear (possibly a stiff rocker soled shoe to offload the balls and heels of the feet further).

      Pain relief for osteoarthritis may also be beneficial if evident in the joints of the foot.

      I hope this helps to answer your question? All the very best with your treatment journey.


      Proactive Podiatry

  • Jerry Duyn

    My 89 year old husband has neuropothy in both legs and loss of fat pads in his feel. Our new house has hard floors and he needs some extra padding for his shoes,or slippers with extra cushion. What do you suggest?

    • Proactive Podiatry

      Hi Jerry,

      Thank you for your enquiry, in terms of footwear it may be best for your husband to wear a sports shoe around the house, instead of slippers as this will give the feet more support and cushioning. Different types of sneakers influence the feet differently. I would suggest having his walking style assessed and a recommendation given as to what type and style he needs. I would also strongly suggest that you have him professionally measured and fitted for footwear due to the neuropathy.

      There are a range of prefabricated cushioning insoles that can be purchased from the chemist. However without seeing your husbands foot type i can not give a specific recommendation. If your husband chooses to wear slippers make sure it has a velcro fastening to hold his foot in the shoes and reduce friction and rubbing under the soles of his feet. If you require any further assistance or specific treatment information please feel free to make an appointment with our podiatrist.


      Proactive Podiatry

    • Jack Crosley

      Hello Jerry,

      I’m 70, but in exactly the same situation as your husband (neuropathy – fat pad atrophy). I was prescribed, by an podiatrist, custom orthotics. These are made from a plaster mold of my foot. Their designed to off-load the sensitive areas of the foot. I honestly couldn’t get around without them.

      In addition, I purchase heavily-padded wool blend socks from Thorlos. The two socks I buy are the EXCOU15699 – Extreme Cold and TKX15650 – Trekking. NOBODY makes a better sock for warmth and heavy padding. Believe me… I’ve looked. They’re expensive, but the quality is the BEST.

      I also needed one size larger/wider shoes to accommodate my sensitive feet, orthotics and extra-thick socks. After much trial and error, the New Balance 857 has been my go-to shoe for everything. I used to wear a 12-D, but now I buy a 13-6E. My feet are now much happier looser-fitting shoes.

      Best Wishes,
      Jack Crosley
      Vancouver, WA

  • ma

    I have heel pain for for 7 years and I tried physical therapy, platelet injection , all stretches and cortisone injection etc etc , nothing seems to be working. I am home Not working due to severe heal pain with lots of burning involved. My podiatrist want to do surgery to release the plantar fascia. But I am little scared to go that route after seeing all the issues . I went for a second opinion with a orthopedic and he says surgery is not an option and he is diagnosing again with another problem fat atrophy in the heel. I did MRI and x rays for the past 7 years my medical bill is only going up with no pain relief. Can anyone help me what should I do ….

    • Proactive Podiatry

      Hi Malamuthan,

      I am sorry to hear you are in such pain and have had no success with previous treatments. May i ask what the MRI showed in terms of pathology?
      Have you tried completely offloading the area with a moon boot? If it is true Plantar Fasciitis a combination therapy of offloading orthotics, supportive footwear, High-load strength training consisted of unilateral heel raises with a towel inserted under
      the toes, foot mobilisation therapy and calf release may be beneficial. Without assessing your feet and lower limbs I can only provide general advise. If you are local it may be worth making an appointment with our podiatrist Alison who is trained in Foot Mobilisation therapy, Dry Needling and Prolotherapy- all alternate treatment options for Plantar Fasciitis.

  • Chad Underwood

    Hi I am a 49 yr old active male Historic Preservationist so I am constantly on hard surfaces with good boots on with gel inserts and never had a problem with my heels.
    I have just over the last week started to experience some slight pain in my left heel and a really weird popping sensation on the lateral posterior corner of the heel.
    It has slowly gotten worse over the last week. I got home from work today and started reading up on the symptoms and landed here. I just did a little test, seated, I put my index finger on the area that pops, while plantar flexed, heel unloaded, then slowly loaded the heel with the weight of my leg. As I loaded it I could feel the fat pad herniate with a pop against my finger.
    Can anything be done to repair the fat pad?

    • Proactive Podiatry

      Hi Chad,

      Thank you for your question. I think the best thing to do would be to have your feet properly assessed by a podiatrist.
      There are many treatment options that can improve heel pain, caused by the displacement of the fat pad. Gel inserts, as much as they provide padding to the foot do not work as well as some other devices in keeping the fat pad in place. You may benefit for specific strapping techniques in the short term and more customised foot orthoses. Please feel free to call our clinic on (08) 8262 4185 to make an appointment.

  • Markee Lyons

    I have stress fracture in right metatarsals (2 yrs) and this has case right tibial plateau stress fractures. Unbelievable pain.used to be active and would love to walk my cocker spaniel. Feeling that life is passing me by. Please help if you can.

    • Proactive Podiatry

      Hi Markee,

      Are you currently wearing an offloading boot and customised orthotic? Stress fractures can be healed and you can return to normal activity if the condition is being managed properly, with correct offloading and rehabilitation. Please feel free to see us at Proactive Podiatry for a thorough assessment and specific advice.

  • Sandy Surface

    In 2012 I had a triple arthrodesis done on my right foot. I have no idea how it “deformed” itself. NO weight on it for over seven months, along with a hard cast and that crazy boot. At that time, my ortho-
    foot surgeon told me I was losing the padding in my for. It wasn’t painful then. Forward to NOW, and I can hardly stand the pain. I’ve only been able to wear Crocs for the last several years. I have spent a small fortune on OTC shoe inserts. He has referred me to a neurologist for an EMG, and I’m terrified. I’ve cancelled three times. I absolutely CANNOT stand to have my feet touched, let alone put needles in them. He (my foot surgeon) won’t give me Neurontin or Lyrica until he has the EMG results. Neither one of the doctors’ offices will explain this procedure to me. It’s so obvious that I have no padding and am walking on bone… do you think it’s really necessary for me to go through that “trauma” (to me, anyway), or is he just being cautious? The pain is to the point of being intolerable. Thank you for taking the time to read this.

    • Proactive Podiatry

      Hi Sandy,

      It seems to me that this EMG procedure is causing you a lot of anxiety and stress. I think you should have a chat to you Orthopedic surgeon about the way you are feeling. In regards to the EMG maybe the ortho will request electrodes only- no needles. Electrodes are tiny devices that are taped to the skin and form part of the EMG test.

      It sound like a lot of your pain may be coming from Central Sensitisation- you may want to research this online, especially given you have had pain since 2012 and the level of pain you are experiencing. There are methods used in specialised pain clinics to help reduce this Central Sensitisation, which I would strongly advise.

      I hope this information helps you.

      Warm Regards

      Proactive Podiatry

  • C. Jensen

    I have heel fat pad syndrome on my right foot. I have customised orthotic, and even though it helps, I still have a lot of pain. In this moment I can feel it constantly – even when sitting down, allthough it’s way better than when I walk or stand.

    What else can be done?
    I’ve read online that using crutches for a while can be a good idea? What do you recommend?

    (I hope you can understand my English – I’m from Scandinavia)

  • Claire Harris

    I have a hollow under my 2nd metatarsal where a surgeon removed the bursa and 1 sq cm of fat pad. A sliver of glass was found which had been causing me pain when walking. My foot is really no better now, just a different type of pain as I am walking on bone virtually. I have tried orthotics, inserts etc but am still quite limited in walking. I am fit and healthy otherwise aged 68 female. I am unable to find a doctor in Australia who knows anything about fat injections or radiesse in sole of foot or graft jacket procedure. Can you help please.

    • Proactive Podiatry

      Hi Claire,

      Sorry to hear of your unrelenting foot pain. It is very hard to comment as I am unsure what your exact orthotic prescription was.
      However a full length, padded customised orthotics with specific offloading under your 2nd metatarsal may be of benefit with a NON-FLEXIBLE rocker bottom shoe. In terms of surgeons who specifically preform graft jacket procedures in Australia I am unsure, it is a fairly new procedure and most commonly preformed in the USA. It may be worth seeing an podiatric or orthopedic surgeon for a surgical opinion to correct the 2nd metatarsal, so that it is not so prominent.

      Warmest Regards

      Proactive Podiatry

      • Claire Harris

        Many thanks for your reply. Since writing to you, my extensive google searching has led me to a surgeon in USA, Dr Jeffrey Gusenoff re foot fat pad grafting (see Podiatry Today). I thought this information may be of interest to you. I had an Australian ortho surgeon suggest shaving off some of the 2nd metatarsal but said only 50% success if that. That’s not an option for me at this stage. . The idea of fat grafting is appealing to me so will check out as thoroughly as I can with my podiatrist, Leah Cook, before going ahead with it. Kind regards and thank you again. Claire

      • Jose john

        As the name says Graftjacket is a allograft to replace mostly ‘skin’. The one and only method to replace loss of fat pad, is to replace it with fat itself, called Autolipotransplantation. Unfortunately only very few physicians in US perform this procedure.
        As a part of Clinical trials for FDA , Dr.Jeff Gusenoff in Pittsbourgh University performs this procedure. Contact them.
        Joseph John.

  • Gloria Collins

    My daughter went for a pedicure, and the guy stretched her foot toward her toes, then hit her on the bottom of the foot, which immediately hurt. The next day she could barely walk, and after 3 weeks decided to see the orthopedics dr. He diagnosed her with fat pad atrophy from a sharp blow. Now what?

    • Proactive Podiatry

      Hi Gloria,

      Thank you for your comment. The next step would be to see a podiatrist and I would suggest to rule out plantar Faciitis from a direct trauma to the area also. The podiatrist will be able to offload the area to allow healing and provide you with modalities of relief. Your daughter may also benefit from a stretching program and reduce activity levels until the foot starts to feel better.

      Warmest Regards

      Proactive Podiatry

  • Prattel

    Hi I’m a 29 year old (very) slightly overweight female with fat pad atrophy. I was overweight verging on obesity in BMI for a couple of years but lost a few kilos and have recently noticed that the balls of my feet are VERY calloused and increasingly painful under my big toe. It’s a problem I’ve had for a while but it’s been getting worse over the past year so I went to a podiatrist, who advised that I have thin fat pads and that I will need orthotics to prevent further damage. I also have hammer toes. I was wondering whether this is normal for someone of my age? I was checked for diabetes a few times and have always come back fine, although I do suffer from polycystic ovaries.

    Should I be doing anything else to help the situation? Will wearing orthotic shoes have to be a way of life forever now?

    Thanks for your kind advice.

    • Proactive Podiatry

      Hi Prattel,

      Thank you for your enquiry. The callus that is forming under your feet is a common complaint and presents in a broad age range. Most callus is formed from increased sheer force, friction and pressure under certain areas of the foot. This can be exacerbated by inappropriate footwear choices. You may want to download our appropriate footwear guide for further advice on this.

      If the pressure under the balls of your feet is being caused by the way you walk or the way your feet function than foot orthoses may be indicated to help offload this area and provide padding under the balls of your feet. The use of a foot file and foot creams can also assist with the management of hard skin under your feet.

      If you are still concerned a second opinion for another treating podiatrist may put your mind at ease? I hope we have been able to help with your enquiry.

      Warmest Regards

      Proactive Podiatry

  • Elaine Snyder

    I have bilateral heel pad atrophy. I am 69 years old, weigh 115 lbs and spend 80% of the day in bed from a back injury.I am interested in autologous heelbpad surgery ( I may not have the correct phrasing). I have had this for 6 months, seen a podiatrist, had an xray with normal findings and followed all medical advice. Also, podiatrist did steroid injection in right heel first visit. So two questions. Is appropriate surgery available in San Diego, California and did initial steroid injection worsen my condition. Thank you s muchl

    • Proactive Podiatry

      Hi Elaine,

      Thank you for your comment. The steroid injection should not have made your condition worse, however it does not sound like it was effective.
      I think surgery for the replacement of the heel pad is really only a last resort and more conservative options such as stretching, strengthening, offloading insoles and footwear would be more appropriate. if you have not already tried this? I am unaware who is preforming this surgery in San Diego, this is a question you may want to ask your doctor.

      Warm Regards

      Proactive Podiatry

  • Leslie

    Hi Dr,

    Can you kindly help me? I’ve this slightly painful heel for nearly 2 years after striking my heel on the ground while riding the kick scooter. I always thought that I have plantar fasciitis and continue the massage and rolling pin treatment but it does not seems to help.

    It did recovered 5 months after i started wearing crocs. I thought that I’ve recovered fully but it was just about 85% healed and I switched back to Vans for 6 months, the pain seems to come back again.

    I am now beginning to suspect that I have a fat pad injury instead. Will massaging and rolling on wooden pin actually make the heel pad injury becoming worst?

    Is this condition treatable and go away eventually if I use the taping treatment? It is it going to stay permanently?

    Was the recurring injury caused because I did not let the heel recovered fully before I switched back to VANs with harder soles? I was like 85-90% recovered after wearing crocs and I thought it has healed and went back to hard soles and normal activities.

    • Proactive Podiatry

      Hi Leslie,

      Thank you for your enquiry. Heel pain is a very common foot condition we see, as podiatrists and can be caused by injury to range of different structures around the heel. This includes the plantar fascia, fat pad, bursa, calcaneal nerve or the calcaneus bone itself.

      The first step is to seek the advice of a podiatrist to determine the exact diagnosis of your injury so that a specific treatment plan can be implemented.

      I would strongly advise you see a podiatrist who specialises in conditions of the feet and lower limbs.

      However as it appears your condition was trauma related initially the chance of a full recovery is achievable with the right care.

      Warmest Regards

      Proactive Podiatry

  • Kevin

    The fat pads at the balls of my feet feel like they have collapsed and pushed forward behind my toes.
    When I walk it feels like my sock is bunched up behind my toes.
    It is not painful just uncomfortable.

    • Proactive Podiatry

      Hi Kevin,

      Thank you for your comment. It may be best for you to have a foot assessment by a podiatrist to determine the exact cause of your symptoms. It may be a neurological problem (nerve) not just fat pad displacement that is causing you to feel this way.

      Warm regards

      Proactive Podiatry!

  • Cathy Judge

    Hello, I have been diagnosed with Planter Fasciitis and Heel Pad Atrophy and have had it for just over two years. My plantar fasciitis seems at last to be recovering but unfortunately six weeks ago I was late for an appointment and ran for 10 mins. Since that time my feet have become debilitating. I can not stand for more than 10 minutes without pain or walk for long at all.

    I believe I have read all there is on heel pad atrophy but have not read why the top of my foot (metatarsals) are so painful. The pain is immediate upon walking and stays all day. It’s actually now as troublesome as the painful heels. I’m guessing it must be the way I find myself now walking but am wondering if there may be some other reason that I ought to check out?

    Thank you so much for your help. I am so low with this constant pain and have custom orthotics and do everything they advise. I’m a bit desperate and very needy!

    • Proactive Podiatry

      Hi Cathy,

      Thank you for your comment and I am very sorry to hear how much pain you are in.
      Have you been diagnosed with fat pad atrophy? At Proactive Podiatry we not only focus on a customised orthotics to help your feet function better but also work on the soft tissue structures and foot bones to help relieve plantar fascial strain and pain. Please click on our foot mobilisation page to read further.


      If you have any further questions please do not hesitate to ask.
      Warmest Regards

      Proactive Podiatry

  • Cathy Judge

    Yes, I have been diagnosed with fat pad atrophy. I was advised by my podiatrist to wear shoes with 1-1 1/2 inch heel to take the weight off my heels. Sadly now I fear I am getting it in my front pads so am wondering if I should now wear flat ones?
    My podiatrist made me custom carbon fibre orthotics.
    He says I won’t recover unless I use These all the time but they are 3/4 length, hard and I much prefer the good quality shop ones with gel heels.
    He diagnosed both Plantar Fasciitis FPA over a year ago. The former is much better but the FPA worsening. What would you recommend I do? Should I stick with what feels most comfortable?
    Thank you.

  • Cathy Judge

    Sorry, but I forgot to mention the pain on the top of my feet.
    It’s been present for 2 1/2 years which is as long as I have had the other problems.
    I haven’t read of anyone else suffering with this and wonder what it might be?
    It seems to stem from the joint, half way along, of the 6th metatarsal but radiates over the whole of the top of both my feet.

    • Proactive Podiatry

      Hi Cathy,

      Customised Foot Orthotics are specifically made to ensure your feet are functioning correctly, and would be a lot more beneficial than over the counter gel ones. However if you find your current pair too uncomfortable you may want to change to EVA which is a softer material. This will need to be discussed with your treating podiatrist. Pain on the top aspect of the midfoot if often directly related to foot structure (very flat feet or very high arched feet), as a lot of strain in place on this area of the foot joints. However without physically assessing you I can not give you a diagnosis. If you would like to have a second opinion please contact us to make an appointment.
      Warmest Regards

  • Bjarni J

    Proactive Podiatry. Is this how you would expect an MRI to look for someone with Fat Pad Syndrome?


    Looking forward to hear from you. Thank you.

    • Proactive Podiatry

      Hi Bjarni,

      Thank you for contacting us. Your MRI does show signs of darkening, indicating pathology within the fat pad under the heel bone, which is what we would expect with Fat Pad Syndrome. The thickness of you fat pad appears to be within normal limits. A clinical assessment and biomechanical examination would be required for further diagnosis.

      Warmest Regards

      Proactive Podiatry

  • Miserable

    Hello, I am 55 yrs old and a mailman for 31yrs. I’m not ready to retire yet! About 7 months ago I had hammertoe surgery on my foot and now when I walk on it the ball of my foot seems to swell up. Like my sock is bunching up and its very uncomfortable to me.By the end of a 10-hour day I can barely walk on it. Can’t even walk barefoot on my hardwood floors in my house.Like there’s too much fat in the ball of my foot Compared to my other foot . Is there anything I can do any procedure I can get done besides surgery to fix this problem. Would customize Orthopedics help but I do need something that would last in the long run not just something temporarily thank you

    • Proactive Podiatry

      Hello and thank you for your comment. I would advised on a thorough podiatry assessment to determine exactly what is going on. Post surgery with the correction of the hammer toe may have changes some bony alignment in the forefoot and this can be causing increased pressure to the area. Customised Foot Orthotics can help to take pressure of this area and support better foot function. Foot Orthotics can be made out of materials that are very durable and long lasting, this will need to be discussed with the treating podiatrist.
      I hope this helps you in you enquiry.
      Warm Regards

  • Jem

    Hello! I took the drug ciprofloxacin which unfortunately messed up my feet bad by taking away the padding. I am currrntly taking collagen to bring back the padding. Will that work? What should I do to help the situation? I am also wearing comfy shoes and sneakers so that it wont stress my feet too much. Hope to gear from you.

    • Proactive Podiatry

      Hi Jem,
      Thank you for your enquiry. However due to the medical nature of your question this would best be discussed with your doctor. From a podiatry perspective comfortable, padded, light weight runners and shock absorbing insoles would be advisable.
      Warm Regards
      Proactive Podiatry

  • pamela cote

    I have experienced discomfort in the balls of my feet for years, but it is steadily getting worse. I cannot walk or stand for any length of time before my feet begin to hurt. Standing still is worse that walking. My feet burn at night and I have to ice them even if I haven’t been on my feet much that day. I have been to 4 different podiatrists over the years. Each has given me some sort of insert and will these have helped, the problem is getting worse. I am not overweight and generally quite healthy at 68 years of age. One podiatrist said that he thought the fatty pads on the balls of my feet had thinned. I have had bunions since I was a teenager and wonder if this is a contributing factor.

    • Proactive Podiatry

      Hi Pamela,

      Sorry to hear you are having ongoing pain in your feet and have not had a definitive diagnosis. It is very important to have the nerves and the blood vessels tested in your feet as damage to either of these systems can cause burning in the feet. A thorough medical history will also need to be taken as certain medications or medical conditions may be contributing to your pain.
      Bunions can cause thinning of the fat pad under the big toe due to increased weight bearing pressure in this area, and can cause pain and burning in the ball of the foot. Customised Inserts that have been moulded and made to your feet are beneficial if your condition is due to the way you walk and stand, however will not provide complete relief if the issue is more systemic.
      If you are local we would be happy to help you.

  • Namita

    Hello. My mother age 65yrs having problem in walking because of fat loss from foot. Her uric acid also is little on higher side. Is this also the reason for foot fat loss. Kindly suggest what should we do and whom to consult.

    • Proactive Podiatry

      Hello Namita,

      Thank you for your enquiry. High uric acid levels that may lead to gout are not directly related to loss of fatty tissue in the feet. However it can cause pain, inflammation, and redness in the joints of the feet, particularly the base of the big toe.

      High uric acid levels can be treated by diet or medication to lower the acid levels in the body. I advise your mother see her doctor in regards to lowering her uric acid levels and a podiatrist to assess the joints in her feet and the way she walks to determine what can be done, to relieve her foot pain symptoms.

  • Avijit

    A burning sensation had gradually developed at the arch of my right feet as I used to put my newly bought two wheeler on double stand, almost 2years ago. No external sign of injury was ever seen. It developed gradually and not on a single day.
    I immediately discontinued putting the scooter on it’s double stand taking the entire pressure on the rt. arch. However, the problem persisted.
    Later, I consulted orthopedics, physiotherapist and neurologist, gone through their medication but it didn’t work significantly.
    Now I sense the foot pad is reducing. Burning sensation is also present, though slightly receded.
    Can anybody give any fruitful suggestion.

    • Proactive Podiatry

      Hi Avijit, Thank you for your comment and sorry to hear you are suffering foot pain. I think it would be a good idea to have a Sports Podiatrist (who specializes in feet) assess you. You may have damaged the Plantar Fascia by the sounds of it and due to the way your foot is functioning this may not be allowing you to get better and causing other issue within the foot to occur. I hope this helps you. Best of luck on your road to recovery.
      Warmest Regards
      Proactive Podiatry.

  • Jax

    I have fat pad syndrome in my heels at age 27. Quick question. Does it ever heal if taken care of the problem properly?


    • Proactive Podiatry

      Hi Jax,

      Thank you for your enquiry. Without a proper assessment it is hard to know the cause of your fat pad issues. However at your age this can occur secondary to pathology with the Plantar Fascia. If this is resolved the fat pad can repair itself.
      I would strongly advise an appointment with a podiatrist to have a proper assessment and treatment plan.

      Warmest Regards

      Proactive Podiatry

  • Bob

    Can PRP therapy help with fat pad atrophy ?
    ( I walk on the bones where the ball of my feet should be .)
    I am 78 and on warfarin for factor 5 in my blood .

    • admin

      Hi Bob,

      Thank you for your comment. I would not advise on PRP for fat pad atrophy as PRP assist in the repair of injury but will not replace fat pad loss within the tissue.

      Proactive Podiatry

  • Kathy

    Could you tell me if it is possible for fat pad atrophy to lead to peripheral neuropathy? I have fat pad atrophy in my hands and feet (confirmed by MRI) and have begun with extreme burning sensation in my feet, particularly at night. I am a 51 year old female (5’2″ 118 pounds) who is not diabetic. I appreciate any wisdom you can share.

    • admin

      Hi Kathy,

      The fat pad provided protection to the structures in the feet including the digital nerves. If the fat pads are worn away this can cause more plantar compression on the digital nerves which can cause a burning pain in the balls of the feet. It would be worth seeing a podiatrist to check your neurovascular status of your feet (meaning to check the sensation and blood flow to your feet) to see what is causing your pains.
      Warmest Regards

      Proactive Podiatry

  • Gail Uzzell

    I’ve always been an active person doing walking, swimming, yoga.etc. In July of 2016 we moved into a new house. My husband and I would walk around the community, but by May of 2017 my feet and legs started to ache and by the middle of July 2017 I was in a podiatrist office to try and find out what was happening. He said I was losing the fat padding on my feet. He made orthotics for my shoes to try and give me cushioning. He thought I had a neuroma, but after I asked for an MRI 5 months later it turned out I never did have a neuroma. He had already given me 3 injections that didn’t work at all. Stayed with him for several months and then decided to get another opinion . Went to another podiatrist and he said the same thing, that I’m losing the fat padding on my feet. He made other orthotics which have helped some, but have a lot of trouble walking without pain. Have spent a couple of thousand dollars on shoes. Also went to an orthopedic foot and ankle doctor recently. He did x-rays and nothing was broken. I’ve done everything they suggested, but now am afraid I’ll never be the same again. Very heart breaking for me. Am 68 yrs old. The house we built has very hard floors which we were not used to and I think that this has had something to do with my problems. Do you think it could have? Also my hands have lost the fat padding over the years but I don’t have to walk on them. I am currently wearing New Balance shoes 1080 and have had to go up to a size 11 and a wide. My feet are very skinny and boney, but need the larger and wider size to be a little bit more comfortable. The shoes have orthotics in them and also I put a piece of memory foam from a Sketchers shoe on top to make them more cushioned. It helps some. Is there anymore that you can suggest I do? I’m also very thin and can’t gain weight. I think this has a lot to do with the anxiety I am having. I also have hypothyroidism which went to the hyper side in the past year. They had given me too high a dose of Synthroid for my weight. Sorry this post is so long. Any suggestions would be appreciated.

    • admin

      Hi Gail,

      Thank you for your post and I am very sorry to hear you are in such pain. The hard flooring would defiantly impact on the feet. When you loose the fat pad, you loose the cushioning to your feet so are more reliant on shoes and soft surfaces to provide relief.
      I would suggest a shoe like the Hoka One One runner as your daily shoe. One with a very thick EVA foam base and a stiffer forefoot sole to significantly reduce pressure to the balls of your feet. I would also use a tennis ball or rubber spiky ball to roll under your feet at night while watching TV to provide self massage and relieve some of your foot pain, make sure you are stretching your calf muscles and seek another opinion if necessary. Without specifically examining you this is the best advice I can give at this stage. I wish you all the very best and hope you recover soon.
      Warmest Regards

      Proactive Podiatry

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