Injections for plantar heel pain are intended to reduce pain and/or heal the tissue. There are a number of different types of injection that can be used to treat plantar heel pain, and two common types are a corticosteroid injection and a platelet-rich plasma injection. When you receive these injection, it is common to experience some discomfort. The health professional providing the injection will usually mix the substance with a local anaesthetic to reduce some of the discomfort associated with the injection.
A range of health professionals can provide injections for plantar heel pain. These may include: a GP, a radiologist, an orthopaedic surgeon, a rheumatologist, and a podiatrist. You should ask these health professionals about the training they have received to administer an injection.
Some health professionals will use ultrasound to help guide the injection. This is done to ensure that the needle is in the right location, and there is evidence to show that using ultrasound guidance is more effective.
Corticosteroid inductions are intended to reduce pain and inflammation. There is evidence to suggest that the pain relief from this injection may only be short term (i.e. 4 weeks).
Platelet-rich plasma injection
Platelet rich plasma is intended to stimulate healing of the affected tissue. To perform this injection, blood is taken from your arm and spun in a machine to extract only the platelets and the plasma. This solution is then injected into the heel. After having this injection people may experience a flare in their pain, but this should reduce over time.
For corticosteroid injection, there is a risk of plantar fascia rupture. To reduce the chance of this happening you should avoid high impact activities for 6 weeks after receiving the injection. Although rare, the following could occur: thinning of fat beneath the heel, loss of colour in the skin near the injection site, or infection.
For platelet rich plasma, there are fewer safety concerns than for corticosteroid injection. There is a risk of infection.
There is evidence to support the use of corticosteroid injections. Currently, there is evidence to suggest that:
- Corticosteroid injection is better than orthoses in the short term only (i.e. 4 weeks).
- Orthoses are better than corticosteroid injection at 12 weeks.
- Corticosteroid injection is similar to shockwave therapy.
- Platelet-rich plasma may be better than corticosteroid injection at 1 year.
Links to research
- Whittaker GA., Munteanu SE., Menz HB., Gerrard JM., Elzarka A., Landorf KB. Effectiveness of Foot Orthoses Versus Corticosteroid Injection for Plantar Heel Pain: The SOOTHE Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy, 2019; 49(7): 491–500 https://www.jospt.org/doi/abs/10.2519/jospt.2019.8807?platform=hootsuite
- Whittaker GA., Munteanu SE., Menz HB., Bonanno D., Gerrard JM., Landorf KB. Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 2019;20: 378 (2019) https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-2749-z