Plantar Fat Pad Atrophy ?

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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Age related plantar fat-pad atrophy is common, as is such atrophy related to specific conditions including rheumatoid arthritis. Pain and discomfort will normally be accentuated in the exceptionally high-arched foot, as an inappropriate amount of weight is borne on the balls as well as the heels of the foot with not enough dispersion of body weight elsewhere on the plantar. Various injectable substances have been tried, but, to date, and to my knowledge, nothing in terms of actual replacement or internal simulation of the fat pad has proven very successful, and one is pretty much left to external pads and cushions and materials to reduce direct and shearing forces. But you might be glossing over the possible Morton's neuroma too lightly. Although padding treatments can sometimes mitigate symptoms, rarely, in my experience do they provide permanent or even long-lasting results.

 

Foot Doc,

Thanks so much for your reply...

Considering the time frame I have described (21 months) and my relatively young age for this type of affliction, am I experiencing a typical decline from normality to my present condition?

How much worse and how fast a decline should I anticipate? Is there anything I can do to slow this decline?

Diet?
Exercise?
Stretching?
Massage?
Pharmacological Pain Management
Weight Loss?
Shoes?
Socks?

Could you also please provide more info related to your concerns regarding the Morton’s neuroma issue?

Thanks Again,
Jack

 

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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A pre-requisite to considering any specific prognosis or how one might attempt to change it for the better would be an accurate diagnosis and etiology. Diagnoses and findings are not the same thing. But Internet forums are not likely venues to obtain diagnoses, which generally are to be based of a hands-on examination.

It was you who brought up the diagnosis of Morton's neuroma, and this condition certainly is a common cause of pain in the ball of the foot. It is not generally a difficult diagnosis to make, but it can present with varying symptoms, from paresthesias such as tingling and burning, to frank numbness to out and out pain. I was simply advising that some or part or perhaps the whole of your problem could be symptoms of the Morton's neuroma which you say was suspected, even in spite of the fact that you may have concomitant fat pad atrophy.

In my experience, an accurately diagnosed Morton's neuroma generally requires an invasive procedure to remove, destroy or decompress the neuroma in order to afford other than temporary relief.

 

Dr, thanks again for your reply...

Do you have knowledge in regards to injection procedures to restore fat pads?

 

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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Jack wrote:
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Dr, thanks again for your reply...

Do you have knowledge in regards to injection procedures to restore fat pads?

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Just that several substances have been tried, and, to my knowledge, none have had any substantial long-term success.

 

Look at this link... this will help you:

http://wmt.test.lunaweb.net/Downloads/Techniques/Plantar Augmentation Tech.pdf

 

is getting fat foot

My bf and I we went to play racketball and we have no idea what;s is going with his foot. Next day his foot was getting fatter and fater. He never have problems like this. so is there any other way for him to get of it the pain
'

 

I have had this problem for years. I was in my 60's when first symthms started. Now 75. I sleep on a magnetic matress pad. I have no pain and walk with regular shoes. I can run if I wantto. Only drawback is I feel asif I'm walking on a sponge.

 

I feel your pain! I too have Morton’s Neuroma. The custom orthotics have helped to a degree - especially the metatarsal pad built into them. I am also looking for some help because not only am I in constant pain when I walk, which gradually worsens but I feel it is also zapping my energy. I feel tired all the time. I have been to the doctors about the fatigue and they find nothing so I am beginning to feel that the inflammation of the nerves in the feet are the problem.

I have read elsewhere on the net that acupuncture has given relief to some. I also hoped that my own fat injected into the soles of my feet would work but haven't found any information on that.

 

I don't have pain, but on the bottoms of my feet, right under my toes, feels like walking on sponge, or something in my shoe.

 

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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Although certainly not to be taken as a diagnosis, the symptoms you relate are often seen in patients with peripheral neuropathy.

 

Hello Doctor,

I have the same problem as Jack does above... Except I am 26years old.
I have been researching and have kinda pin pointed the sympotoms my self.
I've have been to 3 doctors who have only wanted to remake a new orthadic for me and never really answering my question of what is wrong with my foot and why I have so much pain on the balls of my foot.... the answer to all these doctors are x rays and orthadics....

Can you recommend a good doctor in the New York City area?

I beleive I have fat pad atropy because I can feel the bones under my feet and I can also see that the orthadics have created calluses too becasue they are not soft, so I am better walking with out them...

This bites for a 26year who is now having to wear MTBs and granny shoes...

a

 

I've read the posts in this column with interest as I have had a 24 month problem with pain in my left foot. The pain is around the sesamoid bone in my left foot (ball of the big toe thereabouts). I have been to see 3 different doctors, 2 podiatrists and a foot surgeon. It seems there is some confusion in the diagnosis - between Mortons Neuroma to a fractured sesamoid bone - so I have been asked to get a bone density test/scan of some sort (these are soooo expensive..). I was told not to run (I love to run) and I stopped for 6 months - all this time a little lump has developed in the "sesamoid bone" area - and now when I am walking it feels like I am standing on a grain of rice. Needless to say - it hurts like buggery...it can feel like a burning sensation sometimes and then can be a stabbing pain at other times.

I've given up on the not running bit and I run 3 times a week (5k) and just grit my teeth through the pain...seems like after I'm warmed up (around the 1k mark) the pain goes away...(some times I am lucky and I sleep fine through the night other nights I get stabbing pains at 3am that gets me out of bed)...

Like Jack - I'm wondering if there is anyone out there who might be able to suggest some other condition that I can take back to my doctors as suggestions...we seem to be out of answers here...I've had xrays and scans - nothing shows up...orthotics and gel pads etc have not helped at all.

Thanks people

Caroline

 

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DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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Pain in the sesamoid area is generally termed sesamoiditis. Certainly at least one of your 3 doctors could tell the difference between an irritated sesamoid area and a sesamoid fracture, and would know that a Morton's Neuroma does not cause the sort and location of symptoms which I hear you describe. Nor do I know why a bone density scan is warranted.

You have mentioned no definitive treatment other than not running, and certainly your doctors offered you more than that in justification of taking your money. Has anyone considered perhaps a corticosteroid injection into the sesamoid area, real off-loading padding or maybe a sesamoidectomy?

 

Heya Foot Doc,

Thanks for the reply. Cortisoid Injections & an op was discussed by the surgeon but he wanted me to have the bone scan first. I think he said something like he couldn't be sure from the xray if I have a bipartite sesamoid or if it was indeed a fracture. I'm certainly not going to have the operation - I don't want any bones removed...

Guess I'll go have me a bone scan and take it from there. My foot is only slightly swollen so I'm hoping that it isn't a fracture (trying to be optimistic here!)...I've got a half marathon coming up in July...

Thanks again for your reply...

 

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DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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Your choice. It's ONLY pain. No one RELISHES having parts removed, but when appropriately and properly done, the trade-off is usually a good one. If nothing definitive is going to be done, I don't see the need to know if it is a fracture or a bipartite sesamoid. I certainly would have you think again about running a marathon on a foot which is to any degree painful and swollen.

 

Look at this link... this will help you:

http://wmt.test.lunaweb.net/Download...ion Tech.pdf

Foot Doc, do you have any experience/knowledge in regards to this procedure?

Jack

 

Hi,
Has anyone checked into Dr. Thomas Rocchio and his Graftjacket technique to treat atrophy of the plantar fat pads?

I have severe atrophy of the plantar fat pads plus progressive peripheral neuropathy and I am constantly trying to find something that will help. My feet are simply skin and bones. It is excruciatingly painful to walk the few steps.

The study indicates the procedure has been done on over 50 patients. I have searched blogs and web sites to see if I can find one of the patients commenting on the procedure. I know that if I had it done and I saw improvement I would be on every blog and web site telling everyone about it. Does anyone know of someone who has had procedure done and their results? Thank you. Chris

 

This may be a Freudian slip that I forgot to mention that my feet are so severely devoid of fat due to atrophy that I will soon need to choose between sitting in a wheelchair or having my feet amputated and wearing prosthesis if I want to walk. I also have progressive peripheral neuropathy which makes my feet feel as if they are on fire.

Therefore I appreciate any hope something which may be on the horizon. Obviously, stem cell would be ideal but our country is so are behind in stem cell research that I doubt it would help anyone within the next 20 years for this type of problem Thank you for any suggestions. Chris