Plantar fasciitis can be extremely painful for the person struggling with this. I know this from personal experience. In 2018 I dealt with plantar fasciitis, while in my 2nd year of a podiatry residency (ironic, hu?). At the time, I opted out of getting a cortisone shot for plantar fasciitis initially. To read my experience on at-home treatments for plantar fasciitis, click the following link for my blog post on this topic: https://www.directpodiatryaz.com/post/at-home-treatments-for-plantar-fasciitis
What happens if the at-home treatments for plantar fasciitis don't work for you? For me as a foot doctor that is where cortisone shots for plantar fasciitis can come in. It is important for me to arm my patients with as much information as possible, all risks and benefits of a treatment or procedure so that they can make an informed decision. This is my intention today with this post. Cortisone shots for plantar fasciitis do have their place, but at the same time, most treatments in medicine do have some level of risk, and a cortisone shot is no different. At the end of this post, you hopefully will have a better understanding of how cortisone shots work, why they are used for plantar fasciitis, the risks, and the benefits, and then be able to decide if a cortisone shot for plantar fasciitis is right for you.
Table of Contents:
Overview of Plantar Fasciitis
To start, plantar fasciitis is a common foot problem that causes heel pain due to inflammation of the plantar fascia, a thick band of tissue that connects your heel bone to the ball of your foot. The plantar fascia has many functions, one of which is maintaining the arch and structure of your foot. Your risk of developing plantar fasciitis can increase with haveing certain foot types, or wearing the wrong shoes. To learn more about plantar fasciitis causes, click the link for another of my blog posts on this topic: https://www.directpodiatryaz.com/post/12-plantar-fasciitis-causes
How a Cortisone Shot for Plantar Fasciitis Works
Cortisone shots are made from synthetic cortisone, which is a steroid. Cortisone can be a powerful anti-inflammatory medication, when used in the right way. For plantar fasciitis, a cortisone shot would be injected around the plantar fascia to get rid of pain and inflammation. A foot doctor, or podiatrist is one kind of doctor that can give a steroid injection.
A cortisone shot for plantar fasciitis works by lowering the immune response in and around the plantar fascia, when then can decrease your inflammation and pain. Steroid shots also temporarily stop the body making chemicals which do cause pain and swelling in the heel.
Pros of a Cortisone Shot for Plantar Fasciitis
1. Can bring fast pain relief
The main pro about getting a cortisone shot for plantar fasciitis is the possible immediate pain relief. For someone whose plantar fasciitis is to the point where they are limping when they are walking, unable to stand without extreme pain, or on the verge of tears, a cortisone injection can work well and quickly for pain relief. This for me is the best part about this treatment option for plantar fasciitis. Typically, there's no downtime with a cortisone shot for plantar fasciitis.
Cons of a Cortisone Shot for Plantar Fasciitis
1. Doesn't Get to the Root Cause of The Plantar Fasciitis Even though the possible immediate pain relief is great, it's important to stress that getting a cortisone shot for plantar fasciitis can be temporary. This shot does act on the inflammation and pain, but if your doctor and you the patient don't get to the root cause of your plantar fasciitis, the pain will come back. This is why even if you opt to get a cortisone shot for plantar fasciitis, your foot doctor should still guide you on conservative treatment options in order to treat your pain from its source. This includes stretching, icing, wearing better shoes for your foot types, possible physical therapy, and more. Note this was the reason why I initially opted against getting a cortisone shot for plantar fasciitis when I had it during residency. I wanted to get to the root cause of my pain before turning to a steroid injection. Thankfully, I was able to do just that, and haven't dealt with plantar fasciitis pain since. That won't be everyone's story, but again, I want to empower people whether they are my patients are not to explore as many conservative treatment options and modalities you can before turning to a cortisone shot for plantar fasciitis. And even if you get to the point where getting a cortisone shot for plantar fasciitis is right for you, continue to do all of the added conservative treatments to be sure that your pain doesn't come back.
2. Risk of tissue damage
Cortisone injections given incorrectly, or given to often does increase your risk of tissue damage. Steroids are powerful drugs, but they can be very harmful in the wrong hands. Tissue damage includes weakening of tissues surrounding the injection site. increased risk of tendon rupsures tendon ruptures, thinning of the skin, depigmentation of the skin where the skin will get much lighten in comparison to the the surrounding skin, and fat pad atrophy, which is when the fat that cushions your heel is damaged, which can cause chronic pain.
3. Increased infection risk
Any time something enters the skin, there is a risk of infection. This is rare, but the chance is still there, especially if you have diabetes. Diabetes weakens your immune system, which then makes it harder to fight off infection. Diabetes also can slow down the blood flow to your feet, which also makes it harder to fight a foot infection. This is something to keep in mind.
4. Temporary pain flare-up
Ironically, one of the potential cons of getting a cortisone shot for plantar fasciitis is a possible temporary increase in pain after the shot. This is called a "steroid flare," can happen because of the cortisone irritating your plantar fascia and the surrounding area. This pain usually gets better in a few days. To learn more about sterid flares, click here for an article from Healthline https://www.healthline.com/health/osteoarthritis/cortisone-flare
5. Tolerance to cortisone
The body can develop a tolerance to cortisone shots over time, making each added shot less likely to work. Long-term use of cortisone shots for plantar fasciitis is not a sustainable choice for managing chronic pain.
6. Can slow down healing
While they may lower inflammation in the short term, they can stop the body's natural l healing mechanisms.
7. Other Side effects:
Additional side effects from cortisone shots for plantar fasciitis include:
facial flushing
temporary changes in blood sugar levels (particularly in individuals with diabetes)
mood swings
insomnia
weight gain.
Note: These side effects are generally mild and temporary, but it's important to talk about concerns with your doctor.
Important Points
Getting a cortisone shot for plantar fasciitis is an important decision which does require the risks and benefits to be weighed. Each person is different, and it is important that a person be educated about the complete picture of steroid injections so that they can make an informed decision about their treatment. Work with for foot doctor to get rid of your plantar fasciitis for good.
Do you have plantar fasciitis and live in the Phoenix area? My name is Dr. Tarr, and I am the owner of Direct Podiatry Arizona. To view available appointment times, click the following link here: directpodaz.janeapp.com