Foot and Ankle Steroid Injections

Introduction:

Pain in the foot and ankle is a commonly encountered health issue. Foot and ankle pain can significantly impede mobility and diminish one's quality of life, affecting individuals across various age groups. While conservative treatments like physical therapy and analgesic medications are commonly employed, they may not always yield satisfactory results. In such cases, foot and ankle steroid injections have emerged as a promising therapeutic approach.

What Is a Steroid Injection?

A steroid injection is a therapeutic procedure that entails the direct administration of corticosteroid medication into a targeted anatomical site. This medical intervention is employed to mitigate inflammation and assuage discomfort in various ailments, including joint disorders, tendinitis, bursitis, and select forms of arthritis. The injection typically encompasses a combination of a potent corticosteroid, which functions as a robust anti-inflammatory agent, and a local anesthetic to promptly alleviate pain. In a foot or ankle, these injections are administered to curtail inflammation and pain in the affected region.

What Are the Indications for Foot and Ankle Steroid Injections?

Steroid injections are given where there is prominent pain and inflammation. This includes:

• Plantar fasciitis.

• Arthritis - Osteoarthritis or rheumatoid arthritis.

• Tendonitis - Achilles tendonitis, posterior tibial tendonitis.

• Retrocalcaneal bursitis.

• Prepatellar bursitis.

• To treat pain caused by nerve impingement in conditions like Morton's neuronal or tarsal tunnel syndrome.

• Synovitis - To treat inflammation in the synovial membrane that lines the joints.

• Soft tissue impingement in the foot and ankle.

Nevertheless, the indications of steroid injections can differ among individuals to cater to their specific circumstances.

What Are the Contraindications of Foot and Ankle Steroid Injections?

• If there is an active infection like abscess or cellulitis in the foot or ankle, steroids are contraindicated as they can exacerbate the condition.

• People with bleeding and clotting disorders like hemophilia and von Willebrand disease are contraindicated because there is a high potential for the incidence of hematoma.

• Rashes, swelling, or any hypersensitive response to steroids. This can be identified by giving a test dose prior to the steroid injection to identify if an individual is allergic to corticosteroids.

• The chronic hyperglycemic state can cause dysfunction in the wound-healing process resulting in improper and delayed wound-healing. In such cases, steroid injections may further elevate blood sugar levels temporarily, making it important to reconsider the usage of steroid injections.

• Steroid injections are generally contraindicated in carrying mothers.

• Steroid injections should never be administered in cases of severe fractures or instability of the foot and ankle. In such cases, surgical reconstruction is the only viable option.

How Are Steroid Injections Administered in Foot and Ankle?

• The area of inflammation is exposed and numbed with a local anesthetic like Lidocaine.

• The medical professional, commonly a podiatrist or an orthopedician, uses a fine-gauge needle guided by imaging techniques like ultrasound or fluoroscopy to accurately locate the intended target site. The needle is inserted into the specific area where the steroid medication needs to be delivered. Commonly used corticosteroids in foot and ankle injections include Triamcinolone, Methylprednisolone, or Dexamethasone.

• Once the needle is correctly positioned, the corticosteroid medication, often mixed with a local anesthetic (Bupivacaine), is injected slowly and directly into the targeted area. The medication spreads into the nearby tissues, providing anti-inflammatory and pain-relieving effects.

• After the injection, pressure may be applied to the site briefly to minimize bleeding or leakage of the medication.

What Are the Instructions to Be Followed After Foot and Ankle Steroid Injection?

• It is advisable to rest the injected foot or ankle for a short period after the injection. Avoid putting excessive weight or strain on the treated area.

• Protect the skin from any trauma or injury, as it can aggravate the existing inflammation.

• Be vigilant for any signs of infection, such as increased pain, redness, warmth, limited mobility, or drainage of pus at the injection site.

• Follow the instructions of the podiatrist to return back to routine activities without any side effects or complications.

What Are the Benefits of Foot and Ankle Steroid Injections?

• Steroid injections confer rapid pain relief, rendering them an alluring option for individuals afflicted with conditions such as plantar fasciitis, arthritis, tendonitis, and bursitis. By attenuating inflammation, these injections mitigate pain and augment mobility, facilitating the resumption of daily activities with greater ease.

• Foot and ankle steroid injections offer a non-surgical alternative for pain management. Unlike surgical interventions, which often necessitate protracted convalescence periods and entail inherent risks, steroid injections proffer targeted relief devoid of incisions or general anesthesia.

• This localized approach of steroid administration also enhances the effectiveness of the treatment, providing relief where it is needed most.

• Following a foot and ankle steroid injection, patients experience negligible downtime. They can typically resume their regular activities within a day or two, contingent upon the severity of their condition. This swift recovery period confers advantages to individuals seeking prompt pain relief without unduly disrupting their daily routines.

What Are the Disadvantages of Foot and Ankle Steroid Injections?

• Steroid injections engender transient relief by ameliorating inflammation and pain. While highly efficacious in the short term, they may not address the underlying cause of the condition. Hence, it is crucial to supplement steroid injections with appropriate long-term treatments, such as physical therapy or orthotic devices, to secure sustained relief.

• Though infrequent, foot and ankle steroid injections carry the risk of side effects. These may encompass infection, nerve damage, allergic reactions, transient pain exacerbations, skin discoloration, and dermal thinning in the surrounding tissues. It is imperative to discuss potential risks with the administering healthcare professional and adhere to their post-injection care guidelines.

• Steroid injections may not be universally applicable. Individuals with diabetes, compromised immune systems, or active infections in the foot or ankle area may necessitate exploration of alternative treatments. Additionally, steroid injections may not confer commensurate relief in conditions such as stress fractures or nerve entrapment syndromes.

Conclusion:

Foot and ankle steroid injections represent a valuable therapeutic option for individuals grappling with foot and ankle pain. They confer rapid relief, entail minimal invasiveness, and facilitate swift recovery. While not a permanent solution and harboring potential risks, when employed judiciously and in conjunction with other treatments, they can significantly enhance patients' quality of life. It is prudent to seek counsel from a healthcare professional, like a podiatrist, to determine the suitability of foot and ankle steroid injections.