Cortisone Injections for Foot Pain: What to Know Before Your Shot

You've been dealing with foot pain for weeks or months. You've tried rest, ice, new shoes, maybe some stretches. Your doctor suggests a cortisone injection. You've heard it provides fast relief — but you've also heard it "just masks the pain" or "wears off after a few months." So what's the real story?

Cortisone injections are one of the most useful tools in podiatry when used for the right indication at the right time. They're also one of the most misunderstood.

What Cortisone Actually Does

Cortisone (corticosteroid) is a powerful anti-inflammatory medication delivered directly to the site of inflammation. Unlike oral anti-inflammatories that circulate through your entire body, an injection concentrates the medication exactly where it's needed. This produces a stronger effect with fewer systemic side effects.

The injection doesn't "numb" the area (that's a local anesthetic, which is sometimes included in the same injection for immediate comfort). Cortisone reduces the inflammatory process that's causing pain. It typically takes 2–5 days to reach full effect and can last weeks to months depending on the condition being treated.

When Cortisone Injections Help

Cortisone is most effective for conditions involving acute or subacute inflammation. In the foot and ankle, common uses include plantar fasciitis (especially early cases with significant inflammation), Morton's neuroma, bursitis, capsulitis (inflammation of the joint capsule), certain types of arthritis flares, and inflammatory tendinopathy.

In many cases, the injection isn't just palliative — it breaks the inflammatory cycle enough for the tissue to begin healing on its own. Combined with other treatments (orthotics, stretching, footwear changes), a single cortisone injection can be the catalyst that shifts a stalled recovery forward.

When They're Not the Best Choice

Cortisone has limitations and risks that make it inappropriate for some situations. Repeated injections into tendons can weaken them — the Achilles and plantar fascia are particularly vulnerable. More than 2–3 injections to the same area within a year is generally avoided. Cortisone doesn't heal tissue, so for chronic degenerative conditions (like longstanding Achilles tendinopathy), it may provide temporary relief without addressing the underlying problem.

It's also less effective for conditions that aren't primarily inflammatory. If the pain is coming from a structural issue (a bunion pressing on a nerve, a hammertoe rubbing in a shoe), reducing inflammation temporarily won't change the mechanics that are causing the problem.

For diabetic patients, cortisone injections can temporarily raise blood sugar, so monitoring may be needed for a few days after the injection.

What the Injection Feels Like

This is what most patients want to know. The honest answer: it varies by location. Injections into deep tissue (a joint capsule, deep bursa) are generally well-tolerated — you'll feel pressure and a brief sting. Injections into sensitive areas like the plantar fascia can be more uncomfortable, but the discomfort is brief — typically 10–15 seconds.

Most injections include a local anesthetic mixed with the cortisone, so the area goes numb quickly. You may feel improvement from the anesthetic within minutes (this is temporary and wears off in a few hours). The cortisone effect kicks in over the next few days.

What to Expect After

The injection site may be sore for 24–48 hours — this is normal and can be managed with ice and acetaminophen. Some patients experience a "cortisone flare" where the area feels temporarily worse before it gets better. This is caused by the cortisone crystals irritating the tissue before they dissolve and take effect.

Most patients notice significant improvement within 3–5 days. For plantar fasciitis, the relief often lasts long enough (6–12 weeks) for concurrent treatments like orthotics and stretching to take over.

The Bottom Line

Cortisone injections are a safe, effective tool for the right conditions. They're not a cure-all and they're not something to fear. If your foot pain involves inflammation that hasn't responded to basic home care, an injection may be the jump-start your recovery needs. Call (760) 728-4800 to discuss whether it's the right option for your situation.