What is fat pad atrophy?

Foot image by DXfoto.com from Fotolia.com

Fat pad atrophy is a condition that can develop in the ball of the foot as the fat that cushions the bones of the foot is destroyed. This condition is common in elderly people and can cause significant pain while walking. Fat pad atrophy is also known as metatarsalgia.

Fat pad atrophy can be treated through a variety of methods, although it may require surgery to relieve the pain completely.


The foot is made up of five metatarsal bones. These bones are held in place by ligaments. If a metatarsal bone falls out of alignment and is lower than the rest, it will cause pressure on the ball of the foot. This increased pressure will wear away the fat pad that is designed to absorb the shock of walking for the metatarsal. As the fat pad disintegrates the skin will respond by creating thick calluses, which can add to the pain. Individuals with extremely high arches, who wear high heels, or have had an injury to the ball of the foot are more likely to develop fat pad atrophy.


Experiencing pain in the ball of the foot is only one of the symptoms of fat pad atrophy. Other symptoms include pain that gets worse when standing and improves once seated. Toes may feel numb or tingle. A common symptom for patients with fat pad atrophy is the feeling of having a small rock in their shoe. The pain will get worse if walking barefoot, and calluses will appear and become very thick on the ball of the foot.

Non-surgical Treatments

Fat pad atrophy can be treated without surgery if treatment is started soon enough. Custom orthotics inserted into the shoes is the common type of treatment. A mould is taken of the foot and the orthotic is moulded to fit the foot. The result is the lifting of the metatarsal so that it is aligned with the others and no longer carries more of the body weight than the other metatarsals.

Surgical Treatment

If non-surgical treatments fail to relieve the pain, surgery may be necessary. The surgery is designed to restore balance to the metatarsals and alleviate the excess pressure. This is done by cutting the offending metatarsal and raising it into the correct position within the foot. The bone is secured in this new position with a pin. After recovering from the surgery the patient should no longer feel any pain when walking.


An ounce of prevention is worth a pound of cure. A few things can be done to avoid developing fat pad atrophy. Avoid wearing heels higher than three-quarters of an inch to one inch. Heels that are higher than an inch place too much of the body's weight on the ball of the foot and will place excess pressure on the metatarsals. Avoid activities that require walking on tiptoes; this has the same effect as high heels. Switch high-impact exercise routines to low-impact alternatives such as swimming, cycling and pool running.