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How to manage heel pad atrophy

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.

What is Mueller Weiss disease?

Mueller Weiss disorder is a rare reason for pain within the mid-foot in adults which was less commonly called Brailsford disease. Mueller Weiss Syndrome is a spontaneous onset osteonecrosis of the navicular in the foot. You will find there's a more well-known disorder of the navicular bone in young childen known as Köhler disease, and this is an osteonecrosis with the tarsal navicular bone, however they are completely different disorders because of the character with the growing bones in youngsters. The condition was first documented by Schmidt in1925. It was W Muller who later on recommended how the pathophysiology with the disorder was because of an irregular compressive power on the midfoot region. About the same time, K Weiss, reported which the look on x-ray were a lot like those observed in a disorder referred to as Kienbock disease, which is also an osteonecrosis. These two reports led to the most commonly used name for this disorder, Mueller Weiss syndrome.

Mueller Weiss syndrome commonly affects adults between 40 and sixty years of age (Köhler disease has a typical onset around five years of age). Mueller Weiss disease appears to be more common in women. It can impact only one foot, or it can have an effect on both your feet. The typical signs and symptoms are the progressive oncoming of pain in the mid-foot and hindfoot which could turn out to be localised to the most painful place being over the navicular bone. A flat foot is in addition more common in those that have this issue. The gold standard to identify Mueller Weiss disease is via using imaging. On x-ray there will probably look like a crush of areas of the bone and sclerosis and a comma-shaped deformity in the lateral part. A computerized tomography scan may display the same irregularities and could be used to evaluate the stage with the problem in far more depth. A MRI may be more sensitive to assist with the diagnosis because it is capable of find changes in the bone marrow.

Mueller Weiss disease is generally progressive and may produce severe pain and become rather debilitating, and so treatment needs to be commenced as early as possible to prevent it from being damaged too much. Initial treatment methods are to restrict weight bearing, perhaps some pain alleviation medications and make use of supporting shoes or boots. Commonly foot supports are widely used to help further stabilise the area and support the mid-foot (arch) of the feet. This prevents a lot of load off of the navicular bone. If that is not helping, then a additional restriction in exercise amounts is essential so there is a lesser amount of force about the painful bone. A moon boot or walking brace will be the next step to help protect as well as immobilise the region if your symptoms aren't improving. If most of these conservative methods usually do not help, you can also find operative options that will help with the pain but can typically result in some small impairment, which is more desirable in comparison to the continual soreness of an active condition. The particular surgical treatment could be a decompression of the bone with drilling. An alternative choice in case there are areas of navicular bone deterioration are a surgical fusion of the important joints around the damaged bone..