Pain Management Procedures
Plantar Fascia Injection
Plantar Fascia Injection
What is it?
The plantar fascia is the strong band running from the heel toward the toes. Irritation where it attaches to the heel causes the classic pain of plantar fasciitis, often worst with the first steps after rest. An injection places medication near the painful attachment, not randomly into the heel pad.
When may it be recommended?
Most patients improve with stretching, activity modification, supportive footwear, and a gradual strengthening program. Injection may be considered when the diagnosis is clear and several months of appropriate conservative treatment have not provided enough relief. Corticosteroid can reduce pain in the short term; other injectables are used in selected cases, with variable evidence and coverage.
What happens?
Ultrasound can identify the fascia and guide a small needle beside the diseased portion while helping avoid the heel fat pad. Local anesthetic and the selected medication are injected. The heel can be sensitive, so numbing and careful technique are important.
What should I expect?
Walking may be sore at first, and activity restrictions may be given. Continue the prescribed stretching and strengthening plan once permitted. Relief varies, and recurrence is possible if the loading problem continues.
Important risks
Risks include bleeding, infection, skin or fat-pad injury, temporary numbness, and pain flare. Corticosteroid injection has been associated with plantar-fascia rupture and fat-pad atrophy, particularly with repeated injections. New arch flattening, a sudden tearing sensation, or major bruising should be reported.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.