Complications
May ultimately eliminate the source of heel pain in the short and long term with permanent release from the inferior heel. One may avoid this by limiting the volume of corticosteroid injected and discouraging vigorous activity immediately after an injection.
Erythema and blistering around the circumference of the foot and plantar foot are associated with tape adhesive and taping.
No long-term sequelae anticipated.
An injection should be made from the medial side of the calcaneus when treating plantar fasciitis. The point of maximum tenderness should be palpated or an ultrasound obtained for most accurate placement.[53] Long-term numbness and weakness can be a significant end result if nerve damage ensues.[88]
Up to one third of patients experience this complication.
Typically resolves with conservative measures in weeks to months through rest, mechanical support, nonsteroidal anti-inflammatory drugs (NSAIDs), or injection therapy.[77] Avoidance of this complication includes limiting release to <50% of the plantar fascia.[4][69]
Nerve damage may vary in intensity from a temporary paresthesia to longstanding pain or numbness.
More likely following an endoscopic approach to surgical release of the plantar fascia.[89]
Attention to anatomy, careful technique, and experience may help to avoid this complication.
Early detection can assist in having a good outcome.
Physical therapy, ultrasound, massage, and injection therapy are potential treatments.
Infections following skin punctures are rare. Having a high index of suspicion for osteomyelitis is important when dealing with a red, hot, swollen, painful heel, particularly after an invasive treatment or corticosteroid injections. The case report in the literature resulted after a number of corticosteroid injections and was diagnosed definitively through bone biopsy.[87]
While probability is low, this is a serious complication.
Screening individuals and avoiding this treatment in patients who are obese, sedentary, or smokers, or in those with a past history and/or with a family history of DVT, is recommended.
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