Q: Dr. Eppley, I am interested in heel pad fat injections. I had a bad experience with an inexperienced podiatrist. He had given me cortisone injections to the heel pad for fasciitis. Unfortunately the outcome made my condition worse and I have lost most of the fat pad in my left heel. I am very active person and to be left like this at 35 is very depressing. Is there any hope? I don’t know if this requires an orthopedic surgeon instead. Please let me know what you suggest.
A: I believe you are correct in that heel pad fat injections would be the best approach to your heel pad atrophy. The normally tight heel pad which is weight bearing is a difficult place for fat grafts to take. But fat is a natural graft material and between the fat cells, fibroblasts and stem cells it is likely that some heel fat pad thickness restoration can be obtained. For many heel pad problems, it is surprising that more podiatrists do not embrace the use of platelet rich plasma (PRP) and fat injections. These tissue extracts from patients offer a more natural approach to many pain and tissue inflammation problems without any of the side effects of steroid injections.
Dr. Barry Eppley