Heel pain with a thin fat pad can difficult to diagnose. Some of our patients come in with what seems to be classic plantar fasciitis. They even have the morning pain. However when we go to examine the foot they have a very thin fat pad. This is readily visible and easy to determine with ultrasound imaging. At this time it is also possible that there will not be much inflammation or swelling of the fascia. This can be a difficult problem to resolve.
The most important treatment for this is a prescription orthotic with a very deep heel cup with an aperture or hole in the bottom of the orthotic heel cup that is filled with a special Visco/gel. In addition wearing shoes that have excellent cushioning such as hoka shoes can be helpful. Once we are able to address the mechanical component of this problem, if there still are residual symptoms or pain sometimes a cortisone injection or shockwave therapy can be beneficial.
If you have heel pain that is not responding to treatment please consider additional evaluation. Give us a call at 425-880-9552 or contact us online to make an appointment. Myself, Dr. Timothy Young, or my partner Dr. Brandon Nelson would be happy to see you.