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Cortisone Shots in the Heel--More evidence for not doing it!

Posted by BarbJ on 7/15/99 at 00:00 (008717)

From the AOFAS.org website

Released February 16, 1997

Injections used to alleviate heel pain cause symptomatic ruptures in 10% of patients

SAN FRANCISCO - A study presented at the American Orthopaedic Foot and Ankle Society's annual meeting today found one in ten patients
treated for heel pain with corticosteroid injections experience symptomatic ruptures of the plantar fascia, the dense cord of tissue that connects the
heel to the ball of the foot. Long term side effects of plantar fascia ruptures can include strain and discomfort in the arch, stress fracture, swelling, toe
deformities, and/or an awkward change in gait or posture to reduce pain.

Plantar fasciitis, or heel pain, is the single most common foot problem seen by orthopaedic surgeons and affects over two million Americans annually.
Conservative, non-surgical treatment of heel pain provides satisfactory results for 90% of these patients, and corticosteroid injections are a
commonly prescribed element of this treatment.

'Orthopaedists and other physicians need to be aware of the relatively high frequency of rupture that results from these injections,' explained Jorge I.
Acevedo, M.D., Atlanta, Georgia, presenter of the study, 'and make certain that their patients are aware of the painful side effects that can
accompany these ruptures.'

Dr. Acevedo went on to explain that the side effects can be very difficult to relieve. After a twenty five month follow up of the study's patient
population, only 50% rated their treatment and recovery from the rupture as 'good' or 'excellent.' The other half of the patients rated their recovery
as 'fair' or 'poor.'

Treatment initially includes a brief (one or two month) immobilization of the injured foot using hard casts or stiff, ski-boot-like braces. Later treatment
involves cross training, stretching and the use of orthotics (flexible shoe inserts). 'Bracing and stretching will help alleviate most symptoms, but
long-term relief is variable and in some cases never achieved,' added Dr. Acevedo.

The study examined seven hundred and sixty-five patients with a clinical diagnoses of plantar fasciitis over a three year period. Researchers were
unable to discover a common thread in the patient population they examined that would help identify those patients most likely to develop long term
symptoms.

Dr. Acevedo, an author and presenter of this study, is a Resident at the Georgia Baptist Medical Center in Atlanta. The study was co-authored by
James L. Beskin, M.D., Peachtree Orthopaedic Clinic, Atlanta, Assistant Clinical Professor, Tulane University, New Orleans.

Dedicated to advancing research and educational objectives in foot and ankle care, the American Orthopaedic Foot and Ankle Society is the leading
medical organization for orthopaedists with a special interest in foot and ankle problems.


Re: Cortisone Shots in the Heel--More evidence for not doing it!

Bea on 7/15/99 at 00:00 (008722)

Thanks for putting that on the board. It just goes to show you it is all a crap shoot. Good luck to everyone.

Re: Cortisone Shots in the Heel--More evidence for not doing it!

Bea on 7/15/99 at 00:00 (008722)

Thanks for putting that on the board. It just goes to show you it is all a crap shoot. Good luck to everyone.