Corticosteroid Injection for Plantar Fasciitis

TREATMENT OPTIONS FOR 
PLANTAR FASCIITIS

Ice for Plantar Fasciitis

Orthotics for Plantar Fasciitis

Corticosteroid Injection for Plantar Fasciitis

Exercise for Plantar Fasciitis

Surgery for Plantar Fasciitis

Shock Wave Therapy for Plantar Fasciitis

Low Level Laser Therapy for Plantar Fasciitis

Treatment Ratings

R
E
S
C
U
R

RISK: 2/5

2_Hearts_Treatment_Rating

Once a mainstay of treatment for PF, cortisone injections (CSI) is generally no longer recommended. It does provide good immediate relief, but the effect is fairly short-living, lasting only 1-3 months. CSI injections can cause damage to the cartilage, making the fascia weaker and susceptible to rupture. It can also reduce the size of the protective fat pad on the bottom of the foot. Other potential complications include plantar fascia calcification, injury to nerves, sterile abscess, calcaneal osteomyelitis and even impaired vision.

Grice J, Marsland D, Smith G, Calder J. Efficacy of  Foot and Ankle Cortisosteroid Injections. Foot Ankle Int. 2017 Jan; 38(1):8-13.

Dean BJ, Carr AJ. The Effects of Glucocorticoid on Tendon and Tendon Derived Cells. Adv Exp Med Biol. 2016; 920:239-46.

LI Z, YU A, QI B, et al. Corticosteroid versus placebo injection for plantar fasciitis: A meta-analysis of randomized controlled trials. Experimental and Therapeutic Medicine. 2015;9(6):2263-2268. doi:10.3892/etm.2015.2384.

David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden AS. Injected Corticosteroids for treating plantar heel pain in adults. Cochrane Database Syst Rev. 2017 Jun 11; 6:CD009348.

E

EFFECTIVENESS: 2/5

2_Hearts_Treatment_Rating

Studies and years of clinical experience show that corticosteroid injections provide good relief of foot pain, though there may be a brief period of increased pain initially. The effect can last up to 3 months. However this benefit should be weighed against the potential risks, and it appears risks increase with the number on injections.

S

SELF CARE: 0/5

0_Hearts_Treatment_Rating

Corticosteroid injections can only be provided by licensed health care providers.

C

COST: 3/5

3_Hearts_Treatment_Rating

Cortisone injections for plantar fasciitis range from $100-$300 per injection.

U

USEFULNESS (overall rating): 2/5

2_Hearts_Treatment_Rating

Cortisone injections used to be a first line therapy for PF, but recent reviews of evidence regarding potential complications suggest the risks may outweigh the benefits, and that benefits may be short-lived. As a result many national guidelines no longer recommend CSI for plantar fasciitis. We suggest trying other conservative measures for PF first, and perhaps consider steroids only when surgery is the only other option.

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