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injections - healing or masking the pain?

Posted by anne on 9/25/03 at 00:57 (130957)

hi everyone,

i have a question about cortisone injections - do they help 'heal' PF or do they just mask the pain?

The sports doctor whom I'm seeing recommends that I should have one because it will reduce the inflammation and allow for the next phase of healing to start, but the podiatrist i'm seeing doesn't recommend them because all they do is mask the pain... so now i'm all confused!!

Re: injections - healing or masking the pain?

R C on 9/25/03 at 08:44 (130969)

My layman's opinion is that both are true to some extent.

Inflammation is very often the body's *over-reaction* to injury, inhibiting the healing process to some degree. Thus treating inflammation with cortisone can be helpful. I suspect that it is usually necessary to combine the cortisone treatment with something else, such as orthotics, tape, or casting. This is because the cortisone will not act on the biomechanical aspect of PF.

It is also true that an anti-inflammatory medication (this includes iburofen,too) can mask the pain. The risk is then that the patient returns to a level of activity that aggravates the condition, the warning signs being masked by the medication. This risk can be minimized, if you continue restricting activity level until the injury has healed.

With cortisone shots there are a few other considerations. Improperly admninistered, they can lead to weakening and rupture of the tendon. This is a risk that has to be weighed against potential benefit. Also, cortisone shots (especially if repeated) can have significant systemic side effects, which should be discussed.

Re: injections - healing or masking the pain?

francesc on 9/25/03 at 16:42 (131021)

hi anne,

i got a cortisone injection for PF and now i'm awaiting my orthotics. my podiatrist said that treatment comes in 2 forms: part 1 is to reduce the pain and inflammation with the shot. and part 2 is to treat the biomechanics which is with the orthotics.

a lot of people are really against the shot but, if you take care of yourself and do not overdo it, i believe it is quite a relief. i am still not back to doing any major weight-bearing activities. no running or high-impact activities for me. my doc said to stay off of it until i got my orthotics.

the shot forced me to stay off my feet for 3-4 days which really helped. also, i was beginning to develop PF in my left foot because i was favoring my right foot so much. apparently, this is also quite common.

now i just do my stretching, icing, and i am able to walk and be on my feet for a few hours as long as i haven't tried running or carrying my 35 lb toddler while walking. :-) and i am also wearing only my New Balances and Birkenstocks. but, i wake up pain-free and am 85% better than i was before.


Re: injections - healing or masking the pain?

Ed Davis, DPM on 9/25/03 at 23:07 (131102)

Well stated.

Re: injections - healing or masking the pain?

john h on 9/26/03 at 10:29 (131124)

anne: cortisone injections hopefully reduce inflamation and therby reduce pain. In that the injection sometimes has a substance that may cause a little numbing it may mask pain for a short period. Unfortunately it does not address the problem of what is causing the PF pain and in most cases will not cure it. It is certainly worth a try as some people have received much benefit from the injection. It can be somewhat painful but that only last for a second or so. Just take a deep breath and it will be over before you can say ouch.