• Daniel Lopez-Lopez, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Alfredo Soriano-Medrano, Patricia Palomo-Lopez, Angel Morales-Ponce, David Rodriguez-Sanz, and Cesar Calvo-Lobo.
• Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain.
• Pain Physician. 2019 Jan 1; 22 (1): 109-116.

BackgroundHeel pain is one of the most frequent complaints in medical clinical practice for conditions affecting the feet during weight-bearing tasks.ObjectiveThe goal of this study was to measure and compare the thickness of the fat pad in a sample of patients with current unilateral heel pain and patients without unilateral heel pain with normalized reference parameters.Study DesignThis was an observational case-control study.SettingsThe research took place in the podiatry department within a medical health care center.MethodsA total of 375 patients were randomly selected from a pool of patients attending a medical health care center between the years 2008 and 2015 and diagnosed by a single medical podiatrist without having previous treatment. Patients were categorized in 2 groups: a heel pain group (n = 185) and a control group (asymptomatic; n = 190). The thickness of the plantar fat pad was measured with an ultrasonic probe (BodyMetrix® BX 2000; IntelaMetrix, Inc, Livermore, CA).ResultsInitial examination of both groups indicated no significant differences in age, height, weight, or body mass index (P > 0.01). There were, however, significant differences in the thickness of the fat pad between those in the heel pain group and those in the control group, when analyzed by group and by gender (P < 0.01; Cohen´s d = 0.465-1.959).LimitationsThe study was not a randomized controlled trial. Although primary outcome data were self-reported, the assessor was not blinded.ConclusionThis study provides further evidence that people with unilateral heel pain showed a significantly decreased thickness of the subcalcaneal fat pad, regardless of gender.Key WordsHeel pain, subcalcaneal fat, pain.

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