Heel spurs and plantar fasciitis are sometimes still treated with injections. In this treatment, cortisones (also called adrenal cortex hormone or corticosteroids) are injected into the heel with an injection syringe, directly on the heel spur site. Cortisones are an artificial variant of the identical hormone that is produced by the body in the adrenal cortex. It is normally produced in our own body under the influence of stress and has an anti-inflammatory effect. Cortisons (the artificial form) are mainly used by athletes for the treatment of tendon disorders, such as, for example, heel spurs, but sometimes also for, for example, Achilles tendonitis.
The cortisones are introduced in high concentration, directly on the inflammation in the heel. The injection itself can be very painful, although this differs per patient. How quickly and if a positive effect occurs differs per patient. Some experience direct relief almost the same day, others take a few days, and some do not notice anything at all. In exceptional cases or when the injection is used inexpertly, the pain even worsens.
In practice, the effect of cortisone injections is usually only temporary. In those cases, the treatment must be repeated. To prevent harmful side-effects, however, this should not be done more than 3-4 times, otherwise the tendon tissue will be permanently affected. Rest should be taken the first days after the injection. The corticosteroids slightly weaken the tendon tissue. Heavy loads can cause damage and aggravate the heel spur. After a few days, the foot can be loaded again normally.
There are quite some objections to treatment of heel spurs with injections. Sometimes there is no effect at all and the effect is sometimes worked out after a few months. In addition, the tendon tissue can be affected or weakened by cortisone, especially with multiple injections. In one case, the tendon can even tear loose. More than 2-3 injections in a foot should therefore be strongly discouraged. However, if other treatments for heel spurs do not have an effect, it may be worthwhile to try this treatment anyway.
There is a small chance of other side effects, such as temporary hypersensitivity at the site of the injection, skin discoloration or a hypersensitivity reaction.
Recently a publication an Australian study showed that the effect of injections with dexamethasone (a corticosteroid) was positive, but only temporarily. After 4 weeks, the effect usually disappeared again. So it seems to fight the symptoms more than the cause.
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