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let's talk about injections again

Posted by boltthrow on 8/16/01 at 17:41 (056937)

pf for 2.5 years now, been 'managing' it with 2nd set of custom orthotics (after trying lotsa OTC inserts, having arches taped by Pod, stretching, etc etc) but still can't go running, have to be careful with stretching, can only do the elliptical machine at the gym for ~18 minutes.

MY POINT IS: what about cortizone injections? my business partner swore it cured his running injury (even his Pod said 'Yeah orthotics are really only for prevention'). And yet injections are regarded on this board as second only to violent shark attack/sudden collapse of civilization in the pain category. so pls feel free to jump in with your opinions...

thanks, dan

Re: let's talk about injections again

Julie on 8/17/01 at 01:53 (056964)

Dr Z observed a few days ago that if a steroid injection 'works', i.e. if it results in the PF going away for good, it probably wasn't PF in the first place. So cortisone might well have cured your partner's running injury but still not cure your pf (if that's what you've got, and you seem to know).

Orthotics aren't only for prevention, but for ongoing control of the biomechanical fault they were made to address. If they were correctly constructed and are right for you, you should continue with them, but they clearly aren't the whole solution for you. Could you elaborate a bit on the 'etc. etc.' please? What treatments have you followed besides being taped, and stretching (what stretching? )

Re: let's talk about injections again

Paula G. on 8/17/01 at 07:29 (056971)

I have had two cortisone shots. The first one was a life saver for me.
It was last November. It got me through six weeks of wonderful pain free holidays.
Then it began hurting again, and I injured my foot.
I had another shot this June and it did not even last a week. In fact, I have pain in the side of the heel there where I got the shot.
You will find on here that every treatment is a success for some, a failure for others. There is no treatment that is 100 per cent for all of us.
The shot is probably worth trying in my opinion.

Re: let's talk about injections again

Chris L on 8/17/01 at 08:48 (056974)

Dan -

Sounds like Paula and I have had similar results in the cortizone department. I've had 2 shots in the right heel - - the first provided 100% relief for about 3 1/2 weeks; the second, however, provided only about a week of relief.

As for the pain associated with the shots, it is pretty severe for such a simple process. I could hardly walk on the foot for about 2 days after each shot.

Good luck, but if I were you I'd probably pass on the shots.

-Chris

Re: let's talk about injections again

john h on 8/17/01 at 15:05 (057004)

boltthrow: i think there have probably been many people that were given relief and ultimately had the PF depart. i hesitate to say the shot cured them but the results were the same. the shots reduced the inflamation enough for the healing process to take place. i have had two shots and both gave me quick but short term relief. it seems to me that there is a definite place for cortisone shots in the treatment of PF. there is a difference of opinion on how many shots can safely be given in a year. one of our fine doctors gave a very lucid explanation of shots and the different substances used which you should read. it is a recent post and you should search it out on scott's search engine. from the post on this board my observation is that in the early stages of PF shots will probably be more effective. once you have this problem for a couple of years the shots will be less effective. i personally did not find the shots nearly as painful as many have experienced. just take a very deep breath and slowly exhale as the shot is administered and it is over in 5-10 seconds. i will also note that you should have a very definitive sore spot to place the injection because if you can not identify that to your doctor he is shooting in the dark.

Re: let's talk about injections again

Ed Davis, DPM on 8/20/01 at hrmin (057361)

Thanks. The literature sometimes will use two terms: 'acute plantar fasciitis' and 'chronic plantar fasciitis.' We are speaking about, on this web site, 'chronic plantar fasciitis.' Acute plantar fasciitis is really just a strain/sprain of the plantar fascia, often self-resolving.

Individuals who claim 'cures' with one shot of cortisone often have acute plantar fasciitis. Also, there was an infamous plantar fasciitis study designed to bash the orthotic industry in which cheap over the counter inserts were said to be as good as custom devices for plantar fasciitis. The patients in that study had acute plantar fasciitis.
Ed

Re: let's talk about injections again

Julie on 8/17/01 at 01:53 (056964)

Dr Z observed a few days ago that if a steroid injection 'works', i.e. if it results in the PF going away for good, it probably wasn't PF in the first place. So cortisone might well have cured your partner's running injury but still not cure your pf (if that's what you've got, and you seem to know).

Orthotics aren't only for prevention, but for ongoing control of the biomechanical fault they were made to address. If they were correctly constructed and are right for you, you should continue with them, but they clearly aren't the whole solution for you. Could you elaborate a bit on the 'etc. etc.' please? What treatments have you followed besides being taped, and stretching (what stretching? )

Re: let's talk about injections again

Paula G. on 8/17/01 at 07:29 (056971)

I have had two cortisone shots. The first one was a life saver for me.
It was last November. It got me through six weeks of wonderful pain free holidays.
Then it began hurting again, and I injured my foot.
I had another shot this June and it did not even last a week. In fact, I have pain in the side of the heel there where I got the shot.
You will find on here that every treatment is a success for some, a failure for others. There is no treatment that is 100 per cent for all of us.
The shot is probably worth trying in my opinion.

Re: let's talk about injections again

Chris L on 8/17/01 at 08:48 (056974)

Dan -

Sounds like Paula and I have had similar results in the cortizone department. I've had 2 shots in the right heel - - the first provided 100% relief for about 3 1/2 weeks; the second, however, provided only about a week of relief.

As for the pain associated with the shots, it is pretty severe for such a simple process. I could hardly walk on the foot for about 2 days after each shot.

Good luck, but if I were you I'd probably pass on the shots.

-Chris

Re: let's talk about injections again

john h on 8/17/01 at 15:05 (057004)

boltthrow: i think there have probably been many people that were given relief and ultimately had the PF depart. i hesitate to say the shot cured them but the results were the same. the shots reduced the inflamation enough for the healing process to take place. i have had two shots and both gave me quick but short term relief. it seems to me that there is a definite place for cortisone shots in the treatment of PF. there is a difference of opinion on how many shots can safely be given in a year. one of our fine doctors gave a very lucid explanation of shots and the different substances used which you should read. it is a recent post and you should search it out on scott's search engine. from the post on this board my observation is that in the early stages of PF shots will probably be more effective. once you have this problem for a couple of years the shots will be less effective. i personally did not find the shots nearly as painful as many have experienced. just take a very deep breath and slowly exhale as the shot is administered and it is over in 5-10 seconds. i will also note that you should have a very definitive sore spot to place the injection because if you can not identify that to your doctor he is shooting in the dark.

Re: let's talk about injections again

Ed Davis, DPM on 8/20/01 at hrmin (057361)

Thanks. The literature sometimes will use two terms: 'acute plantar fasciitis' and 'chronic plantar fasciitis.' We are speaking about, on this web site, 'chronic plantar fasciitis.' Acute plantar fasciitis is really just a strain/sprain of the plantar fascia, often self-resolving.

Individuals who claim 'cures' with one shot of cortisone often have acute plantar fasciitis. Also, there was an infamous plantar fasciitis study designed to bash the orthotic industry in which cheap over the counter inserts were said to be as good as custom devices for plantar fasciitis. The patients in that study had acute plantar fasciitis.
Ed