Corticosteroid injections for plantar fasciitis

Examples

How It Works

Corticosteroid injections can provide short-term relief from heel pain due to plantar fasciitis.

The site where the doctor injects the steroid may vary. Some inject directly into the plantar fascia on the underside of the heel. Others inject on the big-toe side of the heel or arch.

Injections are advised to be given with an anesthetic mixed with the corticosteroid, but the injections may still be painful. Your doctor may spray a topical anesthetic on your skin before giving you the injection.

Why It Is Used

Your doctor may consider corticosteroid injections if several weeks of nonsurgical treatment have not relieved your heel pain.¹

How Well It Works

• Symptom relief from corticosteroid injection lasts for 3 to 6 weeks, but often the effect wears off and symptoms come back.
• If a series of steroid injections does not help relieve the problem, you and your doctor will probably need to consider other treatment.

Side Effects

Side effects of corticosteroid injections can be serious, such as:

• Pain with injections.
• Shrinking of the fat pad over the heel.
• Degeneration of the plantar fascia from multiple injections, which can lead to plantar fascia rupture.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Some doctors are cautious about using corticosteroid injections for plantar fasciitis.

• Concerns include the pain of the injections, the short-term relief of pain, and the risk that the heel pad or the plantar fascia may be damaged by repeated injections.
• Experts advise using injections sparingly, only when other treatment has failed. They also recommend limiting the number of injections to avoid complications that may be even more difficult to treat than the original plantar fasciitis, such as plantar fascia rupture.
• Other rare complications of corticosteroid injections include infection, bleeding, and accidental damage to the ligament or nerves by the needle.

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References

Citations

1. Frey C, ed. (2005). Plantar fasciitis chapter of Foot and ankle section. In LY Griffin, ed., Essentials of Musculoskeletal Care, 3rd ed., pp. 667-674. Rosemont, IL: American Academy of Orthopaedic Surgeons.

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