What Is Pedal Fat Pad Atrophy?

Pedal fat pad atrophy involves the loss or thinning of the fatty cushion located beneath the metatarsal heads—the bones at the base of the toes.

The pedal fat pad serves as a shock absorber during movement, and when it diminishes patients can experience significant pain, especially when walking barefoot or standing for long periods.

Causes include [Minteer et al, 2018; Basadonna et al, 1999; Bowling et al, 2010]:

• Aging (affecting approximately 30% of adults over 60)

• Repetitive stress or high-impact activity

• Obesity

• Steroid injections

• Prior foot surgeries

• Anatomical foot types or deformities

Conventional treatments typically rely on external devices like orthotics or silicone fillers. Unfortunately, these are temporary solutions, often fail to address the underlying issue, and suffer from poor long-term patient compliance.

References:

Basadonna PT, Rucco V, Gasparini D, Onorato A. Plantar fat pad atrophy after corticosteroid injection for an interdigital neuroma: a case report. Am J Phys Med Rehabil. 1999 May-Jun;78(3):283-5.

Bowling FL, Metcalfe SA, Wu S, Boulton AJ, Armstrong DG. Liquid silicone to mitigate plantar pedal pressure: a literature review. J Diabetes Sci Technol. 2010 Jul 1;4(4):846-52.

Minteer DM, Gusenoff BR, Gusenoff JA. Fat Grafting for Pedal Fat Pad Atrophy in a 2-Year, Prospective, Randomized, Crossover, Single-Center Clinical Trial. Plast Reconstr Surg. 2018 Dec;142(6):862e-871e.