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cortisone

Posted by Lara T on 10/05/02 at 21:52 (096956)

What experiences have people had with cortisone shots for heel spurs/PF?

Re: cortisone

Jan H on 10/06/02 at 12:57 (096977)

I have had 6 shots in one foot and 5 in the other. The first shot I had seemed like a miracle cure. As soon as the POD was done giving me the shot the pain vanished. (by the way, most people think these shots are pretty painful) About a month later the pain came back and as I went for each shot the pain control lasted less and less time until the last one which seemed to make the pain worse than ever. I have heard of some people who had one shot and the pain never returned. I think it is an option to at least try it.

Re: cortisone

Pauline on 10/06/02 at 17:57 (096982)

Jan,
I agree with you that Cortisone is an option that can be tried. I think most doctors realize the complications that can occur and probably inform their patients. Patients should certainly ask their doctors questions about the use of this drug as well as any others given to them.

I don't recall any discussion about the amount (dose and type of Cortisone usually injected by doctors and perhaps the differences you noticed were directly related to each individual dose you received. Maybe the amounts delivered were all different. I wonder what is considered the 'standard' amount to be injected.

I too having had injections from different physicians definitely noticed differences in how my foot reacted to each. On one occassion the amount injected turned the bottom of feet into rockers. At least that is the way they felt. All but one of my injections were made directly into the bottom of my feet. Only one doctor injected from the side. The amount injected was small compared to the others and I noticed very little relief or numbness from the anesthetic used with it.

Dosage and type must definitely play a role in how much relief can be achieved using this drug. Personally, I like the double needle method delivered directly into the bottom of my foot the best. The first injection provided the anesthetic and then the second one was used to deliver the Cortisone deeper and in multiple locations. I found this delivery seem to provide me more and longer lasting relief.

I personally wouldn't discourage anyone from trying a Cortisone injection, but at the same time I'd make them responsible to learn all then can about it before they make their decision. Reading Scott's book is a must for all P.F. sufferers.

Re: cortisone

Dr. Z on 10/06/02 at 21:01 (096986)

Hi

There is nothing wrong with using a local steriod injections for acute insertional plantar fascia with or without a spur formation. Some things to consider are whether the pain is localized or what is called a trigger point. A localized trigger point injection can be very effective. Now if the pain and the examination reveal that the trigger point area is all over the heal then a local injection may not be effective and can make things worse

Types of injections or what is called short and long acting steriod medications are important. I prefer depo- medrol 20 mgs per cc mixed with a local anesthesic such as lidocaine plain. This is a long acting steriod injection. Very important to use a local anesthetic or the injection will be very painful.

In addition to the local steriod injections a strapping or orthosis at the same time is important. Many time the injection will fail due to no support of the pf so the repetitive trauma continues. You must modify your activity at the time of the injection and for at least two weeks.

What you don't want to do is have repeated local steriod injections with hope of relief or cure when the initial injection had no pain reduction.
Multiple local steriod injections can lead to rupture of the plantar fascia

Re: cortisone

Dr. Z on 10/06/02 at 21:03 (096987)

The use of a steriod injection in your case can lead to plantar fascia rupture. It is very important the support or biomechanical control of the plantar fascia after the injection is added or the condition can be made worse or at the least return return return

Re: cortisone

Jan H on 10/06/02 at 12:57 (096977)

I have had 6 shots in one foot and 5 in the other. The first shot I had seemed like a miracle cure. As soon as the POD was done giving me the shot the pain vanished. (by the way, most people think these shots are pretty painful) About a month later the pain came back and as I went for each shot the pain control lasted less and less time until the last one which seemed to make the pain worse than ever. I have heard of some people who had one shot and the pain never returned. I think it is an option to at least try it.

Re: cortisone

Pauline on 10/06/02 at 17:57 (096982)

Jan,
I agree with you that Cortisone is an option that can be tried. I think most doctors realize the complications that can occur and probably inform their patients. Patients should certainly ask their doctors questions about the use of this drug as well as any others given to them.

I don't recall any discussion about the amount (dose and type of Cortisone usually injected by doctors and perhaps the differences you noticed were directly related to each individual dose you received. Maybe the amounts delivered were all different. I wonder what is considered the 'standard' amount to be injected.

I too having had injections from different physicians definitely noticed differences in how my foot reacted to each. On one occassion the amount injected turned the bottom of feet into rockers. At least that is the way they felt. All but one of my injections were made directly into the bottom of my feet. Only one doctor injected from the side. The amount injected was small compared to the others and I noticed very little relief or numbness from the anesthetic used with it.

Dosage and type must definitely play a role in how much relief can be achieved using this drug. Personally, I like the double needle method delivered directly into the bottom of my foot the best. The first injection provided the anesthetic and then the second one was used to deliver the Cortisone deeper and in multiple locations. I found this delivery seem to provide me more and longer lasting relief.

I personally wouldn't discourage anyone from trying a Cortisone injection, but at the same time I'd make them responsible to learn all then can about it before they make their decision. Reading Scott's book is a must for all P.F. sufferers.

Re: cortisone

Dr. Z on 10/06/02 at 21:01 (096986)

Hi

There is nothing wrong with using a local steriod injections for acute insertional plantar fascia with or without a spur formation. Some things to consider are whether the pain is localized or what is called a trigger point. A localized trigger point injection can be very effective. Now if the pain and the examination reveal that the trigger point area is all over the heal then a local injection may not be effective and can make things worse

Types of injections or what is called short and long acting steriod medications are important. I prefer depo- medrol 20 mgs per cc mixed with a local anesthesic such as lidocaine plain. This is a long acting steriod injection. Very important to use a local anesthetic or the injection will be very painful.

In addition to the local steriod injections a strapping or orthosis at the same time is important. Many time the injection will fail due to no support of the pf so the repetitive trauma continues. You must modify your activity at the time of the injection and for at least two weeks.

What you don't want to do is have repeated local steriod injections with hope of relief or cure when the initial injection had no pain reduction.
Multiple local steriod injections can lead to rupture of the plantar fascia

Re: cortisone

Dr. Z on 10/06/02 at 21:03 (096987)

The use of a steriod injection in your case can lead to plantar fascia rupture. It is very important the support or biomechanical control of the plantar fascia after the injection is added or the condition can be made worse or at the least return return return