Pain in the heel frequently occurs and there are many different causes of that. Plantar fasciitis is by far the most common problem and is generally simple to diagnose. However, there are plenty of other causes that aren't as common and are much harder to diagnose. One of the less frequent causes is a ailment referred to as heel fat pad atrophy. There is a covering of fat underneath the heel which acts as a cushion and shock absorber while we are walking or running. Ordinarily there is sufficient fat there to provide that shock absorption, but in some individuals it atrophies or wastes away and it may no longer guard the heel with that cushioning. Precisely why it occurs is not entirely obvious, but there is some atrophy of that fat pad with getting older and some just seem to atrophy a lot more than others quicker. The key signs of this fat pad atrophy are usually increasing pain with weight bearing under the heel. It is also essential to rule out other reasons since they could exist simultaneously.
The main strategy to deal with heel pad atrophy is to substitute the fat which has wasted away. The simplest way is to use pads in the shoe beneath the heel, ideally made of a silicone gel that has the same consistency as the natural fat, because they technically replace the pad that is atrophied. This usually handles the majority of cases of this and that is all that has to be done. The only issue with this approach is that you have to wear the pads and you can’t do this when without shoes or in sandals very easily. The only other option is a surgical procedure called augmentation where some fat is surgically implanted underneath the heel. The inserted fat can come from another part of the body or might be synthetically made in the laboratory. The long term results of this type of method aren't yet known, however early results from the procedure appear good.