Plantar Fasciitis Injection

Plantar fasciitis means inflammation of your plantar fascia. The plantar fascia is a band of tissue that connects your heel bone to the base of your toes. It is a condition that affects around one in ten people at some point in their lives. It's also known as 'jogger's heel' - although you don't have to be a runner to develop it. Luckily, it usually gets better in time, but treatment may speed up your recovery. This information will explain what it is, Dr. Singer can determine if an injection is for you.

What is the plantar fascia?
Your plantar fascia is a strong band of tissue (like a ligament) that stretches from your heel (calcaneum) to your middle foot bones. It supports the arch of your foot and also acts as a shock absorber in your foot.

What causes plantar fasciitis?
Repeated small injuries to the fascia (with or without inflammation) are thought to be the cause of plantar fasciitis. The injury is usually near to where the plantar fascia attaches to your heel bone. Pain is one of the main symptoms of plantar fasciitis. The inflamed plantar fascia can hurt when you put pressure on the foot while walking. This pain can be anywhere on the underside of your heel. However, commonly, one spot is found as the main source of pain. This is often about 4 cm forward from your heel and may be tender to touch. The pain is often worst when you take your first steps on getting up in the morning, or after longterm rest where no weight is placed on your foot. Often, it's described as a stabbing or aching pain. Gentle exercise may ease things a little as the day goes by. However, a long walk or being on your feet for long periods often makes the pain worse. Resting your foot usually eases the pain - this can be very frustrating for people who are trying to improve their fitness levels by taking up running! Sudden stretching of the bottom of your foot may make the pain worse - for example, walking up stairs or on tiptoes. You may limp because of pain. Some people have plantar fasciitis in both feet at the same time.

How is plantar fasciitis diagnosed?
Your doctor can usually diagnose plantar fasciitis just by talking to you and examining your feet. Rarely, tests are needed if the diagnosis is uncertain or to rule out other possible causes of heel pain. These can include X-rays of the heel (usually done to rule out other causes of pain rather than to diagnose plantar fasciitis) or an ultrasound scan of the fascia. An ultrasound scan usually shows thickening and swelling of the fascia in plantar fasciitis.

How is plantar fasciitis treated?
If the above treatments are not helping to relieve your symptoms, or if you are someone such as an athlete who needs a quick recovery, other treatments are available. There is no one specific treatment for plantar fasciitis that appears to stand out as the best.

Steroid injections
A steroid (cortisone) injection is sometimes tried if your pain remains bad despite the above 'conservative' measures. 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. Steroid injections do carry some risks, including (rarely) tearing (rupture) of the plantar fascia and for this reason they are less commonly done these days. Injections can be used to treat plantar fasciitis, a common cause of heel pain in adults. Cortisone injections, a type of steroid, can reduce pain and inflammation in the plantar fascia for up to six months. However, they don't cure plantar fasciitis and should be administered sparingly, no more than twice a year. Repeated injections can damage cartilage and weaken tendons, and multiple injections can cause the plantar fascia to rupture.

After the injection
The numbing effect usually lasts a few hours, after which heel pain may return temporarily. The steroid should relieve pain over the next several days to months, but patients may experience worsening symptoms during the first 24 to 48 hours. This is called a steroid flair and can be treated with ice and NSAIDs like ibuprofen or naproxen. Patients should also avoid strenuous activity involving the injected area for at least 48 hours and should refrain from extreme heat like saunas or steam rooms. The injection site may be sore for up to 48 hours, and patients can take their usual painkillers or anti-inflammatory tablets as advised by Dr. Singer. This information is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects.