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cortisone injections

Posted by lauriel on 9/12/00 at 07:23 (027989)

I have been diagnosed with heel spur due to flat feet. My doc doesn't recommend orthodics. He has given me two cortisone injections, with the second giving me no relief. He wants to do this again within two weeks. I am concerned that this is unhealthy and want to know if there is a limit on number of cortisone injections a patient should have

Re: cortisone injections

Dr. Biehler on 9/12/00 at 10:29 (028006)

The number of shots depends on the type, amount and locations of the shots. A second shot is sometimes given if a short acting steroid was used and there was marked improvement but the steroid didn't last long enough to get the job done. If a shot was give and it didn't help, I would not be giving another shot.

Re: cortisone injections

Dr. Zuckerman on 9/12/00 at 12:24 (028017)

Go to the article on this web site about the dangers of giving two shots of steriods. There is about a 10% risk of rupture of the pf fasica with just two shots of steriods. Most of the ruptures happened after two months from the second shots. So two is the limit in my office.

Re: cortisone injections

lauriel on 9/13/00 at 06:47 (028075)

i'm not clear as to why you would not recommend another shot. the first cortisone injection i received gave me 100% relief for two months. I was expecting same. since i did not get immediate relief from the second shot, my ortho doc said to try another shot within two weeks. my concern is not rupturing the pf, but cortisone absorption. I have always been under the impression that cortisone should be given conservatively. I am willing to try again, because my pain is severe. You didn't address my question re: orthodics. Success rate? type? my doc says it will be a waste of time and $$$.

Re: cortisone injections

Dr. Zuckerman on 9/14/00 at 19:31 (028236)

If your foot has excessive pronation in addition to flat feet then biomechanical orthosis are a good thing to have in your shoes. Taping the foot into neutral positon is one way to determine if your foot can tolerated the biomechanical control that the orthosis will provide .

Re: cortisone injections

Dr. Biehler on 9/12/00 at 10:29 (028006)

The number of shots depends on the type, amount and locations of the shots. A second shot is sometimes given if a short acting steroid was used and there was marked improvement but the steroid didn't last long enough to get the job done. If a shot was give and it didn't help, I would not be giving another shot.

Re: cortisone injections

Dr. Zuckerman on 9/12/00 at 12:24 (028017)

Go to the article on this web site about the dangers of giving two shots of steriods. There is about a 10% risk of rupture of the pf fasica with just two shots of steriods. Most of the ruptures happened after two months from the second shots. So two is the limit in my office.

Re: cortisone injections

lauriel on 9/13/00 at 06:47 (028075)

i'm not clear as to why you would not recommend another shot. the first cortisone injection i received gave me 100% relief for two months. I was expecting same. since i did not get immediate relief from the second shot, my ortho doc said to try another shot within two weeks. my concern is not rupturing the pf, but cortisone absorption. I have always been under the impression that cortisone should be given conservatively. I am willing to try again, because my pain is severe. You didn't address my question re: orthodics. Success rate? type? my doc says it will be a waste of time and $$$.

Re: cortisone injections

Dr. Zuckerman on 9/14/00 at 19:31 (028236)

If your foot has excessive pronation in addition to flat feet then biomechanical orthosis are a good thing to have in your shoes. Taping the foot into neutral positon is one way to determine if your foot can tolerated the biomechanical control that the orthosis will provide .