Corticosteroid injections are a common treatment for plantar fasciitis. They are usually injected at the source of pain, the attachment of the plantar fascia to the heel bone. The aim of a corticosteroid injection is to reduce inflammation and thickening of the fascia and pain. Historically, corticosteroid injections have been used very frequently to treat plantar fasciitis.
Are Corticosteroid Injections Effective?
As corticosteroid injections have been used extensively for a very long time for a wide range of musculoskeletal conditions, including plantar fasciitis, there is actually a lot of published research investigating their effectiveness. With specific reference to plantar heel pain, overall, the majority of the research indicates that corticosteroid injections are effective in the short term (0-3 months), but ineffective in the long term (>3 months) as in most cases the heel pain recurs.
Are Corticosteroid Injections Safe?
Steroid injections come with their risks. The most concerning risk is a subsequent rupture of the plantar fascia. According to studies, the rupture risk following a single corticosteroid injection appears to be to between 5%-10% and the risk of rupture increases with repeated injections. Another significant risk is thinning of the fat pad of the heel, which means the heel has less fat pad available to aid in shock absorption.
Corticosteroid injections often provide a good short term solution by reducing acute pain however they do not address the underlying cause of the problem and if used, should therefore, always be an adjunct treatment along with other treatments such as exercise prescription, night splints, orthoses, suitable footwear and weight loss.