Patient Handout: Cortisone Injections

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)
Achilles Tendinitis
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 it 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?

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 it 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 it 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, PRP, or homeopathic injectables may be better long-term solutions. Dr. Clifford will help you choose the right option for your specific condition and goals.