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Plantar cortisone injections: Painful?

Posted by Don on 8/02/05 at 11:51 (179737)

I have been in treatment for plntar fasciitis for over a year. I wear night splints, ice my foot, wear custom-made Amfit orthotics at all times, stretch my calves religiously, and did physical therapy (with ultrasound) for two months. I walk an hour or more a day.

1) Should I never walk barefoot even in my home? No slippers either, even?

2) The orthopedic Nurse practitioner is suggesting a cortisone shot. Is this a good treatment? There seems to be a lot of disagreement about that. MUST it be painful?? On one web site Doctors Biehler and Zuckerman suggest that it needn't be. The nurse insists that little can be done about the pain (besides mixing some anesthetic in with the cortisone). I asked about numbing the foot and was told, that it is an injection in the foot either way. Is he right, ignorant, or simply unwilling to be bothered?

3) There seems to be a difference of opinion about the value of rest. I would hate to stop walking, as i have lost 20 pounds by walking every day, and feel great. other exercise (like swimming or biking) does not appeal to me.)

Thank you!

Re: Plantar cortisone injections: Painful?

LindaV on 8/02/05 at 13:24 (179744)

I may be wrong, but for me, the pain of the cortisone shots were directly proportional to the amount of inflammation my feet had. I had SEVERE pf when I got my first injection (mixed with anesthetic). I am pretty tough, but I sounded like a woman in labor. The doctor promised the second shot a month later would be better, and he was right. The third one was easy. And the first (and only) shot in my left foot was ok. I did not require any more. My doctor is conservative. I am POSITIVE that if I could have walked an hour, he would NO WAY have done it. There are risks involved.
As for barefeet...I have been told its a no-no for me the rest of my life. One weekend I was feeling pretty good and didn't wear my sneakers and otc orthotics....guess what? I paid for it. I wear custom orthotics in a good slipper made by Hush Puppies,and it works for me.
I agree with you walking is a great exercise, and I miss that I can't do the 25 miles a week I used to....but, hey...I could be a lot worse off.

Re: Plantar cortisone injections: Painful?

Dr. Zuckerman on 8/02/05 at 14:04 (179749)

If the area is very tender then a local posterior nerve block is what I use. The doctor must be willing to take measure that can and does make this a very comfortable injection procedure

Re: Plantar cortisone injections: Painful?

Robert B. on 8/03/05 at 06:46 (179785)

If it is your right foot, take someone to drive for you if your Dr. does a nerve block, I didn't and almost put myself through the windshield when I stepped (HARD!!) on the brake because I couldn't feel the pedal..........

Re: Plantar cortisone injections: Painful?

John H on 8/03/05 at 09:45 (179816)

Certainly pain from a cortisone shot is some real pain but last for most people no more than a couple of seconds. Most of us can deal with that. Prior to the shot take a very deep breath and exhale as the Doctor gives the shot. It will be over by the time you have exhaled. Pain for me is often in direct proportion to what I expect it to be.

Re: Plantar cortisone injections: Painful?

John H on 8/03/05 at 10:00 (179817)

Don: My experience is to keep walking if the pain is not to bad. I have read many times do not 'ever' go barefoot. I often go barefoot for a shortwhile in the house but generally wear birk sandals as houseslippers. Personally, I think a cortisone shot is worth a try but that is between you and your Doctor. Some people report some long term relief. Others only a few days relief. The injection is really not that bad and only last for a couple of seconds. I have not heard of anyone getting an injection to prevent pain from an injection for PF. I have had 3 injections over 9 years. Do not let the fear of pain from the shot stop you. I have not found that rest helped much unless I was in some very bad state. In fact after walking three miles my feet feel better than before I started walking. Keeping the weight off is great and losing 20 lbs may very well help with your PF. I think I would want a Podiatrist to give me the PF shot as they do them all the time and practice makes perfect so they say. The Nurse probably does fewer than 1 a month on the foot.

Re: Plantar cortisone injections: Painful?

nicole m on 9/06/05 at 11:48 (182083)


I had a coritsone shot and yes it was painful, but now my foot is virtually pain free (after a horrible summer of a really sore foot). The shot pain in my opinion is worth it!!!!! How long does the cortisone last and what are the risks???

Re: Plantar cortisone injections: Painful?

John H on 9/06/05 at 14:59 (182103)

Nicole: Do not be misled into thinking you are cured. These shots somtimes help people for months and on a rare occasion the pain does not return. For others, the pain returns in a few days or weeks. I would suggest you still go softly with your feet and not treat them as though they are cured.