Pain in the heel is common and there are a number of causes of that. Plantar fasciitis is certainly the most frequent problem and is usually simple to diagnose. However, there are numerous other causes that are not as frequent and are more complicated to diagnose. Among the less common conditions is a disorder known as heel fat pad atrophy. There is a covering of fat beneath the heel which acts as a cushion and shock absorber when we are running or walking. Generally there is enough fat there to provide that protection, however in some individuals it atrophies or wastes away and it might no longer guard the heel with that cushioning. Precisely why it happens isn't entirely clear, there is however some atrophy of that fat pad with getting older and some simply appear to atrophy greater than others at a faster rate. The main symptoms of fat pad atrophy are increasing pain with weight bearing under the heel. Additionally it is essential to exclude other causes since they could exist concurrently.
The main way to deal with heel pad atrophy is to replace the fat which has wasted away. The simplest way is to use pads in the shoe under the heel, preferably made from a silicone gel that has the identical consistency as the natural fat, as they theoretically substitute the pad which is wasted. This typically works with almost all cases of this and this is all that has to be done. A possible problem with this method is that you have to use the pads and you can’t do this when without shoes or in sandals without difficulty. The only other choice is a surgical procedure called augmentation in which some fat is surgically implanted under the heel. The injected fat can come from another area of the body or could be synthetically created in the laboratory. The long term outcomes of this sort of approach aren't yet known, however early results from the procedure appear good.