Cortisone injections: relief for foot and ankle pain

Foot and ankle pain can get in the way of work, exercise and sleep. When it doesn't settle with other treatment, a cortisone injection can calm inflammation and ease pain in a specific spot. At Foot Ankle Lower Limb, our podiatrists who are endorsed to use scheduled medicines, and our podiatric surgeons, can offer cortisone injections where they're likely to help.

What is injection therapy?

Injection therapy means placing medicine, usually a mix of cortisone and a local anaesthetic, directly into the painful area. That might be a joint, the sheath around a tendon, a bursa (a small fluid-filled cushion) or an irritated nerve. Because the medicine goes straight to where it's needed, a small dose can work on the problem area itself.

What is cortisone and how does it work?

Cortisone is a corticosteroid, a man-made medicine similar to cortisol, a hormone your body makes. Steroid injections are an anti-inflammatory treatment: they reduce inflammation, which in turn eases pain and swelling.¹ They're not the same as the anabolic steroids some athletes misuse.

What can it help with?

We may suggest a cortisone injection for:

• arthritis in the joints of the foot and ankle, whether after an injury or from wear and tear¹
• tendon problems, such as inflammation around the tibialis posterior or peroneal tendons¹
• heel pain from plantar fasciitis²
• Morton's neuroma, a painful, irritated nerve between the toes³,⁴
• bursitis, an inflamed bursa¹
• ganglion cysts, where we may also drain fluid from the cyst at the same time.

We don't inject cortisone into the Achilles tendon itself. Injections aren't a first choice for Achilles tendon pain,⁴ and exercise that gradually loads the tendon works best.

Does it work?

Cortisone can give good short-term relief, but it's rarely a cure on its own.

• Plantar fasciitis: an injection may reduce heel pain a little for about a month, but it doesn't seem to help after that.² That's why we use it alongside stretching, strengthening, footwear changes and orthoses (shoe inserts), not instead of them.
• Morton's neuroma: an injection can ease pain and improve how the foot feels for at least three months, and it's a reasonable thing to try before considering surgery.³
• Joint and soft-tissue pain: relief usually lasts from a few weeks to a few months.¹

How quickly does it work?

The local anaesthetic numbs the area straight away, but this wears off after a few hours.¹ The cortisone normally takes a few days to start working,¹ and some people notice a change within 1–2 days.⁵ If there's no improvement after a couple of weeks, let us know.

How do we make sure the injection goes to the right place?

The foot and ankle have many small joints, tendons and nerves packed close together. Our practitioners use point-of-care ultrasound to guide the needle, so we can see the structure we're aiming for on a screen. Ultrasound guidance is strongly recommended to make injections for Morton's neuroma and plantar fasciitis work better.⁴

Are cortisone injections safe?

Cortisone injections have been used for many decades and serious problems are uncommon. Possible side effects include:¹,⁵

• a flare of pain for a day or two after the injection, which about 1 in 10 people get⁵
• pain, swelling or bruising where the needle went in¹
• changes in skin colour, or a small dent from loss of fat under the skin¹,⁵
• facial flushing and trouble sleeping for a short time¹
• higher blood sugar for a few days if you have diabetes. Check your levels more often for the first few days¹,⁵
• a short-term rise in blood pressure if you have high blood pressure¹
• allergic reactions, which are rare⁵
• infection, which is rare but serious. See a doctor urgently if the area becomes hot, red, very painful and swollen in the days after an injection.¹

Repeated injections into the same area can weaken tendons and other tissues,⁵ so we limit how often we inject.

What to do after an injection

Rest the area for 24–48 hours and avoid heavy exercise or long periods on your feet.¹ If you get a flare of pain, it usually settles within a couple of days.⁵ A cold pack can help, and you can usually take paracetamol.¹ Your podiatrist will give you aftercare instructions for your situation.

Can I drive after a cortisone injection?

Your foot may be numb for a few hours, so it's safest to bring someone who can drive you home. Ask us beforehand if you're unsure.

What to expect at FALL

We'll assess you first and explain whether an injection is likely to help, what the alternatives are, and the risks. If we go ahead, the injection will be one part of your treatment plan.

To find out whether a cortisone injection could help your foot or ankle pain, book an appointment.

References

1. healthdirect Australia (2024). Steroid (corticosteroid) injection. https://www.healthdirect.gov.au/steroid-corticosteroid-injection
2. David JA, Sankarapandian V, Christopher PRH, Chatterjee A, Macaden AS (2017). Injected corticosteroids for treating plantar heel pain in adults. Cochrane Database of Systematic Reviews, 2017(6), CD009348. https://doi.org/10.1002/14651858.CD009348.pub2
3. Thomson CE, Beggs I, Martin DJ, et al. (2013). Methylprednisolone injections for the treatment of Morton neuroma: a patient-blinded randomized trial. Journal of Bone and Joint Surgery (American), 95(9), 790–798. https://doi.org/10.2106/JBJS.I.01780
4. Sconfienza LM, Adriaensen M, Albano D, et al. (2022). Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR), part VI, foot and ankle. European Radiology, 32, 1384–1394. https://doi.org/10.1007/s00330-021-08125-z
5. Guy's and St Thomas' NHS Foundation Trust (2026). Steroid injections for joint and tendon pain. https://www.guysandstthomas.nhs.uk/health-information/steroid-injections-joint-and-tendon-pain

Reviewed by Andrew Schox, Podiatrist, BSc(Hons) PGradDipPod MPod. Last reviewed October 2026.