Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Can cortisone shots 'kill' the fat pad in my heel?

Posted by Lisa C. on 5/06/01 at 22:32 (046843)

I tried vioxx, celebrex, over the counter meds, 2 kinds of shoe inserts and decided to get the cortisone shots for my PF. My pod gave me a shot in one heel and I yelled and pulled my foot away before she could finish. I have a high pain threshold and had no problem with coritsone in my shoulder once for bursitis. I decided to go to the ortho that gave me the shoulder cortisone, thinking that he was a better 'shooter'. He told me that he never shoots cortisone in the heel because it can cause necrosis of the fat pad in the heel. Which he said would be a worse problem then the PF. I can't find any mention of this in any postings. Is 'death' of the heel fat pad even a remote risk of cortisone injections? I am going to start PT and I am stretching at home. (Ortho recommended both, why didn't the pod mention either?) I wear Mephisto sandals at home ALL the time. I was excited about the Ossa Tron, but as usual I am worried about the risks, such as PF tearing , blood vessel damage.. What are the real risks of both treatments? Can you put a % on them? Thank you for your time. Lisa C.

Re: Can cortisone shots 'kill' the fat pad in my heel?

Dr. Biehler on 5/07/01 at 12:19 (046908)

There is the possibility of cutanious atrophy ( skin ) at the injection site. I have seen this when a patient has presented after recieving a sreies of 5 coretizone shots in the same area in a very short period of time. This could also have been brought on by the type of cortizone that was being used. The shots are used ( different mixtures ) for different problems in the heel, ie. bursitis, plantar fasciitis, etc, and can be used in acute cases to help reduce the inflamation and pain. The type of cortizone and or the mixtured used can be very important. Dr. B.

Re: Can cortisone shots 'kill' the fat pad in my heel?

Lisa C. on 5/07/01 at 22:40 (046985)

Thank you for your quick response! How do I find out what mixture I need for my PF? I also was one of those to experience the most horrific pain ever with the 1/2 injection of cortizone I received before pulling my foot away in pain. The pod said that she must have hit the inflammed area & that is why it hurt sooo bad. (I can take botox & collagen without batting an eyelash) I did not have the area numbed ahead of the needle. If I have just one injection in each foot, and it is the right mixture is there NO (zero) risk of fat pad atrophy?... Is there a PF specialist in the Walnut Creek/Concord/Danville Area? Or anywhere nearby? Thanks again for your time!!!
Lisa C.

Re: Can cortisone shots 'kill' the fat pad in my heel?

Dr. Biehler on 5/07/01 at 12:19 (046908)

There is the possibility of cutanious atrophy ( skin ) at the injection site. I have seen this when a patient has presented after recieving a sreies of 5 coretizone shots in the same area in a very short period of time. This could also have been brought on by the type of cortizone that was being used. The shots are used ( different mixtures ) for different problems in the heel, ie. bursitis, plantar fasciitis, etc, and can be used in acute cases to help reduce the inflamation and pain. The type of cortizone and or the mixtured used can be very important. Dr. B.

Re: Can cortisone shots 'kill' the fat pad in my heel?

Lisa C. on 5/07/01 at 22:40 (046985)

Thank you for your quick response! How do I find out what mixture I need for my PF? I also was one of those to experience the most horrific pain ever with the 1/2 injection of cortizone I received before pulling my foot away in pain. The pod said that she must have hit the inflammed area & that is why it hurt sooo bad. (I can take botox & collagen without batting an eyelash) I did not have the area numbed ahead of the needle. If I have just one injection in each foot, and it is the right mixture is there NO (zero) risk of fat pad atrophy?... Is there a PF specialist in the Walnut Creek/Concord/Danville Area? Or anywhere nearby? Thanks again for your time!!!
Lisa C.