Cortisone Injections
A powerful, targeted anti-inflammatory that can provide rapid relief for foot and ankle pain — with a clear understanding of benefits, risks, and realistic expectations.
What Is a Cortisone Injection?
A cortisone injection is a powerful anti-inflammatory medication delivered directly into a painful joint, tendon, or soft tissue. Cortisone is a type of corticosteroid — a medication that mimics hormones your body produces naturally to reduce inflammation. It is not the same as anabolic steroids used by athletes.
Cortisone injections are one of the most common and effective treatments for inflammatory foot and ankle conditions. They provide rapid relief, often within days, and the effects can last for weeks or months.
Common Conditions Treated
- Plantar Fasciitis (heel pain)
- Metatarsalgia
- Posterior Tibial Tendinitis
- Peroneal Tendinitis
- Arthritis (toe, midfoot, or ankle joints)
- Bursitis (inflammation of fluid-filled sacs)
- Morton's Neuroma
- Tarsal Tunnel Syndrome
How Does It Work?
Cortisone works by suppressing the immune system's inflammatory response at the injection site. It reduces the production of chemicals that cause swelling, redness, heat, and pain. This allows the affected tissue to rest and heal.
What to Expect
- The injection itself takes less than a minute
- A local anesthetic is often mixed with the cortisone to minimize discomfort
- Some patients experience a temporary "flare" of pain for 24–48 hours before relief begins
- Full relief typically begins within 2–7 days
- Effects can last from several weeks to several months
Benefits
- Fast relief – Most patients notice improvement within days
- Targeted treatment – Medication goes exactly where it's needed
- No systemic side effects – Unlike oral steroids, cortisone injections affect only the local area
- Breaks the pain cycle – Allows physical therapy and stretching to be more effective
- Can delay or prevent surgery
Risks and Side Effects
Common (Temporary)
- Temporary increase in pain ("cortisone flare") – 1–2 days
- Skin thinning or lightening at injection site
- Temporary rise in blood sugar (diabetics should monitor closely for 2–3 days)
Rare (With Repeated Injections)
- Tendon weakening or rupture
- Cartilage thinning
- Infection (less than 1% risk)
- Fat atrophy (indentation at injection site)
Important Limitation
Most physicians limit cortisone injections to 3–4 per year in the same joint. Repeated injections can weaken tendons and damage cartilage. Cortisone treats inflammation — it does not heal the underlying problem.
Frequently Asked Questions
Will the cortisone injection hurt?
The injection itself feels like a quick pinch. Dr. Clifford uses a very thin needle and often mixes a local anesthetic with the cortisone to minimize discomfort. Some patients experience temporary soreness for a day or two after the injection.
Can I walk normally after a cortisone injection?
Yes. Most patients walk out of the office immediately. You may be advised to rest the foot for 24–48 hours and avoid high-impact activities for a few days.
How long does a cortisone injection take to work?
Some patients feel relief within hours, but full effect typically takes 2–7 days. If you experience a temporary flare of pain (the cortisone flare reaction), relief usually begins after that subsides.
What if the cortisone injection doesn't work?
Not all patients respond to a single injection. If the first injection provides partial relief, a second injection may be considered after 4–6 weeks. If cortisone does not help at all, Dr. Clifford will discuss other options such as shockwave therapy, regenerative injections, or advanced imaging to evaluate for other causes of your pain.
What to Expect at Pathways Foot & Ankle
- A thorough evaluation, including diagnostic ultrasound when needed to precisely target the injection site
- A clear explanation of the procedure, benefits, and risks
- Ultrasound guidance for accurate placement (when indicated)
- Same-day treatment — no need for a separate appointment
- Written aftercare instructions
- Transparent pricing with no surprise bills
- Same-day or next-day appointments, no referral needed
Cortisone vs. Regenerative Injections
Cortisone is excellent for quickly reducing inflammation and breaking the pain cycle. However, it does not heal tissue. For patients seeking true healing — not just symptom relief — regenerative options like prolotherapy, RPA, or homeopathic injectables may be better long-term solutions. Dr. Clifford will help you choose the right option for your specific condition and goals.
Take the next step — reach out today
Pathways Foot & Ankle - Dr. Craig Clifford
216 14th St, Oregon City, OR 97045
(971) 359-5299 — Call Dr. Clifford directly
Same-day & next-day appointments available, no referral needed
House calls also available throughout the region.