Cortisone Injections : Why It Should Be A Last Resort

by | Sep 8, 2020 | Heel Spur, Plantar Fasciitis | 0 comments

Cortisone Injections: A Last Resort For Heel Pain

You may have considered it, or you are considering it now, your doctor remains impassive when you bring it up. Cortisone injections have been an option for your heel pain, and it seems like it may be the only choice you have left to treat your heel pain. While you are hoping to avoid that path, but you have heard of miraculous, pain- free days of people who have had it, and it sounds tempting, there are a few reasons why getting a cortisone injection in your heel to treat a heel spur or other heel pain should be treated as a final resort.

What is Cortisone

Cortisone belongs to a family called corticosteroids, or steroids for short. The corticosteroid family is very useful in medical settings: inhaled to prevent asthma flare ups, or taken orally to help with auto- immune conditions such as lupus. For heel pain or heel spurs, it is reduces inflammation, allowing you to start the journey towards painless walks, usually via heel stretch and proper footwear. Patients who suffer with heel spurs generally opt for a cortisone shot for heel pain without thinking of the potential side effects.

Side Effect of Taking Cortisone

Cortisone can increase risk of tendon ruptures within the first two weeks after injection, especially if you have achilles tendinitis. Other risk include post- injection flare and infection at the injection site, although that is rare with good doctor practice. Another visual risk is atrophy or changes in pigmentations of the skin, resulting in darkening or lightening of the skin surrounding the injection site.


Harmless side effects such as facial flushing or sweating can happen, while some suffer from dizziness or insomnia, which may affect daily function for a short while. Cortisone injections are usually well tolerated, as it is injected directly on the site of inflammation.

Long Term Effect of Cortisone Use

The body produces its own corticosteroid, hence long term use may affect how the body produces the hormone. People who are on long term corticosteroids will typically suffer from Cushing’s syndrome, the signs include weight gain, puffiness around face and neck, and loss of muscles. Other symptoms of long term cortisone use include easy bruising, as well as thinning of the skin.
Osteoporosis is a main long term side effect of chronic corticosteroid use, as well as metabolic diseases like high blood pressure and diabetes. With long term suppression of the immune system, you are also more likely to suffer from infections and illness; and you will also find that it is harder to recover when you are sick.

Alternatives to Cortisone Injection

With new technology such as extracorporal shockwave therapy, you can hold off that decision a little longer. As podiatrists adopt new evidence based practice methods, there are now options you can choose to move towards a path of healing and recovery.

Tatli YZ, Kapasi S. The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies. Current Reviews in Musculoskeletal Medicine. 2009;2(1):3-9. doi:10.1007/s12178-008-9036-1.