Plantar Fascia Injection

The plantar fascia (PF) is a thick band of tissue that connects your heel bone to your toes. It helps support the overall shape of your foot, especially when standing, and helps with shock absorption. Irritation and scarring of the plantar fascia, known as plantar fasciitis, is one of the most common causes of heel pain.

Ten percent of people have pain in the bottom of the heel at some point in their life. The most common cause is plantar fasciitis, which can result from overactivity, improper shoes, flat feet, or excessive weight on the feet.

The standard treatment for plantar fasciitis starts with approaches to decrease pain by decreasing inflammation. Initial methods include daily stretching and splinting of the foot at night. Aspirin-like medications also may be used. If these treatments do not help, the next step is often steroid injections into the PF.

Diagnosis

Patients who have plantar heel pain because of plantar fasciitis may benefit from an injection when other non-surgical treatments do not help. Do not have an injection at the PF if there is an allergy to the medicines being used or skin problems at the heel.

Treatment

Your foot and ankle orthopaedic surgeon will inject the PF where it is most painful. The injection can be made of steroids, numbing medicines, or a combination of both. Once the injection is done, the site is covered. The patient is encouraged to restart exercises when it’s comfortable.

Specific Technique
Most doctors inject the PF from the inner (medial) side of the heel, instead of directly underneath. This helps to avoid pain and injury at the heel’s fat pad. With the patient lying down, the heel is marked where it will be injected. A thin needle is used to inject into the patient’s foot.

Recovery

The numbing effect usually lasts a few hours after the injection. When this numbness wears off, your heel pain may return temporarily. The steroid will relieve heel pain over the next several days, and it will continue to work for several weeks to months.
Most doctors recommend that patients resume foot stretching. Hard activities should be avoided for the first few days after the injection. A removable walking boot may be used for a short period of time to decrease pain and inflammation.

Risks and Complications

Risks include thinning of the fat pad and bleaching of the skin at the plantar heel. Tearing or rupture of the PF also can occur.