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Cortisone advice, dr. Z?

Posted by Jan on 5/22/01 at hrmin (048579)

I'm a two-year suffer that have tried everything but cortisone/surgery. I have tried for pairs of orthotics along with all the various PT and NSAIDs to no avail. (Not an unusual story.) Anyway, I'm at the point of considering injections but am still hearing so much mixed information. First of all, where's the best place to put the needle? I've heard some to do it from the side of the arch, some to the bottom were the pain is, and some to the top of the foot. How do you know which is correct?

Also, Dr. Z., you mentioned something about 8 percent chance of rupture after the second shot. Is this because the shot itself ruptures the facia or is it because the patient starts to walk around too much because they can't feel pain? If you can't feel pain, how are you ever supposed to know if you are cured or not? And how long does it takes to know if you are?

Please e-mail responses to me directly at:jcooper@gers.com Any information is appreciated.

Re: Cortisone advice, dr. Z?

Dr. Zuckerman on 5/22/01 at 13:29 (048582)

Local steriod injections can weaken the attachment of the plantar fascia due to the reaction of steriods to the healing process. In addition if can make you feel better and thus you go out and do the Tango or run 50 miles. Either way rest is part of the injection strapping, stretching, proper shoes. evaluation for biomechanical orthosis are important.

As to the placement of a local steriod injection I prefer the side approach instead of the bottom approach.

Re: Cortisone advice, dr. Z?

jeffrey.N on 5/23/01 at 01:06 (048612)

In response to Jan at jcooper@gers.com

Several years ago I had a very painful heal spur, being fearful of what I'd heard about cortisone injections, I looked for alternatives. My local GP prescribed a course of anti-inflammatory tablets (Naprosen 500) which I took regularly. After 6 weeks I was walking without pain and have had only one slight recurrence in 7 years, again a course of Naprosen eliminated the problem. May be worth a try. Worked for me. Good luck.

Re: Cortisone advice, dr. Z?

Caroline L. on 7/05/01 at 14:19 (052297)

I too have a very painful heel spur and was prescribed Naprosen 500. I have been taking it for about three weeks now and believe it has helped some. Just how long did you take it when you stated that you took a course of it?

Re: Cortisone advice, dr. Z?

Dr. Zuckerman on 5/22/01 at 13:29 (048582)

Local steriod injections can weaken the attachment of the plantar fascia due to the reaction of steriods to the healing process. In addition if can make you feel better and thus you go out and do the Tango or run 50 miles. Either way rest is part of the injection strapping, stretching, proper shoes. evaluation for biomechanical orthosis are important.

As to the placement of a local steriod injection I prefer the side approach instead of the bottom approach.

Re: Cortisone advice, dr. Z?

jeffrey.N on 5/23/01 at 01:06 (048612)

In response to Jan at jcooper@gers.com

Several years ago I had a very painful heal spur, being fearful of what I'd heard about cortisone injections, I looked for alternatives. My local GP prescribed a course of anti-inflammatory tablets (Naprosen 500) which I took regularly. After 6 weeks I was walking without pain and have had only one slight recurrence in 7 years, again a course of Naprosen eliminated the problem. May be worth a try. Worked for me. Good luck.

Re: Cortisone advice, dr. Z?

Caroline L. on 7/05/01 at 14:19 (052297)

I too have a very painful heel spur and was prescribed Naprosen 500. I have been taking it for about three weeks now and believe it has helped some. Just how long did you take it when you stated that you took a course of it?