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Given cortisone shot in foot due to inflammation. Having pain while walking. What treatment should be done?

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Orthopaedic Surgeon
Practicing since : 2000
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Hello, on Monday my wife was given a cortisone shot by her podiatrist in her left foot below the ankle bone toward the heel area. She had pain in the mornings when walking. around the ankle and heel and behind the ankle. She had twisted her foot 10 years ago and he found inflammation still there. He also found a small heel spur. Was the cortisone appropriate, and how often should it be given? Today is Thursday and although she does not have the pain when walking she felt some discomfort when lying down last night. He recommended some foot exercises.
Posted Sat, 28 Jul 2012 in Bones, Muscles and Joints
Answered by Dr. Atul Wankhede 2 hours later
Dear user,
Thanks for writing in.

The pain in heels can be due to a condition called plantar fasciitis. Its one of the commonest reason for heel pain. Pain in morning and improvement on walking for some time is its classical presentation. The initial treatment with anti inflammatory medicines with rest and cold fomentation works fine for most of the patients. Cortisone injection is a good mid to long term treatment. Your wife might need a repeat dose in a few months. Beware not to take it frequently since it causes induced tear of plantar fascia. Consider using soft silicone heel cushions for preventing any further damage to fascia.

Exercises also play an important role and I'm afraid they are the only long term mainstay of the treatment. I'm sure you already know but these are few exercises she'll have to do for long time-

1. Calf stretch- Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.

2. Plantar fascia stretch- This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot.

These exercises are best done in the morning before standing or walking. You also need to understand that with help of medicines, injections and physiotherapy the effects shall be appreciated after a year or so.

Hope you find this answer helpful. For any further help I'm available for follow up.
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Follow-up: Given cortisone shot in foot due to inflammation. Having pain while walking. What treatment should be done? 34 minutes later
Thank you again, Dr. Wankhede. As a matter of fact she DOES suffe from plantars fasciatis (and small bunions on both big toes). Your comments reinforce what the podiatrist was discussing with her. She's had the heel pain/fasciatis for several years but is not very disciplined in self-care. This must be the reason for her complaining about leg pain and discomfort. Unfortunately she also has arthritic deterioration in the lower couple of vertebrae with some stenosis and ankylosing spondylitis which may be involved, but which we hope does not worsen over the years.

What is the best method for cold treatments on the feet?
Answered by Dr. Atul Wankhede 39 minutes later
Dear user,
Thanks for the acknowledgement.

Indeed she's suffering from the fasciitis, and the treatment as I mentioned previously is applicable. I'm not sure what you mean with Cold treatments, but if you are referring to my aforesaid cold fomentation, rolling the feet over a bottle of cold water or ice in the evening or night can be done to relieve inflammation.

Please feel free to ask more queries.
Above answer was peer-reviewed by
Follow-up: Given cortisone shot in foot due to inflammation. Having pain while walking. What treatment should be done? 8 minutes later
In that case the fasciaitis would be curable then?
And how long might it take for her ankle to stop swelling permanently, or is that likely never to end because she twisted her ankle 10 years ago?
Answered by Dr. Atul Wankhede 34 minutes later
Dear user,
It's more or less curable. But undisciplined self care as you described meets poor results. Her ankle swelling might have nothing to do with fasciitis. You need to investigate her in lines of her twist injury 10 years back. Possibility of arthritis, chronic synovitis or unhealed torn ligament are high.

Above answer was peer-reviewed by
Follow-up: Given cortisone shot in foot due to inflammation. Having pain while walking. What treatment should be done? 46 minutes later
Thank you. The swelling is a little less today, but she has discomfort near the arch. Can heel spurs be improved with a calcium/magnesium supplementation?
Answered by Dr. Atul Wankhede 14 minutes later
Hello once again.
Glad to know that swelling has reduced. She'll have the arch discomfort till the fasciitis exists. Heel spurs as contrary to common belief is not always responsible for plantar fasciitis. Calcium supplements have no role in improving spurs.

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