Fat Pad Atrophy of the Foot

The risk profile and prevalence of fat pad atrophy is fairly comparable in males and females. However, some experts believe that females are relatively more vulnerable to develop this condition because of:

• High heels which do not support the bottom of the foot; and,
• Ill-fitting or very tight footgear which aggravates the risk of injuries such as callus formation. If left untreated, such injuries can lead to various degenerative foot changes.

Certain factors that may aggravate the risk of developing Fat Pad Atrophy such as:

• Age: The risk of developing degenerative foot conditions increases with progressing age. With increasing age new cartilage and fat tissue formation decreases which makes the bones weaker and more prone to damage. (By our mid-30’s, foot fat pads begin to deteriorate or thin. Sometimes, the thinning doesn’t happen evenly. By our 50’s, some people lose as much as half of the fat that normally pads and protects the ball and heel area of the foot. By our 70’s, the fat pads can be quite thin.)
• Collapsed bone: Degeneration or damage to the long bones of the foot can exert significant pressure over the fat pad leading to increased wear and tear damage..
• Footwear: As discussed previously, the footwear selection can cause as well as aggravate the risk of foot pad atrophy.
• High arch: Certain anatomical characteristics, such as high pedal arches can also cause changes in the foot pad by applying direct pressure on the connective tissue architecture.
• Injury: Injuries caused by significant trauma such as an accident, or other forms of trauma which leads to multiple fractures or surgeries can also increase the risk of developing fat pad atrophy
• Family history: Family history or genetics plays a very important role in development of atrophic and degenerative conditions.
• Arthritis: Inflammation of joints especially in the setting of rheumatoid arthritis aggravates the risk of fat pad atrophy as the bones becomes more vulnerable to damage as a result of ongoing inflammation
• Diabetes: Individuals with persistently high blood sugar levels are vulnerable to develop neuropathy (which leads to numbness and loss of sensation in the foot). The chances of developing pressure-induced atrophic changes increases resulting in fat pad atrophy.
• Steroid Injections: Steroid injections in the foot, especially if done too frequently can cause fat pad atrophy.
• Medications: Chronic use of steroids is also known to cause fat pad atrophy in adults.