For Heel Pain Relief, Doctor Knab, MD, Doctor Arora, MD and Physicians Assistant Anthony Gore Provide Treatment for Plantar Fasciitis and Heel Spurs
Plantar Fascia Injection
Plantar fasciitis is a common cause of heel and foot pain. It results when the thick band of tissue connecting your heel bone to your toes becomes inflamed. It is estimated that about 10% of the population will experience plantar fasciitis at some point in their life. The most commonly reported symptom is a sharp/stabbing pain that occurs when a person first puts their feet on the floor in the morning, or after driving or sitting for a prolonged period of time. Symptoms typically occur as a result of overuse or injury, however, they can sometimes present suddenly, without any specific cause. As you might expect, symptoms are more common in patients who are overweight or spend a lot of time running or standing for prolonged periods of time on hard surfaces. The most common location for patients to report pain is at the base of the heel, closest to the toes, but pain can stretch all the way through the arch and into the ball of the foot as well. Numbness and tingling are uncommon, but may also occur.
Most of the time, symptoms from plantar fasciitis will resolve over time and with the use of conservative measures such as splints, rest, NSAIDs, and stretches. Some people find benefit from rolling the bottom of the foot on top of a frozen water bottle, which helps to reduce inflammation. If symptoms do not resolve, more intensive treatments can be pursued.
If you are in the 10% of patients who do not have a resolution of symptoms within 6 months, you may want to consider image–guided injection therapy with steroids. This injection is typically done with ultrasound or fluoroscopic (x-ray) guidance so that the most inflamed areas of the plantar fascia can be targeted precisely. Injecting a mixture of local anesthetic and steroid into the tender area can provide immediate pain relief for some, and help to clarify the diagnosis. Relief of the inflammatory pain will typically enable the patient to undergo effective physical therapy to restore normal function.
In cases where steroid–based therapies provide only short-term relief, other “regenerative” therapies such as prolotherapy (injection of substances which help to stimulate the body’s own natural healing process) or PRP (platelet rich plasma) injections can be pursued. These therapies will typically reduce or eliminate the need for surgical treatments.
Steroid injections and regenerative therapies are generally very well tolerated, however, some patients may experience side effects from steroids such as flushing of the face, difficulty in sleeping, or temporary increase in blood sugar. These side effects are usually mild and will often resolve within a few days. In the case of regenerative therapies, pain may sometimes “flare up” for a few days after the procedure before the healing process begins.
How much time do I need to take off work?
The procedure takes about 5-10 minutes. Patients are usually instructed to take it easy on the day of the epidural steroid injection. In most patients, normal activities may be resumed the following day.