It should be remembered that whatever substance is being injected into the foot it is worthwhile remembering that to work well it is best to have 48 hours of reduced activity with a gradual increase following this. WE DO NOT recommend that patients drive following their injection, this is especially so if a local anaesthetic is involved.
Generally a small plaster will be placed over the injection site and this should be left in place overnight. It is likely that the foot will feel bruised for a day or two following the treatment.
Steroid injections are used when we want to introduce a powerful, anti-inflammatory agent into a specific area. Common reasons for this are:
Steroids work in two ways, firstly there is a powerful anti-inflammatory effect that is used to break the cycle of pain and inflammation. This vicious cycle is quite common in the foot as it is, in fact, very difficult to rest an injured area completely. Steroids also work by reducing the bulk of soft tissue in an area. Like any treatment there are risks involved with steroid injections, to include:
In our experience the first injection is usually the best one and it is rare to offer more than two injections in a course of treatment. We do, however, find that some patients gain considerably from their injection but over time the effect wears off and they require a further injection, perhaps a year later. This is a perfectly safe approach to take to the use of steroids but repeated injections, at short intervals, are to be avoided in the foot.
Ultrasound guided steroid injections are used more commonly in my practice now as this allows both further investigation of the area to be treated as well as pinpoint accuracy in placement of the drug.
Medical grade silicone is used when we want to introduce synthetic padding into a specific area. The usual reasons for this are:
Where deformity is present it is better to correct this initially rather than merely padding the area. The technique, however, is very useful for those patients who are either unable to undergo surgery due to medical reasons, or are finding it difficult to take the time away from normal activities required for rehabilitation.
Just like all other treatments complications can occur however these are very rare, but do include:
This technique is used for introducing an artificial lubricant and buffer into painful, early stage arthritic joints as seen in Stage I hallux rigidus. This is not a technique I use a lot as I find I get excellent results with steroid injections for the same problem.
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