Expert: Dr. Marc Katz - 5/6/2009

Question
I am writing about my husband's recent diagnosis of fat pad atrophy in the feet. He is only 35 years old, so we were led to believe that he is rather young for such a condition. Being a very active and athletic person, this condition has cause him to stop many of the activities in which he normally participates. We have seen several doctors and have spent hundreds of dollars on 3 different pairs of orthotics. None of these seems to be helping - when one area starts to feel better, another area begins hurting. My husband describes the pain as a "burning" sensation - in the heel, metatarsal region, and ball of the foot. The symptoms have quickly gotten worse in the past year. The physiotherapist who is currently adjusting the most recent orthotics has mentioned neuropathy, but the doctor  didn't think so. We are desperate for something that will relieve the pain, and I'm wondering if you might have any suggestions at all. For a 35 year old man with an active 2-year old little boy who wants his daddy to be able to play and run with him, this is very disheartening and depressing. Can you shed any light on this strange condition? Any help would be greatly appreciated. Thanks.

Answer
Hi Lynne,

Silicone padding works well for fat pad atrophy.  The thick gel insoles seem to work well.  Fat pad causes are many so a definitive reason would be difficult.  He can be checked for neuropathy by having a nerve conduction study with a neurologist.  I would also consult with a rheumatologist to see if there is some autoimmune problem or arthritis.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

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