Fat Pad Atrophy is the thinning or flattening of the “cushion” or pad that protects the underlying structures of your feet, such as neurovascular tissues, sensitive periosteum, ligaments and tendons.The fat pad is the first cushion you have for your gait. 

With age, this pad becomes so thin that the foot starts to suffer from repetitive trauma. Irritation, inflammation, stress fractures, pain and many others are the results for such trauma.

Symptoms

A normal, healthy fat pad measures 1 to 2 cm in thickness. Seniors with this have less than 1 cm of fat pad. In some cases it might be asymptomatic, but others might experience the following symptoms:

• Sensation of walking on the bone
• Foot pain that worsens when walking on hard surfaces
• Foot pain when standing for a long period of time
• Foot swelling
• Callus formation on the ball of the foot

Risk Factors

Age: With age, cartilage and fat tissue formation decreases. Studies have shown that by the age of 50’s people have lose half of the fat pad.

Rheumatological Diseases:  Diseases such as rheumatoid arthritis, scleroderma and lupus, affect the connective tissues in the feet aggravating the risk of fat pad atrophy.

Foot Conditions: Seniors with foot conditions such as high arch can cause abnormal pressure on the heel leading to a higher risk of fat pad atrophy.

Others: Weight, sports, diabetes, injuries and some types of medicine might increase the risks of fat pad atrophy in seniors. Family history or genetics can also play a role in development of this condition.

Treatment

According to the case, Doctors of Podiatric Medicine will assess and treat the condition. Custom made orthotics and shoes with good padding and support are the first steps to treat fat pad atrophy. Nowadays, shoes brands have created footwear specialized for seniors’ needs. Consult your Podiatrist for better assessment.

Fat Grafting: Method in which fat cells are harvested through liposuction of belly or thighs, processed and then injected into the affected area. Even though this method has been used since the early 90’s, it is considered "new".

Other methods such as Platelet Rich Plasma Injections and Stem Cell Therapy have shown positive results in the treatment of fat pad atrophy.