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Heel Pain: Heel Fat Pad Syndrome, Lateral Plantar Nerve Entrapment, Sports Medicine

Reno Ravindran, MD, CAQSM, Richard E. Rodenberg, MD, FAAP, CAQSM and Thomas L. Pommering, DO, FAAFP Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Heel fat pad syndrome:

    • The heel pad is composed of columns of adipose tissue (globules) separated by fibrous septae extending from the skin to the calcaneal periosteum.

    • The fibroelasti...

DIAGNOSIS

HISTORY

  • Gradual onset of plantar heel pain, which may be unilateral or bilateral

  • May have a history of local trauma

  • Pain may radiate into the arch or proximally to the medial heel area.

  • If pain ...

TREATMENT

  • The earlier treatment is started generally lends to improvement in most patients.

  • Nonsteroidal anti-inflammatory drug (NSAID) of choice

  • Rest, modified weight-bearing activities

  • Injections of lo...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Heel fat pad syndrome responds very well to conservative treatment and is usually self-limited.

  • LPN: Approximately 90% of patients improve with nonoperative manage...

REFERENCES

1
Lareau C, Sawyer G, Wang JH, et al. Plantar and medial heel pain: diagnosis and management. J Am Acad Orthop Surg.  2014;22(6):372–380.
2
Hossain M, Makwana N. “Not plantar fasciitis”: ...

ADDITIONAL READING

  • Aldridge T. Diagnosing heel pain in adults. Am Fam Physician.  2004;70(2):332–338.

  • Alvarez-Nemegyei J, Canoso JJ. Heel pain: diagnosis and treatment, step by step. Cleve Clin J ...

CLINICAL PEARLS

  • Both soft heel cups and more rigid ones have been used with some success. The hard cups are intended to encompass the heel pad beneath the calcaneus, helping to restore some of its com...

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