A steroid (cortisone) injection is sometimes used if your heel pain remains bad despite more conservative remedies. It may relieve the pain in some people for several weeks but does not always cure the problem. It is not always successful and may be sore to have done. Steroids work by reducing inflammation. Sometimes two or three injections are tried over a period of weeks if the first is not successful. Steroid injections do carry some risks, including tearing or rupture of the plantar fascia.
Complications of cortisone shots can include:
- Joint infection
- Nerve damage
- Thinning of skin and soft tissue around the injection site
- Temporary flare of pain and inflammation in the joint
- Tendon weakening or rupture
- Thinning of nearby bone (osteoporosis)
- Whitening or lightening of the skin around the injection site
- Death of nearby bone (osteonecrosis)
- Temporary increase in blood sugar
Limits on the number of cortisone shots:
There’s concern that repeated cortisone shots might cause the cartilage within a joint to deteriorate. So doctors typically limit the number of cortisone shots into a joint.
In general, you shouldn’t get cortisone injections more often than every six weeks and usually not more than three or four times a year.
Warning: If you take blood thinners, you might need to stop taking them for several days before your cortisone shot to reduce your bleeding or bruising risk. Some dietary supplements also have a blood-thinning effect. Ask your doctor what medications and supplements you should avoid before your cortisone shot.
After the cortisone shot:
Some people have redness and a feeling of warmth of the chest and face after a cortisone shot. If you have diabetes, a cortisone shot might temporarily increase your blood sugar levels.
After your cortisone shot, your doctor might ask that you:
- Protect the injection area for a day or two. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. If you received a cortisone shot in your knee, stay off your feet when you can.
- Apply ice to the injection site as needed to relieve pain. Don’t use heating pads.
- Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.
- Don’t use a bathtub, hot tub or whirlpool for two days. You may shower.