Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave. #1100, Chicago, IL, 60611, USA.
J Foot Ankle Res. 2022 Aug 16;15(1):60. doi: 10.1186/s13047-022-00568-x.
The heel fat pad is an important structure of the foot as it functions as a cushion to absorb shock and distribute plantar force during ambulation. Clinical practice guidelines or decision support platforms emphasize that heel fat pad syndrome (HFPS) is a distinct pathology contributing to plantar heel pain. We aimed to identify and synthesize the prevalence, etiology and diagnostic criteria, and conservative management of HFPS.
A comprehensive search was conducted in May 2021 and updated in April 2022, using MEDLINE, Scopus, Cinahl, EMBASE, Cochrane Library, SPORTDiscus, and PEDro and ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform (ICTRP) for pertinent registrations. We included all study types and designs describing the prevalence; etiology and diagnostic criteria; and non-pharmacological, non-surgical interventions for HFPS.
We found a small body of original research for HFPS (n = 7). Many excluded full-text articles were expert-opinion articles or studies of heel fat pad in participants with plantar fasciitis/fasciopathy or unspecified heel pain. HFPS may be the second leading cause of plantar heel pain, based on two studies. A number of differentiating pain characteristics and behaviors may aid in diagnosing HFPS vs. plantar fasciopathy. Thinning heel fat pad confirmed by ultrasonography may provide imaging corroboration. Randomized controlled trials assessing the efficacy of viscoelastic heel cups or arch taping for managing HFPS do not exist.
The research literature for HFPS is sparse and sometimes lacking scientific rigor. We have identified a substantial knowledge gap for this condition, frequent inattention to distinguishing HFPS from plantar fasciopathy when describing plantar heel pain, and an absence of robust clinical trials to support the commonly recommended conservative management of HFPS.
足跟脂肪垫是足部的重要结构，它起到缓冲作用，在行走时吸收震荡并分布足底力。临床实践指南或决策支持平台强调，足跟脂肪垫综合征（HFPS）是导致足底足跟疼痛的一种独特病理。我们旨在确定和综合 HFPS 的患病率、病因和诊断标准以及保守治疗。
我们于 2021 年 5 月进行了全面搜索，并于 2022 年 4 月更新，使用了 MEDLINE、Scopus、Cinahl、EMBASE、Cochrane 图书馆、SPORTDiscus 和 PEDro 以及临床试验.gov 和世界卫生组织国际临床试验注册平台（ICTRP）搜索相关登记处。我们纳入了所有描述 HFPS 患病率、病因和诊断标准以及非药物、非手术干预的研究类型和设计。
我们发现了少量关于 HFPS 的原始研究（n=7）。许多被排除的全文文章是专家意见文章或足跟脂肪垫在足底筋膜炎/筋病或不明原因足跟疼痛参与者中的研究。根据两项研究，HFPS 可能是足底足跟疼痛的第二大主要原因。一些区分疼痛特征和行为可能有助于诊断 HFPS 与足底筋膜炎。超声证实足跟脂肪垫变薄可能提供影像学佐证。不存在评估粘弹性足跟杯或拱形贴带治疗 HFPS 疗效的随机对照试验。
HFPS 的研究文献很少，有时缺乏科学严谨性。我们已经确定了这种情况的大量知识空白，在描述足底足跟疼痛时经常没有注意到将 HFPS 与足底筋膜炎区分开来，并且缺乏支持 HFPS 常用保守治疗的有力临床试验。
