chronic heel pain - Fat pad atrophy? SOS this is affecting my life and job

Hi,I’m hoping someone here can help me figure out what direction to look in. I’ve been dealing with heel pain for a while and I’m struggling to find a solution. I was hesitant to see a podiatrist initially since in the past they've not been helpful, but the pain is much worse now.
I bartend and work a desk job. I struggle with a standing desk and working more than 3hrs.

My symptoms:

  • Pain is mostly in my heels, sometimes extending into the forefoot
  • It happens mainly after standing/walking for longer periods (bar shifts)
  • It improves significantly when I take my shoes off
  • I do not have morning heel pain or painful first steps after getting out of bed
  • No tingling/numbness
  • I’m active (bike commute, gym, bouldering, running occasionally)

I have high arches and a podatrsit told me I have low fat pads.

All the shoes I have tried, some being street shoes:
HOKA Bondi 8, HOKA Bondi 8 (newer model), ASICS Gel Nimbus 27, ASICS Gel Cumulus 27, KEEN Jasper Zionic, HOKA Arahi 6, HOKA Transport, New Balance Fresh Foam Arishi v4, ASICS Gel Sonoma 15-50, Saucony Guide 18, HOKA Bondi 9, VANS UltraRange 2.0, HOKA Clifton 9, Brooks Ghost Max 3, ON Cloudmonster.
I've tried multiple insoles and heel cups.

The Brooks and Cliftons I could wear for 3hrs before pain.

  • Does this sound like fat pad issues?
  • What tests or assessments should I ask for?
  • What type of specialist should I look for?
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