In response to the question about how soon you can do another steroid injection, there is no clear answer in the literature that I can find. Everyone recognizes the risks of tendon rupture and fat pad atrophy with repeated injections but nobody seems to have studied how many might be too many. I have used as a general rule that I don’t do it more than twice a year on the same location and no more than 4 times total but that rule is somewhat arbitrary, I just copied it from a sports med doctor that I trust.
To recap the list of treatments for plantar fasciitis:
- Daily stretching – Are you doing this?
- NSAIDs for 2 weeks
- Over the counter orthotics – You’ve tried a bunch of these right?
- Night splints – Tried it?
- Steroid shot – Helped temporarily
- Avoiding activities that exacerbate it – (like taking 6 months off from running, Zumba, HITT)
- Walking boot – This should work if you wear it long enough
- Surgery – Last resort
- Stem Cell – This is promising but expensive and the science is still new
- PRP injections – There is still debate about the efficacy of platelet rich plasma in the treatment of plantar fasciitis. Two of the studies below say it is effective but not as effective as corticosteroid at 3 months. The third study shows it being much more effective than corticosteroid. One of the major arguments against using it is the cost to the patient given it is not paid for by insurance but here that is not an issue and we have an inexpensive way of delivering it that is at no cost to you. If you are optimizing the treatments above, this may be a next good step.