Corticosteroid Injection for Plantar Fasciitis

Podiatrist treating feet during procedure

Overview

Cortisone injections provide good immediate relief of foot pain, but their effect is short-lived (2-3 months). There are potential risks or complications that may outweigh the benefits.

RESCU Treatment Ratings

R = Risk      E = Effectiveness      S = Self-Care

C = Cost     U = Usefulness (overall rating)

1 = Least Favorable     5 = Most Favorable

R

RISK: 2/5

2_Hearts_Treatment_Rating

Once a mainstay of treatment for plantar fasciitis (PF), cortisone injections (CSI) are generally no longer recommended. They do 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.

Sources:

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.

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