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Cortisone Shots

Posted by elvis on 7/22/05 at 01:47 (178832)

Cortisone shots in the heel are a piece of cake. The injection time is short enough that by the time you're ready to scream the shot is over. I had two shots in my 4th and 5th metatarsal area and those darned things hurt much worse than the heel shot because the doctor had to manipulate my foot after the needle was in so that he could shove the needle into the metatarsal joint! Ouch!!!

How would you like to get a cortisone shot in the shoulder? That must really hurt like a female dog! :-)


Re: Question for Julie (or anyone else) regarding taping

Julie on 5/01/05 at 16:04 (174040)

Hello KW

Taping was important for me, and I'm happy to share my experience of it with you. I was first taped by my podiatrist - a full, complex wrapping job. It was helpful, but soon afterwards I found Scott's much simpler techniques in the heel pain book Taping in that way was much easier (and cheaper!) and equally helpful, so I continued with it until after my PF was healed. (That took about 5-6 months, and I continued taping for another 2-3 months until I was sure I no longer needed to.)

The important thing is getting the tension right: too loose and the tape won't give adequate support, too tight and it will hurt. You will need to experiment, and it may take several tries before you get it right, so be patient. I found that if I flexed my foot too strongly the tape was too loose when I stood up and walked (no support) but if I held my foot in neutral, neither dorsiflexed nor plantarflexed, it was too tight. It's not possible to say what will be right for you, but as you have had trouble with your night splint I would start out with your foot fairly strongly dorsiflexed and go from there, moving towards neutral if you find it too loose. The tape, once applied, should feel firm and supportive, comfortable when you walk (once you are used to it) and you should have less pain.

Use a good quality tape - it's not very expensive if you use Scott's simple technique which isn't especially tape-intensive, and you want a tape that will hold its tension and give support throughout a day's activities. Leuko tape is very good, and is available on line.

Remove the tape at night so that the skin can breathe and heal. This is an instruction that Scott gives and I think it's very important: the skin weakens if the tape remains on overnight or for several days, especially if it gets wet - one more reason why self- taping with a simple technique can be more useful than a professional job (with all due respect to the professionals, including my own podiatrist, I did NOT like the way my skin looked, or smelled, for that matter, after being encased in tape for four days).

So the watchwords are: good quality tape, the correct tensioning, and perseverance. Don't expect miracles, but if taping works for you you can expect some relief of pain, and if you get relief of pain you can assume that the fascia is being 'rested' and getting a chance to heal.

Shortly after I started taping I got orthotics, and used them as well as the tape. I also used an elastic ankle brace when I felt I needed extra support, and that was helpful too.

Don't hesitate to ask questions once you've had a go.

Re: Question for Julie (or anyone else) regarding taping

KW on 5/01/05 at 18:29 (174051)

Brilliant Julie! Thank you. I will see where this takes me. Did you ever try a night splint? I'm wondering if the two could be used in conjunction?

Re: Question for Julie (or anyone else) regarding taping

Julie on 5/02/05 at 03:10 (174066)

No, I didn't use a night splint. It was offered by my podiatrist as one of several possible treatment options, but I never got round to it because the mixed bag of treatments I developed (relative rest, taping, orthotics, Birkenstocks, and better walking shoes) began quite soon to be effective, it didn't feel as though I needed to do anything else. But I've always liked the principle behind the night splint: keeping the foot gently dorsiflexed so that the fascia, achilles tendon, and calf muscles are held in a gently elongated position to prevent the inevitable tightening of those structures overnight.

When you say 'I wonder if the two ( taping and night splint) could be used in conjunction, do you mean together, at night? If so, the answer is probably no: the purpose of the night splint is as above; taping is for reducing tension on the fascia during weightbearing.

But if you mean would it make sense to tape during the day and use the night splint at night, yes.

Re: Question for Elvis

KR on 7/22/05 at 21:59 (178902)

Elvis, What kind of pain were you having to have to get a shot in your 4th and 5th metatarsal area? I am having pain in that area on one for the first time for about a week now and it just keeps getting worse as the days go on. My pain is an intense, stinging feeling. Came on after a massage was done by a licensed massage therapist. Pain is all the time, not just when walking. Just wondering what might be going on. Thanks!

Re: KR....Metatarsal Pain

elvis on 7/23/05 at 17:13 (178941)

After my cast came off last summer I started having all sorts of pains in my foot that I never ever had before. In January this year I tried walking about a half mile and it really started hurting bad on the top of my foot on the lateral side (behind the pinky toe and the ring (?) toe) . It started getting gradually worse. Like the heel pain with pf, it hurts alot upon the first few steps out of bed in the morning. When I got relief from the dotor's tape job and got fit for my new rigid orthotics I told the doctor about the metatarsal pain and he was pretty sure (not aboslutely positive Ralph!!! :-) )that the metatarsal pain was caused by a change in gait (limping) that I had developed from the heel pain due to pf. I started walking more and now I can basically walk for 2-3 miles with no flare up in pain in my heel. However, my metatarsal area in the middle of my foot and up near the base of my leg in the front and around the outside right under my ankle still hurt. I've gotten my orthotics adjusted 2 times now and somedays my heel feels pretty darned good. Somedays it hurts a little. This seems to be a common observation from reading this site. Also, the pain in the metatarsal area could be masking a milder pain in my heel although I swear that my heel is much less sensitive when I poke it with my finger. Before it always hurt when I pushed on my heel. There's an infamous Three Stooges scene where curly has a sever toothache. So Moe stomps as hard as he can on Curly's foot who immediately forgets about his toothache and tends to his foot. I think they call that relative pain! :-)

It took a couple of years to develop and I'm now into 19 months being hampered by this dreaded pf. Actually I'm grateful that it is mor of a nuisance for me and not what I would call a debilitately problem.

Good luck to you.

Re: KR....Metatarsal Pain

elvis on 7/23/05 at 17:20 (178943)

KR....forgot to say that when I got fitted for my orthotics the doctor gave me a shot of cortisone in my 4th and 5th metatarsal joints and it hurt like a SOB!!! I did however get rid of the pain in that area immediately.

Re: KR....Metatarsal Pain

KR on 7/24/05 at 13:17 (178991)

After you got the shot and the pain went away immediately - did the same type of pain come back eventually? Did you ever have pain in your toes? Heard the shot for that area of your foot is no fun! Did they give you the shot through the top of your foot or the bottom of your foot?

Re: KR....Metatarsal Pain

elvis on 7/26/05 at 18:32 (179180)

KR.......The pain has not come back in the area that I got the shot. My toes have never hurt. The metatarsal shot went in on the top of the foot.

Re: KR....Metatarsal Pain

KR on 7/27/05 at 07:33 (179227)

Elvis, I know there are risk with all treatments, but do you know if there is a risk for this type of shot, for example, with the cortisone shot in the heel for PF, there is a risk for rupture. Do you know the risks for the metatarsal shot?

Re: KR....Metatarsal Pain

elvis on 7/27/05 at 21:06 (179286)

No, but I think the risk is minimal at least for one shot. I didn't ask though.

Re: KR....Metatarsal Pain

KR on 7/28/05 at 08:02 (179306)

Thanks Elvis! I appreciate your input!