►Are there unusual steroid complications after treating plantar fasciitis?

Plantar fasciitis is one of the most common causes of heel pain. The exact cause is still not known. One out of ten people will experience the condition in their lifetime (1). Steroid injections have been used to treat the condition (2). Although rarely, heel pad atrophy and plantar fascia rupture are complications that have been reported after steroid injection (3).

About 90% of patients can be treated conservatively with good outcomes (1,4). Stretching of the Achilles tendon and plantar fascia can have good outcomes after four weeks (4). Other conservative management include foot orthosis, night splints, steroid injections, platelet-rich plasma, and electrocorporal shock (1,2).

The most common side effect is reported to be injection site pain. However, other trials have not reported any complications (5). There are few case reports that indicate other complications of plantar fascia steroid injection.  Kim et al., in their study, reported 2.4% of plantar fascia ruptures following steroid injection (6). The patients were found to have partial medial cord band tears that responded well to conservative treatment.  Patients were found to be having body mass index of more than 30 kg/m². Lateral plantar nerve injury can occur if foot anatomy and injection technique are not taken into consideration (7). One case of calcaneal osteomyelitis has been reported (8). Buccilli et al. reported a case of sterile abscess formation that was treated surgically (9). Although rare, one should be aware of other complications that can occur following steroid injection for plantar fasciitis.