How many cortisone injections do I need when I have heel pain?



Many people have heard that cortisone injections help to treat heel pain, also called plantar fasciitis.  I find one of the most utilized tools that I have in my doctor bag is a cortisone injection.  A cortisone injection can be used anywhere in your body, such as your joints, in your knee, in your hip, in other areas of pain called trigger points, but it is very effectively used in treating the pain from plantar fasciitis.  For example, I had a patient who came in today. She had been going to physical therapy for a number of weeks. She had been stretching and using a night splint. She had gotten new shoes and over-the-counter inserts for her shoes and taking anti-inflammatories and icing her foot.  None of those seemed to get her heel pain better. When she came into the office after seeing her general practitioner and a physical therapist, she ended up needing a cortisone injection, which we did in the office.  The cortisone took away all of her pain on that day and helped to reset the pain circuit, that is the way I kind of explain it to patients, so that she was able to then rest her foot and recover from the illness.  The magic number is usually about three. I try not to give more than three injections in one area in one calendar year because when you do put an injection, it has a few components.  The injections that we put in have a short and long-acting anesthetic, kind of like novocaine, and then a short and a long-acting steroid.  If you put too much steroid or cortisone into a location, it can weaken the tendons and ligaments in the area.  So, typically, the rule of thumb is three to four injections in one year in one location.  You can give them in different locations and it is fine, but we try not to do it in the same location.  

If you found this helpful and would like to learn more about healing different types of heel pain click HERE.