Cortisone Injection for Plantar Fasciitis: What to Expect, Does it Hurt and Is It Safe?

By StepSistersDPM  - Published January 17th, 2026

Have you been limping out of bed every morning, grabbing the wall just to make it to the bathroom because of heel pain? If so, you’re not alone. Plantar fasciitis is one of the most common causes of heel pain, affecting millions of people each year. And if your doctor mentioned a cortisone injection, it’s completely normal to feel nervous or unsure about what that really means.

At StepsistersDPM, we want to take the fear out of the unknown. In this post, we’ll walk you through exactly what a cortisone injection is, how it works, when it’s recommended, and what to expect before, during, and after the procedure.

What Is Plantar Fasciitis?

Before we dive into cortisone injections, let’s explain what plantar fasciitis is and why it can be so painful.

The plantar fascia is a thick band of connective tissue that runs along the bottom of your foot, from your heel to your toes. Its job is to support your arch and absorb shock when you walk or run.

When this tissue becomes inflamed, it can cause sharp heel pain, especially in the morning or after long periods of sitting. The pain often feels like a stabbing sensation when you first step on your foot.

Chronic inflammation can occur when the fascia is repeatedly stressed and your body’s natural healing process cannot keep up. Factors that can contribute include:

    •    Tight calf muscles or Achilles tendon

    •    Poor footwear or unsupported shoes

    •    Overuse from walking, running, or standing for long periods

    •    Abnormal foot mechanics (flat feet, high arches)

What Is a Cortisone Injection?

A cortisone injection is an anti-inflammatory treatment, not a “pain shot.”

Cortisone works by reducing inflammation in the plantar fascia. This helps decrease:

    •    Swelling

    •    Pain

    •    Thickening of the fascia

Think of it as a reset button that calms the inflammation, giving your body the opportunity to heal. While cortisone provides relief, it does not address the root cause of plantar fasciitis—so it’s often combined with stretching, strengthening, orthotics, and other treatments.

When Is a Cortisone Injection Recommended?

We typically recommend cortisone injections in the following situations:

    •    Persistent pain after 6–8 weeks of conservative treatment (stretching, inserts, night splints, PT)

    •    Pain severe enough to limit daily activities

    •    Patients seeking faster relief to continue rehabilitation or daily life

Alternative treatments may include:

    •    Shockwave therapy

    •    Laser therapy

    •    Platelet-rich plasma (PRP) injections

A cortisone injection is optional. If your heel pain is improving with other methods, there may be no need for an injection.

What Happens Before the Injection?

A proper evaluation is essential before any injection. Here’s what to expect:

    1.    Clinical Exam: The doctor will examine your foot, check for tenderness, and identify the exact area of inflammation.

    2.    X-Ray: To rule out a stress fracture, which is a contraindication for cortisone injection.

    3.    Ultrasound (sometimes): Can confirm plantar fascia inflammation and measure thickness. Fascia thicker than 4 mm often indicates plantar fasciitis.

Once the diagnosis is confirmed and you choose to proceed, the doctor prepares the medications:

    •    Local anesthetic to numb the area

    •    Cortisone steroid to reduce inflammation

Does It Hurt?

Pain perception varies. Some patients report minimal discomfort, while others feel more intense pressure. Most patients fall in the middle.

We use several techniques to make the injection more tolerable:

    •    Cold spray to numb the skin

    •    Very fine needles (30-gauge)

    •    Slow injection technique

    •    Side-of-heel injection (thinner skin, fewer nerve endings)

    •    Distraction techniques (talking, visualization, devices like Buzzy)

The numbing medication usually works within minutes. Many patients leave the office with immediate relief.

What to Expect After the Injection

After your injection, you can:

    •    Walk normally

    •    Drive

    •    Perform light daily activities

Avoid:

    •    Running

    •    High-impact exercise

    •    Gym workouts that stress your foot

Why: The numbing medication can give a false sense of security. Pain may temporarily be absent, but the fascia still needs time to respond to the cortisone.

Timing of relief:

    •    Lidocaine: 1–2 hours of numbness

    •    Marcaine: Up to 8 hours of numbness

    •    Cortisone effect: 2–3 days to start reducing inflammation

    •    Continued improvement: over 1–2 weeks

How Long Will Relief Last?

Duration of relief varies:

    •    Some patients feel better for weeks

    •    Some for months

    •    Some only need one injection in their lifetime

We typically follow up 4 weeks after injection to assess improvement. If two injections provide no benefit, we do not recommend a third in the same area.

Risks and Safety

Cortisone injections are generally very safe when performed properly. Rare risks include:

    •    Steroid flare: temporary burning or aching

    •    Skin hypopigmentation: lightening of skin at the injection site

    •    Infection: extremely rare with sterile technique

    •    Temporary rise in blood sugar for diabetic patients

    •    Fascia or ligament weakening if multiple injections are done

Important: Do not exceed 3 injections per year in the same location.

Special Considerations for Diabetic Patients

Cortisone can temporarily increase blood glucose. Monitoring your sugars and coordinating with your physician is essential.

Cortisone vs Other Treatments

While cortisone provides fast relief, it works best alongside:

    •    Stretching and strengthening exercises

    •    Proper footwear and orthotics

    •    Physical therapy

    •    Lifestyle adjustments

Other interventional options like shockwave therapy, PRP, or laser may be used when cortisone is not preferred or as complementary therapy.

Final Thoughts

A cortisone injection for plantar fasciitis is a powerful tool that:

    •    Reduces inflammation

    •    Relieves pain

    •    Restores mobility

    •    Allows patients to engage in rehabilitation

It’s not a permanent cure, but it gives your body a chance to heal and get back to life.

If you’d like to see this explained visually, watch our full YouTube video. And if you’ve ever had a cortisone injection, leave a comment to share your experience—it helps others know they’re not alone.