The subcutaneous tissue of the heel has fibers perpendicular to the skin that connect the skin to the surface of the heel bone, forming the fatty fiber pad of the heel, which has the role of absorbing oscillations. In the elderly, the fatty fiber pad of the heel often has varying degrees of atrophy and thinning, thus causing heel pain when standing or walking. Cause: The heel pad is a fat-rich piece of tissue below the heel bone. The disease occurs over the age of 50, due to the loss of water, collagen and elasticity, resulting in atrophy of the heel pad. Clinical manifestations: The pain is mostly deep, non-radioactive, and concentrated in the central weight-bearing area of the heel node. It is easily misdiagnosed as plantar fasciitis and is easily triggered by barefoot walking or walking on hard surfaces, and is relieved by less walking. The plantar aspect of the heel node is prone to pressure pain, which correlates with the degree of swelling. The pain is usually independent of ankle and toe mobility and nodal compression. Diagnosis: Lateral radiographs of the heel can be used to measure the thickness of the heel pad, and MRI is not required, but its can indicate swelling and atrophy of the heel pad. Treatment: Non-steroidal anti-inflammatory drugs such as ibuprofen, celecoxib, custom-made orthotic shoes and orthotic insoles are best. Since the disease is mostly caused by mechanical reasons, reducing compression and weight bearing is an effective method. Local injections of corticosteroids should be avoided because of their tendency to cause further atrophy in the long term. Surgical methods are also not recommended, and there is no effective way to dispose of or replace the heel pad with a new one. Instead, other complications such as skin necrosis are likely to result.