Steroid injection for heel pain: evidence of short-term effectiveness. A randomized controlled trial.
OBJECTIVE
To compare the effectiveness of a steroid injection (25 mg/ml prednisolone acetate) with a local anaesthetic control in the treatment of heel pain and to determine any advantage for patients' comfort of using a posterior tibial nerve block to anesthetize the heel prior to infiltration.


METHODS
A double-blind randomized controlled trial using a 2 x 2 design in a hospital-based rheumatology clinic. Subjects comprised 106 patients with heel pain referred by general practitioners and other rheumatologists working in Camden and Islington Health Authority.


METHODS
heel pain reduction at 1, 3 and 6 months, and patient comfort at the time of injection. All outcomes were measured using a 10 cm visual analogue scale.


RESULTS
A statistically significant reduction in pain was detected at 1 month (P=0.02) in favour of steroid injection, but thereafter no differences could be detected. Patient comfort was not significantly affected by anaesthesia of the heel (P=0.5).


CONCLUSIONS
A steroid injection can provide relief from heel pain in the short term. There appears to be no increase in patient comfort from anaesthetizing the heel prior to infiltration.
Crawford
F
F
Department of Health Sciences and Clinical Evaluation, University of York and Centre for Rheumatology, University College London, London, UK.
Atkins
D
D
Young
P
P
Edwards
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D004311:Double-Blind Method; D005208:Fasciitis / Q000150:complications; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy*; D006365:Heel; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011355:Prodrugs / Q000008:administration & dosage*; D011379:Prognosis; D013979:Tibial Nerve; D016896:Treatment Outcome
D000779:Anesthetics, Local; D011355:Prodrugs; C009935:prednisolone acetate; D008012:Lidocaine; D011239:Prednisolone