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Scleroderma & Raynaud's UK (SRUK)
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loss of fat pads on soles of feet

hi has anyone suffered the loss of fat pads on soles of feet or has anyone tried derma fill to fill the fat pads ?

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Strange I hadn't heard of this happening before until my Rheumy told me that was the reason for my really tender big toes. She said I had no fat pads on the end of my toes. Please tell me about seem a fill as it seems that my shoes are going to have to be trainers or toe keepers in the summer

They aren't a problem in winter boots. Just in my ballet shoes etc which i love wearing.

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That was supposed to say derma fill

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Hi , for year's i have felt like i am walking on pebbles. It's like you are walking across a beach without shoe's on the stones . My Chiropodist said that i had lost all of the fat under my feet. The only thing that he suggested was to buy shoes with thick soles. I go to the Chiropodist every 5-6 weeks .The only thing that helps with me is extra innersoles. I gave up buying lovely 👡 shoe's year's ago in favour of comfort 👟 . Just keep putting one foot in front of the other 😅

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Hi me too know fat pads on feet been like it for years I have special built inersoles everywhere shoes slippers wellies and walking boot/ shoes. 😥so painful if I try to walk without.

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Hi, I also lost the bottom of my fat pads on both feet years ago. I have to wear inserts in my shoes. We don’t realize the things we take for granted until we lose it.

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Hi there, I have some nice flat, fat pad less feet too. Boots, trainers, insoles, doubling up on socks...you name it I do it.

What a shame that all us lovely ladies have fat less feet, but that it doesn't seem to disappear from elsewhere...i.e. your tummy, hips and backside!!! :)

I don't feel inclined to have any fillers in my feet. Too many other complications with any invasive procedures puts me off, but anyone who has had good experience it would be fantastic to hear about.

All my best

Lucy xxx

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Hello LucyJean. Have you tried the NHS orthotics from the Community Health orthopaedics team at Bowthorpe Road? I have had very good results.

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Thanks Tim, I know about that service so I will bear that in mind. Did you get your Consultant or GP to do the referral and do you know what the wait time is? Lxx

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I first saw Biomechanics in March 2014 at the instigation of my GP. In April they produced a report: "Painful corns on outer tips of both 4th toes. Pain across balls of feet. Increasing difficulty walking". I was given a diagnosis and then recommended treatment: "New functional foot orthotics prescribed to improve stability, cushioning and function of feet in gait". The orthotics were then made and fitted in May. Continuing problems with painful toes has necessitated addition of the toe props as described below. It all seems to be working well.

Please let me know how you get on.

Tx

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I know this may sound obvious but does that mean you are having to buy shoes with room in them for insoles? And what insoles would you suggest i buy. Are they gel? Thanks any info would be handy9

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Yes: my version of this started at an early age...have always had to wear bespoke orthotic insoles and buy shoes a size larger to fit them in...i couldn’t walk & stand without these insoles...including padding under forefeet. But i have Hypermobile Ehlers Danlos Syndrome and infant onset Lupus as well. Am 64. I get my insoles from a podiatrist who updates my “insoles prescription” annually much as an optician does my spectacle lenses. The firm who make my insoles is LBG Medical:

lbgmedical.com

LBG does both bespoke insoles (called Langer) and OTC insoles etc

🍀🍀🍀🍀 coco

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Hi I was referred to a podiatrist years ago by my GP via my Rheumatologist on the NHS and they make them for me every year because your feet do change. They watch the way you walk examine your shoes and feet then take a moulding of your feet. I couldn’t do without them. Hope this helps

Best wishes

Joan

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Re. insoles, see my comments below and also to @LucyJean above about orthotics.

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By the way can anyone explain why or how on earth this happens

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This SRUK website link gives you their official feet info, which goes some way to explaining things v clearly, including this loss of padding:

sruk.co.uk/raynauds/managin...

Seems to me that all AIDs overlap a lot re feet manifestations...eg Diabetic issues are v similar to ours...i especially like Lupus UK’s feet info: my feeling is that we’re all pretty similar, eg the Arthritis Research UK feet info is also v similar, and actually discusses systemic sclerosis & feet in the section on connective tissue diseases:

arthritisresearchuk.org/hea...

lupusuk.org.uk/medical/gp-g...

🍀🍀🍀🍀 coco

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I imagine a gradual conversion of elastic connective tissue to calcinotic strands with no 'give' in them. This is accompanied by myopathy (muscle wastage). The weight of your body presses the metatarsal heads and toe pads against the floor or shoe soles and they very soon get traumatised (like pressure sores). Diffuse calluses quickly develop within two or three days, and also focalised corns. Bingo! We are hobbling around and cursing.

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Hi i have that as i can't walk on the beach etc bare foot it's torture!

Plus often my feet feel like been run over i have acupuncture which helps for a while.

But if on my feet too long esp if fatigued their very painful spend all the time twitching my feet trying to get comfort.

Is that a Raynauds thing or systemic sclerosis?

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After a lifetime of having my complex overlapping feet stuff explained to me by medics, i suspect the 3 things you’ve described are due mainly to your primary AID (systemic sclerosis) but your Raynauds also is responsible....in my case + in the cases i know of other AID patients’ feet trouble these sort of signs & symptoms aren’t down to just one cause

Eg although for sure my infant onset lupus and ehlers danlos hypermobility are mainly what’s caused my lifetime of feet trouble, I do wonder, if my feet are so bad partly due to a degree of undiagnosed systemic sclerosis ...cause i do have quite a few characteristic SSc manifestations (eg tendon tightening in legs & feet, early loss of padding in feet, early childhood onset Raynauds + small vessel vasculitis which respond better to losartan than nifedipine, and then there is my GI tract: typical very early onset mouth to a**s slow transit dysmotility issues + chronic Intestinal pseudo obstruction etc)

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Hi i seem to have often slow transit as my food either sits on chest or not gone through was remarked on when had camera it wasn't clear even with extra prep!

I do get tight legs often feels like walking like a duck!

But all my muscles get tight/fatigued as loosing gums also and eyesight issues where they don't focus as had eye test again Friday found changing while doing test.

But much is never looked at properly years back so accumulates like luggage

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You are so right...much of my health stuff gets sorta “set aside” by medics (mainly) until it’s emergency...but also, i tend to only pressure medics for help with my worst health stuff...and i’ve tended to see private medics about my feet eg podiatrists (the nhs seems to save podiatry care for diabetics)...meanwhile health stuff accumulates

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I went to a users group where said kicking users off! read there bumpf at meeting which reading it i fit into the criteria ie poor nerve and low blood flow to feet (there words after testing me)so asked them lady said if that your still in! then got letter saying about it but pretty sure my appoinment was after that? ho the F in joys of a stroke as lost/loose my time lines Grrr

So i'd ask foot people!

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went back to dentist again other day as getting worse gum peeling and dam painful we had a chat about a few things and she said my gums look like the ends of my finger red and shiney

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Would that also apply to backside as painful when sitting down

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I have wastage of the fatty padding and it leads to painful calluses on pressure points on soles and toes.

My solution has been a) to get orthotic insoles made by the NHS (wonderful!) for the soles, b) to use toe props to stop corn development on toes (preferably the chamois leather type rather than silicone gel as the latter get too tight), c) to have bi-monthly NHS chiropody to deal with any hard patches and corns I cannot deal with myself, and d) wear solid walking boots able to contain the insoles whenever I go out (otherwise I just wear well-padded sandals indoors).

It took me a couple of years to get this system worked out. The insoles cannot deal with the toe problems. I could send you pictures if the insoles if that would help.

As oscarbravo points out walking on beaches is impossible. I also find walking anywhere on hard surfaces is painful. Best keep a spare pair of shoes with you when visiting friends if you have to leave your outdoor footwear at the door.

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My situation is exactly as tall-tim describes. I have spent a fortune on orthotic insoles, expensive (and ugly) shoes to accommodate them, and regular chiropody to remove painful corns and calluses. Still, I'm walking less than I'd like because of the pain, particularly in the ball of my left foot.

The joys of Scleroderma.

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I think that repeated trauma to the tissues between bone and sole or floor produces diffuse callousing with occasional centres or 'peas', as I call them (cf 'The Princess and the Pea' story). I have been able to use a foot rasp or file to grind down the hard stuff wherever it can be identified, and also a craft knife to (very carefully using a mirror, bearing in mind my leg joints are stiff and my hands crippled up) to pare away the 'peas'.

What sort of orthotics are you referring to, PJSammy? I have tried Scholl gel insoles without much success (I even tried cutting one up and sewing a double layer onto the pad of one). My successful NHS orthotics cradle the entire sole from toes to heel and are constructed of cork and two types of plastic. I had to press my feet into blocks of foam at the clinic, from which plaster casts were made. They are a god-send!

As for 'ugly' shoes, I really like my boots; they are beautiful brown leather and made by Scarpa for outdoor purposes. They may not suit everyone's idea of attractive footwear, but - hey! - 'Needs must where the devil drives' and Scleroderma is a devil.

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Could that be linked to it with sitting down pains and in hands when gripping something is painful?

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I'm a bit unclear what you mean, OB.

By 'sitting down pains' are you referring to pain in your bum-bones when sitting? Muscle wastage gives me that problem. Luckily my fingers still have some padding. Any pain in my hands comes from either ulceration or stiffness.

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when sitting down gets dam painful which carries on either when stood up etc like been kicked in the butt.

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I haven't experienced anything like that. Might we worth asking a separate question on this topic.

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It's what happens with scleroderma. I've had it for years. I wear shoes and slippers with compensating soles. My latest ones are from DAMART.

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