Cortisone shots are a common and effective treatment for localized pain in the foot and ankle. These injections deliver powerful anti-inflammatory medication directly to the site of discomfort. They offer relief when conservative treatments, such as rest or physical therapy, have not been successful. The goal is to reduce inflammation in specific tissues, alleviating pain and improving mobility.
Understanding Corticosteroid Injections
A cortisone shot contains a corticosteroid, a potent anti-inflammatory drug, often mixed with a local anesthetic. “Cortisone” is the common name for synthetic versions of cortisol, a hormone naturally produced by the body’s adrenal glands to regulate inflammation and stress response. The corticosteroid mimics this natural hormone to suppress the inflammatory reaction at the injection site. This medication is not the same as anabolic steroids used for muscle building.
The local anesthetic provides immediate, temporary pain relief, but the corticosteroid takes longer to become fully effective. By reducing swelling and inflammation, the injection calms irritated tissues, nerves, or joints. This window of reduced pain can be beneficial for starting physical therapy or other long-term rehabilitation efforts.
Common Foot Ailments Suitable for Injection
Cortisone injections treat several foot and ankle conditions where inflammation causes pain. Because the foot contains numerous small joints and soft tissue structures, the ability to pinpoint the source of inflammation makes this treatment highly valuable.
Plantar Fasciitis
This involves inflammation of the thick band of tissue across the bottom of the foot, often causing heel pain. The injection targets the inflamed fascia near the heel bone to reduce swelling and irritation.
Morton’s Neuroma
This condition involves a thickened, irritated nerve, usually between the third and fourth toes. Corticosteroids injected around the nerve decrease inflammation and reduce the compression causing burning pain and numbness.
Tendonitis and Bursitis
Tendonitis, such as Achilles or posterior tibial tendonitis, can benefit from reduced inflammation in the tendon sheath or surrounding tissues. Injections are also beneficial for various forms of bursitis, where fluid-filled sacs that cushion joints become inflamed.
Arthritis
Localized injections can provide temporary relief for pain associated with arthritis in the small joints of the foot, including ankle osteoarthritis.
What Happens During the Procedure
The cortisone injection is typically a quick, in-office procedure lasting only a few minutes. The area is cleaned with an antiseptic solution to minimize infection risk. For precise placement, the doctor often uses imaging guidance, such as ultrasound or fluoroscopy, especially for deep structures like small joints or nerves.
Imaging allows the clinician to visualize the needle tip in real-time, ensuring the medication is delivered directly into the inflamed tissue. This precision is important for avoiding nearby structures like blood vessels or tendons. The patient may feel a sharp pinch upon insertion.
Once the needle is positioned correctly, the medication mixture is injected, which may cause a feeling of pressure or a brief burning sensation from the local anesthetic. This anesthetic works immediately to numb the area, reducing pain caused by the corticosteroid solution. The process is completed swiftly, and the injection site is covered with a small dressing.
Managing Results and Recovery
Patients are advised to rest and limit weight-bearing activity on the foot for 24 to 48 hours following the injection. This rest allows the medication to settle and begin working effectively. While the immediate pain relief from the anesthetic wears off quickly, the anti-inflammatory effect of the corticosteroid may take three to seven days to fully manifest.
Some people experience a temporary increase in pain, known as a “cortisone flare,” within the first 48 hours. This flare is caused by the injected steroid crystals and can be managed with ice application and over-the-counter pain relievers. The duration of pain relief varies significantly, lasting from several weeks to many months.
Healthcare providers generally limit the frequency of shots because repeated injections can potentially lead to complications like tissue weakening or cartilage damage. It is recommended to receive no more than three or four injections in the same site over a one-year period. The injection is a tool to temporarily reduce pain, creating an opportunity to pursue physical therapy or other treatments for longer-term resolution.