A cortisone shot can be administered in the foot to treat a variety of painful conditions. This common medical procedure involves injecting a medication mixture directly into an affected area, such as a joint or soft tissue. The shot typically contains a corticosteroid, a powerful anti-inflammatory drug, and often a local anesthetic for immediate pain relief. Delivering this combination directly to the site of injury reduces localized inflammation and swelling. This targeted approach aims to calm irritated tissues, providing pain relief that can last for several weeks to months.
Foot Conditions Treated with Cortisone Injections
Cortisone injections are frequently used in the lower extremity to manage pain stemming from specific inflammatory conditions. One of the most common applications is for plantar fasciitis, characterized by inflammation of the thick tissue band running across the bottom of the foot. The injection targets the inflamed tissue near the heel bone to reduce swelling in the fascia, which is often the source of stabbing heel pain experienced, particularly in the morning.
Another use is for Morton’s neuroma, which involves tissue thickening around a nerve, often between the third and fourth toes. The injection works to shrink the inflamed nerve tissue, decreasing compression and the resulting burning or tingling sensation. Similarly, for tarsal tunnel syndrome, where the posterior tibial nerve is compressed near the ankle, the steroid helps reduce inflammation around the nerve and surrounding tunnel structure.
Localized arthritis, including osteoarthritis or inflammatory arthritis in the small joints of the foot, also responds to this treatment. Injecting the corticosteroid directly into the affected joint suppresses the inflammatory response that causes swelling, stiffness, and pain. This targeted relief can offer functional improvement, especially when standard oral medications and physical therapy have not provided sufficient relief.
The Injection Process and Immediate Aftercare
The procedure for a cortisone injection in the foot is typically quick and performed in a doctor’s office. Before the injection, the provider will thoroughly clean the site to minimize infection risk. To ensure the medication is delivered precisely to the inflamed tissue or joint, the provider may use ultrasound guidance, which allows visualization of the underlying structures in real-time.
During the injection, the patient may feel a brief stinging or burning sensation as the needle enters the tissue and the medication is delivered. The local anesthetic mixed with the corticosteroid usually provides immediate numbing, meaning any discomfort from the injection itself quickly subsides. This instant relief is temporary, lasting only a few hours until the anesthetic wears off.
Immediately following the procedure, patients are generally advised to rest the injected foot for 24 to 48 hours and avoid strenuous activity. This initial rest period is intended to allow the corticosteroid to settle and begin its anti-inflammatory action without being displaced by excessive movement. Applying ice to the injection site can help manage any local soreness that may occur after the anesthetic effect wears off.
Potential Risks and Adverse Effects
While generally safe, cortisone injections carry potential risks and side effects, especially when administered in the weight-bearing structures of the foot. A common temporary reaction is a “steroid flare,” a short-term increase in pain, swelling, and irritation that typically occurs within the first 48 hours. This flare is thought to be an inflammatory response to the injected steroid crystals and can usually be managed with ice and over-the-counter pain relievers.
More concerning is the potential for tissue damage, particularly with repeated injections into the same area. Corticosteroids can weaken tendons and ligaments, raising the risk of rupture, such as in the plantar fascia or Achilles tendon. There is also a risk of fat pad atrophy, where the cushioning fat beneath the heel thins out, which can lead to chronic pain due to decreased shock absorption.
As with any injection, there is a small risk of infection at the injection site, requiring immediate medical attention if symptoms like spreading redness, warmth, or fever develop. For individuals with diabetes, cortisone can temporarily elevate blood sugar levels for several days, requiring close monitoring and possible adjustment of their management plan. The injection provides temporary relief but does not correct the underlying mechanical problem, meaning long-term resolution often requires complementary treatments like physical therapy and supportive footwear.