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foot spur and a cortosine shot.

Posted by Derek on 3/19/03 at 21:43 (113587)

I went to the doctors today in regards to the foot pain I have been having for 3 days now. he immediately suggested a shot of cortisone. because this was my first time visiting him and he wasn't a podiatrists, I felt uncomfortable.
I have read the info on your page about the use of cortisone and the intense pain caused by the shot. In your opinion, is it normal for a regular Dr. to offer this on a first visit?
Also, he didn't X-ray my foot either.

Re: foot spur and a cortosine shot.

Dr. Z on 3/19/03 at 21:55 (113589)

Hi

A local steriod injection can be very effective in the early acute phase of plantar fasciitis. I will always x-ray the human foot before any steriod injection is given. There are some podiatrists that feel that that a x-ray isn't needed.
My feeling is that you need to go to a doctor who gives a alots of injections and see alot of plantar fasciits. Very rare for your family doctor to have that experience but it is possible. Taking oral NSAID medication could also resolve your pain it if used in conjunction with taping

Re: foot spur and a cortosine shot.

Dr. David S. Wander on 3/20/03 at 08:14 (113620)

There is some controversey whether an x-ray is needed for every patient presenting with heel pain. Since the majority of patients have plantar fasciitis, and we're all pretty confident the spur isn't causing the pain, the need for x-rays is sometimes questioned. I personally still take an x-ray prior to treatment to rule out other abnormalities. I am rarely ever concerned about the actual spur. Although x-rays don't often change our treatment protocol, once in a while an unusual finding does occur that warrants further investigation.

It is also a myth that cortisone injections must be painful. As per Dr. Z's comments, if the injection is performed by someone with a lot of experience, the injection does not have to be painful and can result in dramatic relief. There is some debate on whether the injection should be given in the side of the foot or bottom of the foot. I can tell you that I've performed injections both ways and if performed correctly, neither method should be associated with much discomfort. The actual method is best left to the individual doctor's preference.

Re: foot spur and a cortosine shot.

RinH on 3/20/03 at 16:55 (113661)

I have been injected twice for a heelspur. I recently went to another doctor who thinks I should go to a sports rehab to have this foot examined because she doesnt seem to think it is the heelspur causing me this much pain.She seems to think it is the Pf. And rehab as well as a antiinflamitory could be a solution since the injections seemed only to be a quick temp fix. Any suggestions on any special shoes or what can be done to eliviate some of this pain? I have to work at least 8 hours a day on my feet. Thank you for any suggestions and if you can you can email me.
Thanks,
Rin

Re: foot spur and a cortosine shot.

Dr. Z on 3/20/03 at 22:17 (113695)

Hi

Local steriod injections are only one phase for treating plantar fasciitis. You need to support the foot with taping. If the taping helps and you have biomechanical foot abnormality then orthosis must be considered. Physical therapy to strenghten and stretch the achillest tendon is very important. I would see a podiatist due to their ability to treat plantar fasciitis with multiple treatment and at the saem time correct any biomechanical problems that may be contributing to your pf pain. I hope that this is very helpful